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Journals / Ağrı / 2015 / Cilt: 27 - Sayı: 4

Majör abdominal cerrahi uygulanan yüksek riskli hastalarda total intravenöz anestezi ile kombine epidural analjezinin etkileri

Effects of combined epidural analgesia with total intravenous anesthesia on risky patients underwent major abdomin

Tülin AYAZOĞLU AKARSU
Aynur ÖZENSOY
Fatih Doğu GEYİK
Muhittin ÇALIM
Uğur DUMAN
Mehmet Akif CANDAN
Journal
Ağrı
Pages
171–180
DOI
—
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⚡ TL;DR(Too Long; Didn't Read)

Conclusion: Based on lower requirements for propofol and remifentanil as well as the favourable effects on clinical param- eters; we conclude that bispectral index score guided combined epidural with total intravenous anaesthesia is superior to solely total intravenous anaesthesia in this type of surgery.

📌 3 Key Takeaways

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Objective & Hypothesis:Objectives: The aim of this study is to investigate the effects of combined epidural analgesia with total intravenous anaesthe- sia and only total intravenous anaesthesia on the different clinical parameters.
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Key Findings & Data:Induction of anaesthesia was performed with IV remifentanil 0.5µg/kg and propofol titrated to achieve bispectral index score between 40 and 50. after intubation; in Group E, 0.1% bupivacaine and 2 µg/mL fentanyl were administered by an infusion rate at 0.15 ml/kg/h via the epidural catheter and Group C received epidural normal saline as same infusion rate.
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Conclusion & Impact:Conclusion: Based on lower requirements for propofol and remifentanil as well as the favourable effects on clinical param- eters; we conclude that bispectral index score guided combined epidural with total intravenous anaesthesia is superior to solely total intravenous anaesthesia in this type of surgery.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Abstract

Objectives: The aim of this study is to investigate the effects of combined epidural analgesia with total intravenous anaesthe- sia and only total intravenous anaesthesia on the different clinical parameters. Methods: Sixty high risk patients undergoing a major abdominal surgical procedure were included in this prospective, dou- ble blind, randomized study. Induction of anaesthesia was performed with IV remifentanil 0.5µg/kg and propofol titrated to achieve bispectral index score between 40 and 50. after intubation; in Group E, 0.1% bupivacaine and 2 µg/mL fentanyl were administered by an infusion rate at 0.15 ml/kg/h via the epidural catheter and Group C received epidural normal saline as same infusion rate. Results: In group E, intraoperative MAP values were significantly lower than those in group C (p<0.05). Time of extubation, time of eye opening with audible warning and time of verbal response was significantly lower in group E than those in group C. Total anaesthetic drug consumption was significantly higher in group C than those in group E (p<0.05). Conclusion: Based on lower requirements for propofol and remifentanil as well as the favourable effects on clinical param- eters; we conclude that bispectral index score guided combined epidural with total intravenous anaesthesia is superior to solely total intravenous anaesthesia in this type of surgery.

Özet

Amaç: Bu çalışmanın amacı, farklı klinik parametreler üzerinde sadece total intravenöz anestezi ve total intravenöz anestezi ile kombine epidural analjezinin etkilerini araştırmaktır. Gereç ve Yöntem: Bu prospektif, çift kör, randomize çalışmaya majör abdominal cerrahi geçirecek yüksek riskli 60 hasta dahil edildi. Anestezi indüksiyonu; IV remifentanil 0.5 mg/kg ve 40 ile 50 arasında bispektral indeks elde edilecek halde titre edilmiş propofol ile yapıldı. Entübasyon sonrası; Grup E için 0.1% bupivkain and 2 µg/ml fentanil infüzyon hızı 0. 15 ml/kg/h olacak şekilde epidural kataterden başlandı. Grup C ye ise aynı hızda serum salin infüzyonu başlandı. Bulgular: İntraoperatif ortalama arter basınçları Grup Ede Grup Cye oranla düşük bulundu (p<0.05). Ekstübasyon süresi, göz açma ve sözel cevap süresi Grup Ede Grup Cye oranla düşük bulundu (p<0.05). Total anestezik ilaç tüketimi Grup Cde Grup Eye göre daha yüksek bulundu (p<0.05). Sonuç: Düşük doz remifentanil ve propfol kullanımının klinik parametreler üzerine olumlu etkilerine dayanarak; bispektral indeks klavuzluğunda kombine epidural analjezi ve total intravenöz anestezinin tek başına total intravenöz anesteziye oranla daha üstün olduğunu öne sürmekteyiz

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Cite This Article

AKARSU, T. A., ÖZENSOY, A., GEYİK, F. D., ÇALIM, M., DUMAN, U., CANDAN, M. A. (2015). Majör abdominal cerrahi uygulanan yüksek riskli hastalarda total intravenöz anestezi ile kombine epidural analjezinin etkileri. Ağrı, Cilt: 27 - Sayı: 4, 171–180. https://ajindex.com/articles/353315

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