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Spinal Anestezide Levobupivakain ve Fentanilin Farklı Enjeksiyon Hızlarının Karşılaştırılması

Comparison the Different Delivery Speeds of Levobupivacaine and Fentanyl in Spinal Anesthesia

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Abstract (2. Language): 
In this study, we aimed to compare the different delivery speeds of alow dose combined solution of levobupivacaine and fentanyl on haemodynamia, sensorial and motor blockade. 60 ASA I-III patients for spinal anesthesia undergoing transuretral resection were randomly assigned into two groups by using the combined solution of 7.5 mg levobupivacaine and 25 µg fentanyl in four seconds in group I and 40 seconds in group II with 22 G spinal needle for spinal anesthesia. Heart rate, noninvasive blood pressure, sensorial and motor blockade status were evaluated both before and after injections on regular intervals. When the sensorial block level reached to T10 dermatome, the operation began. There was no statistically significant difference between patients demographic data, operation time, ASA status. There were difference was noticed between hemodynamic status of the patients between two groups (p>0.05). Changes in sensorial blockade levels were similar in both groups (p>0.05), but motor blockade level was one in Group I, while it was noticed two in Group II and it was statistically significant (p<0.05). Motor blockade regression time was longer in Group I when compared with Group II (p<0.05). Among side effects both of the groups were not statistically significant (p > 0.05). In this study it was shown that both of the injection rates of combination of levobupivacaine and fentanyl prove stable hemodynamia, but it was shown that motor blockade regression time was longer in rapid injection group
Abstract (Original Language): 
Bu çalışmada, transüretral cerahide intratekal düşük doz levobupivakain ve fentanilin farklı enjeksiyon hızlarının hemodinami, duyusal ve motor blok üzerine etkilerini karşılaştırmayı amaçladık. Benign prostat hiperplazisi nedeniyle opere edilecek ASA II-III grubu 60 hasta rastgele iki gruba ayrılıp, 22 G spinal iğne ile intratekal aralığa 7.5 mg levobupivakain + 25 μg fentanil karışımı Grup I’ deki hastalara 4 sn, Grup II’ deki hastalara ise 40 sn hızında verildi. Enjeksiyon öncesi ve sonrasında belirli aralıklarla hastaların kalp atım hızı, noninvaziv kan basınçları, duyusal blok seviyesi ve motor blok seviyesi kaydedildi. Duyusal blok seviyesi T10 olduğunda operasyona izin verildi. Hastaların demografik verileri, cerrahi süreleri ve ASA fiziksel durumlarında, kalp atım hızı, Sistolik arter basıncı, Diastolik arter basıncı ve Ortalama arter basıncı ölçümlerinde gruplar arasında istatistiksel olarak anlamlı fark bulunmadı (p>0.05). Duyusal blok değerleri benzer değişimler gösteriyordu (p>0.05). Operasyon sonrasında motor blok dereceleri Grup I’de 2 iken, Grup II’de 1 olarak değerlendirildi ve istatistiksel olarak anlamlı bulundu (p<0.05). Motor blok geri dönüşüm zamanı da Grup I’de, anlamlı derecede daha uzundu (p<0.05). Yan etki gelişiminde ise, gruplar arasında herhangi bir fark görülmedi (p>0.05). Bu çalışmada levobupivakain ile fentanil kombinasyonunun her iki infüzyon hızında da hemodinamik açıdan güvenli olduğu, ancak motor blok geri dönüşüm zamanının hızlı infüzyon yapılan grupta daha uzun olduğu gösterilmiştir.
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