İntravenöz deksmedetomidin premedikasyonunun bupivakain ile uygulanan spinal anestezide duyusal blok süresine etkisi
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Date
2008-05-28
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Uludağ Üniversitesi
Abstract
Çift kör, randomize ve plasebo kontrollü olarak planlanan çalışmada spinal anestezi öncesi intravenöz tek doz uygulanan deksmedetomidin ve midazolamın, duyusal ve motor blok süresi üzerine etkisinin karşılaştırılması amaçlanmıştır. Transüretral prostat rezeksiyonu (TUR-P) operasyonu planlanan ASA I-II, 75 olguda spinal anesteziden 5 dakika önce intravenöz deksmedetomidin 0.5 μg kg-1 (Grup D, n=25), midazolam 0.05 mg kg-1 (Grup M, n=25) veya serum fizyolojik (Grup K, n=25) uygulamasından sonra, sedasyon seviyesi, duyusal blok üst seviyesi, duyusal ve motor blok gerileme zamanı kaydedildi. Ramsay sedasyon skoru, Grup D ve Grup M’de benzer ve Grup K’den daha yüksek bulundu (her iki grup için p<0.001). Duyusal blok üst seviyesi, Grup D’de, Grup M ve Grup K’ye göre daha yüksek olarak saptandı (her iki grup için p<0.001). Deksmedetomidin grubunda duyusal blok süresinin, midazolam ve kontrol grubundan daha uzun olduğu, ancak motor blok süresini uzatmadığı belirlendi (her iki grup için p<0.05). Postoperatif ilk analjezik gereksinim zamanı, Grup D’de Grup M ve K’ye göre daha uzun bulundu (her iki grup için p<0.01). Postoperatif analjezik tüketimi Grup D’de, Grup M ve Grup K’ye göre daha azdı (her iki grup için p<0.05). Deksmedetomidin ile premedikasyon midazolama benzer sedasyon ve daha belirgin analjezi sağlar. Ek olarak, deksmedetomidin bupivakain ile uygulanan spinal anestezinin duyusal blok süresini uzatır.
In this double blind, randomized and placebo-controlled study, we aimed to compare the effects of dexmedetomidine and midazolam on the sensory or motor blockage, following a single dose administration, before spinal anesthesia. Seventy-five ASA I-II patients undergoing transurethral resection of the prostate (TUR-P) either received intravenous dexmedetomidine 0.5 μg kg-1 (Group D, n = 25) or midazolam 0.05 mg kg-1 (Group M, n = 25) or saline (Group K, n = 25) 5 minutes prior to spinal anesthesia were enrolled.Level of sedation, upper level of sensory blockage and the time of sensory and motor blockage regression were then recorded. The Ramsay sedation scores were detected to be similar in Group D and Group M both of which were higher than those in the Group K (p<0.001 for two groups). The upper sensory blockage level was revealed to be higher in Group D compared to Group M or Group K (p<0.001 for two groups). The duration of the sensory blockage in the dexmedetomidine group was detected to be longer than the midazolam or saline group, but not the duration of motor block (p<0.05 for two groups). It was found in Group D that the postoperative first analgesic necessity time was longer than Group M or Group K (p<0.01 for two groups). Postoperative analgesic consumption were less in the group D compared with groups M and P (p<0.05 for two groups). Premedication with intravenous dexmedetomidine provided equal levels of sedation and more evident analgesia compared with midazolam. In addition, dexmedetomidine prolonged sensory blockage of bupivacaine-induced spinal anesthesia.
In this double blind, randomized and placebo-controlled study, we aimed to compare the effects of dexmedetomidine and midazolam on the sensory or motor blockage, following a single dose administration, before spinal anesthesia. Seventy-five ASA I-II patients undergoing transurethral resection of the prostate (TUR-P) either received intravenous dexmedetomidine 0.5 μg kg-1 (Group D, n = 25) or midazolam 0.05 mg kg-1 (Group M, n = 25) or saline (Group K, n = 25) 5 minutes prior to spinal anesthesia were enrolled.Level of sedation, upper level of sensory blockage and the time of sensory and motor blockage regression were then recorded. The Ramsay sedation scores were detected to be similar in Group D and Group M both of which were higher than those in the Group K (p<0.001 for two groups). The upper sensory blockage level was revealed to be higher in Group D compared to Group M or Group K (p<0.001 for two groups). The duration of the sensory blockage in the dexmedetomidine group was detected to be longer than the midazolam or saline group, but not the duration of motor block (p<0.05 for two groups). It was found in Group D that the postoperative first analgesic necessity time was longer than Group M or Group K (p<0.01 for two groups). Postoperative analgesic consumption were less in the group D compared with groups M and P (p<0.05 for two groups). Premedication with intravenous dexmedetomidine provided equal levels of sedation and more evident analgesia compared with midazolam. In addition, dexmedetomidine prolonged sensory blockage of bupivacaine-induced spinal anesthesia.
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Keywords
Alfa-2 adrenoreseptör agonist, Deksmedetomidin, Premedikasyon, Spinal anestezi, Alpha-2 adrenoreceptor agonist, Dexmedetomidine, Premedication, Spinal anaesthesia
Citation
Kaya, F.N. vd. (2008). “İntravenöz deksmedetomidin premedikasyonunun bupivakain ile uygulanan spinal anestezide duyusal blok süresine etkisi”. Uludağ Üniversitesi Tıp Fakültesi Dergisi, 34(3), 87-92.