Hızlı Entübasyonda Roküronyum Bromürün Hemodinami Ve Entübasyon Koşulları Üzerine Etkisinin Farklı İndüksiyon Ajanları İle İncelenmesi
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Dosyalar
Tarih
2000
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Turgut Özal Tıp Merkezi Dergisi
Erişim Hakkı
Attribution 3.0 United States
info:eu-repo/semantics/openAccess
info:eu-repo/semantics/openAccess
Özet
Hızlı entübasyonun amacı, aspirasyon riskini azaltmak için, anestezik ve kas gevşetici ilaçların birlikte uygulanarak, hızlı ve uygun entübasyon koşulları sağlamaktır. Çalışmamızda, hızlı ve kısa etkili bir nondepolarizan kas gevşetici olan roküronyum bromürün (0.6 mg.kg-1), alfentanil (10 mg.kg-1) ilavesi ve tiyopental (5 mg.kg-1) veya propofol (2.5 mg.kg-1) ile birlikte hemodinami ve 60.- 90. saniyelerdeki (sn) entübasyon koşulları üzerine etkileri karşılaştırıldı. Materyal ve metot: ASA I-II risk grubu, elektif cerrahi girişim geçirecek 80 olgu, dört gruba ayrıldı. Yavaş hızla alfentanil verilmesini takiben tüm olgulara, spontan solunumla preoksijenasyon yapıldı. Grup I’de tiyopental ve roküronyum bromür verilip 60. sn’de, Grup II’de tiyopental ve roküronyum bromür verilip 90.sn’de, Grup III’te propofol ve roküronyum bromür verilip 60. sn’de ve Grup IV’te propofol ve roküronyum bromür verilip 90. sn’de entübasyon yapıldı. Olgular entübasyon öncesi maske ile %100 oksijen almaya devam etti. Kas gevşetici verilmesini takiben 1, 2, 5 ve 15. dakikalarda (dk) kan basıncı, kalp atım hızı, periferik oksijen saturasyonları kaydedildi. Entübasyon durumu, mükemmel, iyi, zayıf ve yetersiz olarak değerlendirilip, mükemmel ve iyi, uygun entübasyon koşulları olarak kabul edildi. Sonuçlar One-Way Analiz ve Chi-square testleri ile karşılaştırıldı. p<0.05 istatistiksel olarak anlamlı kabul edildi. Bulgular: Propofol gruplarında daha fazla olmak üzere tüm gruplarda uygun entübasyon koşulları sağlandı. En mükemmel entübasyon durumu Grup IV’te saptandı ve bu istatistiksel olarak anlamlı idi (p<0.05). Sonuç: Olgunun klinik durumu göz önünde bulundurularak, acil entübasyon durumlarında en uygun kombinasyon 90 sn’de propofol-roküronyum ile olmakla birlikte, araştırmamızdaki tüm seçenekler uygulanabilir kanısındayız.
The aim of rapid sequence intubation is to create fast and satisfactory intubation conditions to decrease risk of aspiration with anesthetic and muscle relaxant drugs. In our study, we compared the effects of rocuronium bromide (0.6 mg.kg-1), a fast and short effective non-depolarizing muscle relaxant with addition of alfentanyl (10 µg. kg-1) and thiopental (5 mg.kg-1) or propofol (2.5 mg.kg-1) for rapid sequence intubation on hemodynamics and intubation conditions at 60 to 90 seconds. Material and Methods: 80 cases in ASA I-II classification undergoing elective surgery were divided into four groups. After slow administration of alfentanyl, all of the patients were preoxygenated with spontaneous breathing. The intubation had been performed at 60 s after administration of thiopental and rocuronium bromide in group I, at 90 s after administration of thiopental and rocuronium bromide in group II, at 60 s after administration of propofol and rocuronium bromide in group III and at 90 s after administration of propofol and rocuronium bromide in group IV. The patients continued to receive 100% oxygen by mask before intubation. After the administration of neuromuscular relaxant the blood pressure, heart rate, peripheral oxygen saturation at 1, 2, 5 and 15 minutes were recorded. The intubation state evaluated as excellent, good, poor and impossible, excellent and good were considered to be satisfactory. Results were compared with One-Way analysis and Chi-Square tests. p<0.05 was statistically significant. Results: Suitable intubation conditions were provided in all groups but were more pronounced in propofol groups. The most excellent intubation conditions were found in group IV and this was statistically significant (p<0.05). Conclusion: Providing the clinical state of the case, at emergeny conditions, propofol with rocuronium in 90 seconds is the best way of rapid intubation. However, we also consider other alternatives satisfactory.
The aim of rapid sequence intubation is to create fast and satisfactory intubation conditions to decrease risk of aspiration with anesthetic and muscle relaxant drugs. In our study, we compared the effects of rocuronium bromide (0.6 mg.kg-1), a fast and short effective non-depolarizing muscle relaxant with addition of alfentanyl (10 µg. kg-1) and thiopental (5 mg.kg-1) or propofol (2.5 mg.kg-1) for rapid sequence intubation on hemodynamics and intubation conditions at 60 to 90 seconds. Material and Methods: 80 cases in ASA I-II classification undergoing elective surgery were divided into four groups. After slow administration of alfentanyl, all of the patients were preoxygenated with spontaneous breathing. The intubation had been performed at 60 s after administration of thiopental and rocuronium bromide in group I, at 90 s after administration of thiopental and rocuronium bromide in group II, at 60 s after administration of propofol and rocuronium bromide in group III and at 90 s after administration of propofol and rocuronium bromide in group IV. The patients continued to receive 100% oxygen by mask before intubation. After the administration of neuromuscular relaxant the blood pressure, heart rate, peripheral oxygen saturation at 1, 2, 5 and 15 minutes were recorded. The intubation state evaluated as excellent, good, poor and impossible, excellent and good were considered to be satisfactory. Results were compared with One-Way analysis and Chi-Square tests. p<0.05 was statistically significant. Results: Suitable intubation conditions were provided in all groups but were more pronounced in propofol groups. The most excellent intubation conditions were found in group IV and this was statistically significant (p<0.05). Conclusion: Providing the clinical state of the case, at emergeny conditions, propofol with rocuronium in 90 seconds is the best way of rapid intubation. However, we also consider other alternatives satisfactory.
Açıklama
Turgut Özal Tıp Merkezi Dergisi. Malatya.
Anahtar Kelimeler
İntravenöz anestetik, tiyopental, propofol, anestezi tekniği, hızlı entübasyon, entübasyon, trakeal, nöromüsküler kas gevşetici, roküronyum bromür
Kaynak
İnönü Üniversitesi Turgut Özal Tıp Merkezi Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
7
Sayı
1
Künye
Bakan, N.; Karaaslan, E.;Hasçalık, M.;Ersoy, M. Ö.; (2000) Turgut Özal Tıp Merkezi Dergisi.
