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Amaç: Laringoskopi ve endotrakeal entübasyona bağlı sempatoadrenerjik aktivitenin artışına bağlı olarak hipertansiyon, taşikardi yanıtı görülebilir. Bu yanıt özellikle intrakraniyal ve kardiyovasküler hastalığı olan hastalarda yaşamı tehdit eden komplikasyonlara neden olabilmektedir. Biz bu çalışmada çalışmada, remifentanil, amiodaron, fentanil, esmolol ve lidokain’in trakeal entübasyonda hemodinamik yanıt üzerindeki göreceli etkinliğini karşılaştırdık. Gereç ve Yöntemler: Bu çalışmaya elektif cerrahi geçirecek 20–60 ASA I-II, 90 hasta dahil edildi. Hastalar kapalı zarf tekniği ile altı gruba ayrıldı. Entübasyona yanıtı engellemek için Birinci grup kontrol grubu (G1) hariç, ikinci gruba (G2) fentanil, üçüncü gruba (G3) remifentanil, dördüncü gruba (G4) esmolol, beşinci guruba (G5) amiodaron, altıncı gruba (G6) ise lidokain entübasyon öncesi ek olarak uygulandı. Tüm hastalara aynı anestezi tekniği uygulandı. Sistolik kan basıncı (SKB), diastolik kan basıncı (DKB) ve kalp atım hızı (KAH) için belirlenen zamanlarda ölçümler yapılarak kaydedildi. Bulgular: Gruplar arasında demografik veriler açısından fark bulunmadı (p>0.05). Remifentanil grubundaki SKB stabilitesi esmolol ve fentanil gruplarına göre daha fazlaydı. Remifentanil grubundaki DKB’daki düşüş diğer gruplara göre daha fazlaydı. KAH’daki düşüş remifentanil grubunda 1. 3. ve 5. dakikalarda daha fazla idi. Sonuç: Bizim çalışmamıza gore, entübasyona hemodinamik yanıtı önlemede remifentanilin 0.5 mikrogram/kg infüzyon dozunda diğer ilaç gruplarına en etkin ilaç olabileceğini söyliyebiliriz.
Purpose: Depending on the increase in sympatoadrenergic activity associated with laringoscopy and endotrakeal entubation, hypertension, tachycardia response may be seen. This response can lead to life-threatening complications especially in patients with intrakranial and cardiovascular diseases. In this study, we compared the relative effectiveness of remifentanil, amiodaron, fentanil, esmolol and lidokain on the hemodynamic response in the traceal entubation. Tools and Methods: This study included 20-60 ASA I-II, 90 patients who will be subjected to elective surgery. The patients were divided into six groups with the closed cover technique. In order to prevent the response to entubation, except the first group control group (G1), the second group (G2) fentanyl, the third group (G3) remifentanil, the fourth group (G4) esmolol, the fifth group (G5) amiodaron, and the sixth group (G6) lidocaine were applied as pre-entubation supplement. The same technique was applied to all patients. The systolic blood pressure (SKB), diastolic blood pressure (DKB) and heart rate (KAH) were recorded by measurements at the time determined. Results: There is no difference between the groups in terms of demographic data (p>0.05). The SKB stability in the Remifentanil group was higher than the esmolol and fentanil groups. The decrease in the DKB in the Remifentanil group was greater than in other groups. Reduction in the remifentanil group 1. It was more in the 3rd and 5th minutes. Result: In our study, we can say that remifentanil in the prevention of hemodynamic response to entubation in the infusion dose of 0.5 micrograms/kg may be a drug for other medication groups.
Objective: Hypertension and tachycardia response may occur due to increased sympathoadrenergic activity due to laryngoscopy and tracheal intubation. This response may result in life-threatening complications, especially in patients with intracranial and cardiovascular disease. In this study, we compared the relative efficacy of remifentanil, amiodarone, fentanyl, esmolol and lidocaine on hemodynamic response in tracheal intubation. Material and Methods: In this study, 90 patients with ASA I-II physical status and between the ages of 20 and 60 were included. The patients were divided into six groups with closed envelope technique. In order to prevent the intubation response, except for the first group control group (G1), fentanyl to the second group (G2), remifentanil to the third group (G3), esmolol to the fourth group (G4), amiodarone to the fifth group (G5), and sixth group (G6) lidocaine before the intubation to the additionally applied.All patients received the same anesthetic technique. Systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate(HR) measurements were done at specified times and recorded. Results: There was no difference between the groups in terms of demographic data (p> 0.05).SBP stability in remifentanil group was higher than esmolol and fentanyl groups. The decrease in DBP in the remifentanil group was higher than in the other groups. The decrease in HR was higher in the remifentanil group at the 1st, 3rd and 5th minutes. Conclusion: According to our study, we can say that remifentanil may be the most effective drug for other drug groups at 0.5 microgram / kg infusion dose to prevent hemodynamic response to intubation
Field : Sağlık Bilimleri
Journal Type : Uluslararası
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