A Comparison Study of Single Dose versus Continuous Subarachnoid Levobupivacaine for Transurethral Resection Transüretral Rezeks‹yonda Tek Doz Ve
نویسندگان
چکیده
Girifl: Transüretral rezeksiyon planlanan geriatrik hastalarda anestezi kalitesi, hemodinamik parametreler ve olas› komplikasyonlar aç›s›ndan, intratekal levobupivakain ile tek doz ve sürekli spinal anestezi uygulamalar› karfl›laflt›r›ld›. Gereç ve Yöntem: Transuretral rezeksiyon planlanan 60 geriatrik hasta tek doz spinal anestezi (n=30) ve sürekli spinal anestezi (n=30) olarak iki gruba ayr›ld›. Tek doz spinal anestezi grubuna 12.5 mg izobarik levobupivakain (%0.5), sürekli spinal anestezi grubuna 5 mg bafllang›ç dozundan sonra T10 düzeyinde analjeziye ulafl›ncaya kadar 2.5 mg dozlarda izobarik levobupivakain (%0.5) intratekal uyguland›. Bulgular: Levobupivakain miktar› sürekli spinal anestezi grubunda daha düflüktü (p<0.0001). Duyusal blo¤un medyan maksimum düzeyi tek doz spinal anestezi grubunda T8, sürekli spinal anestezi grubunda T9 idi. T10’da duyusal blok bafllama zaman› ve maksimum duyusal blo¤a ulaflma zaman› sürekli spinal anestezi grubunda uzundu (p<0.0001). Ameliyat s›ras›nda, tek doz spinal anestezi grubunda 25. ve sürekli spinal anestezi grubunda 40. dakikadan bafllayarak kalp h›z›nda azalma vard› (p<0.05). Tek doz spinal anestezi grubunda 15 ve 40’›nc› dakikalar aras›ndaki sistolik arter bas›nc› kontrol de¤erlerine göre düflüktü (p<0.05). Sürekli spinal anestezi grubunda duyu blo¤unun yavafl bafllamas› hipotansiyon geliflmesini önledi. Giriflim s›ras›nda parestezi sürekli spinal anestezi grubunda yüksekti (p<0.05). Sonuç: Geriatrik hastalarda levobupivakain ile sürekli spinal anestezi, duyusal blo¤un daha yavafl bafllamas› nedeniyle daha iyi hemodinamik stabilite sa¤lad›¤›ndan tek doz spinal anesteziden daha güvenlidir. Anahtar Sözcükler: Transüretral Rezeksiyon; Spinal Anestezi, Levobupivakain. ABSTRACT
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