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Endotrakeal entübasyonda oluşan hemodinamik yanıta remifentanilin etkisi

Effects of remifentanil on the haemodynamic response to endotracheal intubation.

Journal Name:

  • Selçuk Tıp Dergisi

Publication Year:

  • 2001

Key Words:

Keywords (Original Language):

Author NameUniversity of Author
Abstract (2. Language): 
Larygoscopy and endotracheal intubation are known to İncrease blood pressure and heart rate by release of cathecholamines from the sympathetic nervous system. Our study aimed to evaluate, remifentanil's effect on this response. This study was performed on 40 ASA l-ll class patients aged between 19-45 years planned tor laparoscopic elective surgery. Patients were randomised in two groups. AH patients received 0.03 mg kg-1 midazolam IV. After Standard monitohsation (ECG, noninvasive blood pressure, heart rate, SpO^ 1.5 f/g kg-1 remifentanil was given to group i and 25 fjg kg1 alfentanil to group II patients as bolus injection. Standard anesthesia induction was made 1 minute after these drugs. (Propofol 2 mg kg-1, succinylcholine 1.5 mg kg-1). Measurements (sistolic blood pressure, diastolic blood pressure, heart rate) were performed: in the beginning (t0), before propofol (t-,), before laryngoscopy (t2), 1and 3 minutes after the endotracheal intubation (t3, t4), 1 minutes after skin incision / trochar insertion (t5). Statistical compahsons were made by student t tests. İn each of the two groups th t2, t3, t4, ts values (systolic, diastolic blood pressures, and heart rate) were significantly decreased (p<0.05). The response to tracheal intubation (t3, t4) and skin incision (t5) were less in remifentanil group than in alfentanil group (p<0.05). As a resuit, we think that remifentanil can be preferred to alfentanil because remifentanil can supress the haemodynamic response sufficiently the larygoscopy endotracheal intubation
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Abstract (Original Language): 
Laringoskopi ve endotrakeal entübasyonun sempatik sinir sistemini uyararak katekolamin salınımı yoluyla arter basıncı ve kalp atım hızını artırdığı bilinmektedir. Çalışmamızda remifentanilin bu yanıta etkisini incelemek amaçlanmıştır. Çalışma elektif laparoskopik cerrahi uygulanacak 19-45 yaş arası ASA l-ll sınıfına giren 40 olguda gerçekleştirildi. Hastalar randomize olarak iki gruba ayrıldı. Tüm hastalara 0.03 mg kg-1 midazolam IV uygulandı. Standart monitorizasyon (EKG, noninvaziv arter basıncı, kalp atım hızı, SpOg) yapıldıktan sonra 1.5 fjg kg-1 remifentanil I. gruba, 25 {jg kg-1 alfentanil U. gruba uygulandı. 1 dk sonra standart anestezi indüksiyonu gerçekleştirildi (propofol 2mg kg-1, süksinil kolin 1.5 mg kg-1). Başlangıçta (t0), propofol uygulamasından önce (t-,), laringoskopi öncesi (tg), endotrakeal entübasyondan 1 ve 3 dk sonra (t3, t4) ve cilt insizyonu/trochar uygulamasından 1 dk sonra (t5) ölçümler (sistolik arter basıncı, diastolik arter basıncı, kalp hızı) yapıldı. İstatistiksel değerlendirme student t testleriyle yapıldı. Her iki grupta da th t2, t3,t4, t5 değerleri (sistolik-diastolik arter basıncı, kalp hızı) anlamlı olarak düştü. Trakeal entübasyona (t3, t4) ve cilt insizyonuna (t5) yanıt remifentanil grubunda alfentanil grubuna göre daha azdı (p<0.05). Sonuç olarak laringoskopi ve trakeal entübasyonda gelişen hemodinamik cevabı yeterince baskılaması nedeniyle remifentanilin alfentanile tercih edilebileceği kanısındayız.
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  • 3
175-179
  • Turkish

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