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Genel anestezi sırasında uygulanan Tramadol'ün anestezi derinliği üzerine etkisi

Effect of Tramadol used during general anesthesia on depth of anesthesia

Journal Name:

  • Gülhane Tıp Dergisi

Publication Year:

  • 2005

Key Words:

Keywords (Original Language):

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Abstract (2. Language): 
In this study we aimed to investigate the effect of tramadol, a centrally acting and synthetic analgesic, on depth of anesthesia. Thirty patients aged 18-65, “American Society of Anesthesiologists-I and II”, undergoing lower abdominal surgery were included. Diazepam 10 mg p.o. was given as premedication, at the morning of operation. After the intravenous access was performed, all of the patients were monitorized with ECG, blood pressure, peripheral oxygen saturation and bispectral index. Induction of anesthesia was performed with 6 mg/kg thiopental and 0.1 mg/kg vecuronium. Anesthesia was maintained with 50% N2O+50% O2 at 4 L/min fresh gas flow. After maintaining stable end-tidal sevoflurane concentrations of 1.5% for 20 minutes, Tramadol 100 mg i.v or saline 2 ml i.v was injected in Tramadol and control groups, respectively, and then skin incision was performed. Mean blood pressure, heart rate and bispectral index measurements were recorded just before and 5, 20, 35 minutes after injection. While mean blood pressure values were found to be slightly higher at the 5th min in both groups, a reduction in mean blood pressure was observed at the 20th and 35th minutes. Heart rate values decreased 35 minutes after injection in both groups. Compared with pretreatment levels, a reduction in heart rate was accepted as significant at 5, 20, 35 minutes and 20, 35 minutes in Tramadol group and control group, respectively, however no statistically significant differences were observed in mean blood pressure and heart rate between two groups (p>0.05). Bispectral index values at 20th and 35th minutes were significantly lower than that of the pretreatment value in Tramadol group but there were no statistically significant differences in bispectral index between two groups (p>0.05). We conclude that use of Tramadol during general anesthesia does not cause significant changes in mean blood pressure, heart rate and bispectral index values, and intraoperative administration of Tramadol does not seem to cause a problem with respect to depth of anesthesia.
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Abstract (Original Language): 
Çalışmamızda, santral etkili sentetik bir analjezik olan Tramadol'ün anestezi derinliği üzerindeki etkisini araştırdık. “American Society of Anesthesiologists-I ve II”, 18-65 yaşında, alt batın cerrahisi uygulanacak olan 30 hasta çalışmaya alındı. Kalp atım hızı, kan basıncı, periferik oksijen satürasyonu ve bispektral indeks monitörizasyonunu takiben indüksiyonda 6 mg/kg tiyopental, 0.1 mg/kg vekuronyum intravenöz yapıldı. Anestezi idamesi %50 O2+%50 N2O 4 L/dk akım ile sağlandı. Endtidal sevofluran konsantrasyonunun 20 dk süreyle %1.5 değerinde stabil olarak idamesi sağlandıktan sonra Tramadol grubuna 100 mg intravenöz Tramadol, kontrol grubuna 2 ml intravenöz serum fizyolojik verildi ve cilt insizyonu uygulandı. Enjeksiyondan hemen önce ve 5., 20., 35. dakikalarda ortalama arter basıncı, kalp atım hızı, bispektral indeks değerleri kaydedildi. İki grupta 5. dakikadaki ortalama arter basıncı hafif derecede artış gösterirken, 20. ve 35. dakikadakilerde azalma gözlendi. Kalp atım hızı, enjeksiyonu takiben 35 dakika boyunca her iki grupta da düşüş gösterdi. Tramadol grubunda 5., 20. ve 35. dakikalardaki, kontrol grubunda ise 20. ve 35. dakikalardaki kalp atım hızı değerindeki düşüş, enjeksiyon öncesine göre anlamlı oldu, ancak iki grup karşılaştırıldığında ortalama arter basıncı ve kalp atım hızı bakımından anlamlı farklılık bulunmadı (p>0.05). Tramadol grubunda 20. ve 35. dakikalardaki bispektral indeks, enjeksiyon öncesine göre anlamlı olarak düşük olmakla birlikte, iki grup arasında bispektral indeks açısından anlamlı farklılık saptanmadı (p>0.05). Genel anestezi sırasında uygulanan Tramadol'ün ortalama arter basıncı, kalp atım hızı ve bispektral indeks değerlerinde anlamlı değişikliğe neden olmadığı ve anestezi derinliği açısından sorun yaratmayacağı sonucuna varılmıştır.
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  • 4
256-259
  • Turkish

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