Buradasınız

Anasayfa » Content

Diz Protezi Operasyonlarında Anestezi Yönteminin Hemodinami Üzerine Etkileri

The Effect of Anesthetic Technique on Hemodynamic Parametres in Total Knee Surgery

Journal Name:

  • Fırat Tıp Dergisi

Publication Year:

  • 2010

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Objective: To compare the effects of spinal and general anaesthesia on hemodynamic variations during tourniquet application and cementation in patients undergoing total knee surgery. Materials and Methods: 38 ASA physical status I/II patients undergoing total knee surgery were randomized into two groups as spinal anesthesia group (n=18) where 3 mL of 0.5% levobupivacaine injected intrathecally and sevoflurane based general anesthesia group (n=20). Radial artery catheterization was performed in all of the patients and cardiac output, invasive arterial pressure and heart rate were measured and recorded before anesthesia indication or spinal blockade, at 5th, 10th, and 15th min following endotracheal intubation or spinal blockade, just before and after tourniquet inflation, just before and at 1st, 3rd, 5th, and 10th min following bone cement placement, and at 1st min after tourniquet deflation. Results: Tourniquet application caused a significant increase in the blood pressure and cardiac output when compared to the values recorded before anesthesia in both groups. Sementation and deflation of the tourniquet caused decrease in blood pressure in both groups, but there was no significant difference between two groups. Conclusion: We concluded that total knee surgery with sementation and tourniquet application did not affect hemodynamic parameters in both spinal and general anesthesia groups.
Bookmark/Search this post with
Abstract (Original Language): 
Amaç: Diz protezi ameliyatlarında spinal ve genel anestezi yöntemlerinin metil metakrilat uygulaması, turnike şişirilmesi ve turnike indirilmesi sırasındaki hemodinamik değişiklikler üzerine olan etkilerini karşılaştırmayı amaçladık. Gereç ve Yöntemler: Total diz protezi cerrahisi yapılacak olan ASA I/II grubu 38 hasta randomize olarak sevofluran bazlı genel anestezi (n=20) ve 3 mL %0.5 levobupivakainin intratekal olarak uygulandığı spinal anestezi (n=18) grubu olmak üzere iki gruba ayrıldı. Tüm hastalara radial arter kateterizasyonu yapıldıktan sonra kardiyak output, arteriyel kan basınçları ve kalp atım hızı anestezi indüksiyonu veya spinal anestezi öncesi, entübasyon veya spinal anestezi sonrası 5, 10, 15. dakikalarda, turnike öncesi, turnike sonrası, kemik çimento öncesi ve sonrası 1, 3, 5, 10. dakikalar¬da ve turnike indirildikten 1 dakika sonra ölçülerek kaydedildi. Bulgular: Spinal anestezi ve genel anestezi grubunda turnike uygulaması kardiyak outputta ve kan basıncında anestezi öncesi değerlerine göre anlam¬lı olarak artışa sebep oldu. Kemik çimentosu uygulaması ve turnike çözülmesi her iki grupta kardiyak outputu ve kan basıncını düşürdü, ancak gruplar arası anlamlı bir farklılık bulunamadı. Sonuç: Turnike ve kemik çimentosu uygulanan diz protezi operasyonlarında uygulanan anestezi yöntemlerinin hemodinamik açıdan birbirinden farklı olmadığı sonucuna vardık.
FULL TEXT (PDF): 
PDF icon arastrmx_135291_15_pp_83-86.pdf
  • 2
83-86
  • Turkish

REFERENCES

References: 

1. Valli H, Rosenberg PH. Effects of three anaesthesia methods on haemodynamic responses connected with the use of thigh tourniquet in orthopaedic patients Acta Anaesthesiol Scand 1985; 29: 142-147.
2. Byrick RJ, Kay JC, Mullen JBM. Pulmonary marrow embolism: a dog model simulating dual component cemented
arthroplasty. Can J Anaesth 1987; 34: 336-342.
Fırat Tıp
Dergis
i 2010;15(2): 83-86
İnanoğlu ve Ark.
3. Karlsson J, Wendling W, Chen D, et al. Methylmethacrylate monomer produces direct relaxation of vascular smooth muscle
in vitro. Acta Anaesthesiol Scand 1995; 39: 685-689.
4. Donaldson AJ, Thomson HE, Harper NJ, Kenny NW. Bone cement implantation syndrome. Br J Anaesth 2009; 102: 12-22.
5. Rinecker H. New clinico-pathophysiological studies on the bone cement implantation syndrome. Arch Orthop Trauma Surg 1980; 97: 263-274.
6. Dahl OE. Cardiorespiratory and vascular dysfunction related to major reconstructive orthopedic surgery. Acta Orthop Scand
1997; 68: 607-614.
7. Peebles DJ, Ellis RH, Stride SD, Simpson BR. Cardiovascular
effects of methylmethacrylate cement. Br Med J 1972; 1: 349¬351.
8. Hardinge K. The direct lateral approach to the hip. J Bone Joint Surg Br 1982; 64:17-19.
9. Alexander JP, Barron DW. Biochemical disturbances associated with total hip replacement. J Bone Joint Surg Br 1979; 61: 101¬106.
10. Breed AL. Experimental production of vascular hypotension, and bone marrow and fat embolism with methylmethacrylate cement. Traumatic hypertension of bone. Clin Orthop Relat Res
1974; 102: 227-244.
11. Ling RS, James ML. Blood pressure and bone cement. Br Med J
1971; 2: 404.
12. McCaskie AW, Barnes MR, Lin E, Harper WM, Gregg PJ.
Cement pressurisation during hip replacement. J Bone Joint Surg
Br 1997; 79: 379-384.
13. Phillips H, Cole PV, Lettin AW. Cardiovascular effects of
implanted acrylic bone cement. Br Med J 1971; 3: 460-461.
14. Clark DI, Ahmed AB, Baxendale BR, Moran CG. Cardiac
output during hemiarthroplasty of the hip. A prospective, controlled trial of cemented and uncemented prostheses. J Bone Joint Surg Br 2001; 83: 414-418.
15. Wheelwright EF, Byrick RJ, Wigglesworth DF, et al. Hypotension during cemented arthroplasty. Relationship to cardiac output and fat embolism. J Bone Joint Surg Br 1993; 75:
715-723.
16. Button D, Weibel L, Reuthebuch O, et al. Clinical evaluation of the FloTrac/Vigileo system and two established continous cardiac output monitoring devices in patients undergoing cardiac
surgery. Br J Anaesth 2007; 99: 329-336.
17. Sharrock NE, Savarese JJ. Anesthesia for orthopedic surgery. In: Miller RD (editor) Anesthesia. 5. baskı, New York: Churchill
Livingston. 2000; 2118-2136.
18. Kaufman RD, Walts LF. Tourniquet-induced hypertension. Br J Anaesth 1982; 54: 333-336.
19. Valli H, Rosenberg PH, Kytta J, Nurminen M. Arterial hypertension associated with the use of a tourniquet with either general or regional anaesthesia. Acta Anaesthesiol Scand 1987; 31: 279-283.
20. Girardis M, Milesi S, Donato S, et al. The hemodynamic and metabolic effects of tourniquet application during knee surgery. Anesth Analg 2000; 91: 727-731.
21.
Kabukç
u HK, Özdemir H, Şahin N, Titiz TA. Diz Artroskopisinde Spinal Anestezi Altında Turnike Uygulanması¬nın Hemodinamik ve Metabolik Etkileri. Ankara Üniversitesi
Tıp Fakültesi Mecmuası. 2004; 57: 13-18.
22. Honarmand A, Safavi MR. Preoperative oral dextrometorphan vs. clonidine to prevent tourniquet-induced cardiovascular responses in orthopaedic patients under general anaesthesia. Eur
J Anaesth 2007; 24: 511-515.
23. Tetzlaff JE, O'Hara J, Yoon HJ, Schubert A. Tourniquet-induced hypertension correlates with autonomic nervous system changes detected by power spectral heart rate analysis. J Clin Anesth 1997; 9: 138-142.
24. Valli H, Rosenberg PH. Effects of three anaesthesia methods on haemodynamic responses connected with the use of thigh tourniquet in orthopaedic patients. Acta Anaesthesiol Scand 1985; 29: 142-147.
25. Modig J, Kolstad K, Wigren A. Systemic reactions to tourniquet ischaemia. Acta Anaesthesiol Scand 1978; 22: 609-614.

Thank you for copying data from http://www.arastirmax.com