Elektif Sezaryenlerde İntratekal Bupivakaine İlave Edilen Fentanil ve Morfinin Efedrin Gereksinimi ve Fetusa Etkisi
Yükleniyor...
Dosyalar
Tarih
2005
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
İnönü Üniversitesi Tıp Fakültesi Dergisi
Erişim Hakkı
Attribution 3.0 United States
info:eu-repo/semantics/openAccess
info:eu-repo/semantics/openAccess
Özet
Bu çalışmada elektif sezaryenlerde intratekal bupivakaine ilave edilen fentanil ve morfinin, efedrin gereksinimine ve fetus üzerine etkilerini karşılaştırmayı amaçladık. Gereç ve Yöntem: Elektif sezaryen planlanan 54 olgu çalışmaya alındı ve tüm olgulara laktatlı ringer; anestezi öncesi 10-12 mL kg-1 ve operasyon süresince 8-10 mL kg sa-1 verildi. Grup I (n=18)’de 2 mL %0.5 bupivakain, Grup II (n=18)’de 1.5 mL %0.5 bupivakain + 0.5 mL’de 25 ?g fentanil ve Grup III (n=18)’te 1.5 mL %0.5 bupivakain + 0.5 mL’de 0.1 mg morfin kullanılarak spinal anestezi uygulandı. Spinal anestezi sonrası 5 mg bolus efedrini takiben operasyon süresince kan basıncı, giriş sistolik arter basıncı değerinin %80-110’ları olacak şekilde efedrin infüzyonu uygulandı. Bulgular: Operasyon süresince grupların total efedrin ihtiyacı Grup I’de 58.4±25.4 mg, Grup II’de 46.3±22.3 mg ve Grup III’te 38.6±16.3 mg idi. Kullanılan total efedrin miktarı Grup III’te Grup I’e göre anlamlı olarak düşük bulundu (p<0.05). Fetal umblikal pH, Grup I’de Grup III’e göre daha düşük tespit edildi (p<0.05) Sonuç: Spinal anestezi uygulanmış elektif sezaryenlerde, bupivakain ile morfin kombinasyonunun, bupivakainin tek başına kullanımına göre daha az dozda efedrin ile aynı hemodinamik koşulları sağladığı kanısına varıldı.
In this study, we aimed to compare the effects of intrathecal bupivacaine-fentanyl and bupivacainemorphine on ephedrine requirements and on health status of fetus. Methods: We enrolled 54 cases undergoing elective cesarean section in this study. Ringer’s lactate was infused to all patients at a rate of 10-12 mL kg-1 preoperatively and 8-10 mL kg hr-1 during operation. Spinal anesthesia was achieved with 2 mL of bupivacaine %0.5 in Group I (n=18), with 1.5 mL of bupivacaine %0.5 + 0.5 mL fentanyl, 25 ?g, in Group II (n=18) and with 1.5 mL of bupivacaine %0.5 + 0.5 mL morphine, 0.1 mg, in Group III (n=18). After spinal anesthesia, ephedrine infusion was given following a bolus dose of 5 mg ephedrine, to maintain arterial pressure during the operation at the level of 80-110% of the basal value. Results: We found that total ephedrine requirements during operation was 58.4±25.4 mg in Group I, 46.3±22.3 mg in Group II and 38.6±16.3 mg in Group III. The total amount of ephedrine administered in Group III was found to be significantly lower than that in Group I (p<0.05). Umblical blood pH in Group I was detected lower than that in Group III (p<0.05). Conclusion: We concluded that; combination of bupivacaine+morphine with lower doses of ephedrine achieved the same hemodynamic states than bupivacaine alone in elective cesarean sections.
In this study, we aimed to compare the effects of intrathecal bupivacaine-fentanyl and bupivacainemorphine on ephedrine requirements and on health status of fetus. Methods: We enrolled 54 cases undergoing elective cesarean section in this study. Ringer’s lactate was infused to all patients at a rate of 10-12 mL kg-1 preoperatively and 8-10 mL kg hr-1 during operation. Spinal anesthesia was achieved with 2 mL of bupivacaine %0.5 in Group I (n=18), with 1.5 mL of bupivacaine %0.5 + 0.5 mL fentanyl, 25 ?g, in Group II (n=18) and with 1.5 mL of bupivacaine %0.5 + 0.5 mL morphine, 0.1 mg, in Group III (n=18). After spinal anesthesia, ephedrine infusion was given following a bolus dose of 5 mg ephedrine, to maintain arterial pressure during the operation at the level of 80-110% of the basal value. Results: We found that total ephedrine requirements during operation was 58.4±25.4 mg in Group I, 46.3±22.3 mg in Group II and 38.6±16.3 mg in Group III. The total amount of ephedrine administered in Group III was found to be significantly lower than that in Group I (p<0.05). Umblical blood pH in Group I was detected lower than that in Group III (p<0.05). Conclusion: We concluded that; combination of bupivacaine+morphine with lower doses of ephedrine achieved the same hemodynamic states than bupivacaine alone in elective cesarean sections.
Açıklama
İnönü Üniversitesi Tıp Fakültesi Dergisi
12(1) 5-9 (2005)
Anahtar Kelimeler
Sezaryen, Bupivakain, Fentanil, Morfin, Efedrin, Cesarean section, Bupivacaine, Fentanyl, Morphine
Kaynak
İnönü Üniversitesi Tıp Fakültesi Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
12
Sayı
1
Künye
But, A.Kadir ; Öztürk, Erdoğan ;Gülhaş, Nurçin ;Durmuş, Mahmut ; Doğan, Zafer ;Ersoy, M.Özcan ;İnönü Üniversitesi Tıp Fakültesi Dergisi 12(1) 5-9 (2005)
