Journals / Türk Anestezi ve Reanimasyon Dergisi / 2007 / Cilt: 35 - Sayı: 2
Comparison of haemodynamic response to entubation, venous irritability and myoclonus activity of etomidate dissolved in propylen glycol and lipid emulsion and fentanyl added combinations
- Pages
- 111–119
- DOI
- —
Abstract
Introduction: In this study we compared the haemodynamic effects of entubation, venous irritability and myoclonic activity after the injections of etomidate dissolved in propylen glicol and in lipid emulsion. We also compared the combinations of these solutions with fentanylMaterials and Methods: 80 patients were randomly divided into four groups. In Group I, etomidate propylen glycol, in Group II, etomidate lipid emulsion, in Group III; etomidate propylen glycol with fentanyl, in Group IV, etomidate lipid emulsion with fentanyl were administered at induction. During induction, patients were asked for feeling of pain, heat, coldness and contraction on the surface of the hand. The time from the beginning of anesthesia until the disappearence of cooperation and eyelash reflex was measured. At the same time myoclonic activity was evaluated. After induction, SAP, DAP, MAP, HR and SPO2 values were measured and than repeated after 1., 5., 10.,15. and 30th minutes. Patients were observed for syptoms of thrombophlebilitis at the 1st, 2nd and 3rd postoperative days.Results: In this study no differnce was found with respect to age, sex, weight and ASA scores, SPO2 values, cooperation and eyelash reflex among the groups. One minute after intubation the increases in SAP values, in propylen glicol and lipid emulsion groups were significant, but not in fentanyl combinated groups. One minute after intubation the increase in heart rate were significant in all groups. Pain and burning effects were higher after the administration of etomidate propylen glycol without fentanyl. Venous complications like thrombophlebitis, were significantly minimal in lipid emulsion groups combinated with fentanyl.Coclution: Myoclonic activity and haemodynamic response are less when etomidate used with fentanyl. We think that, etomidate in lipid emulsion form with fentanyl will decrease the injection pain, myoclonus and postoperative venous complications when administered in appropriate dose and time, from a large luminated vessel way.
Özet
Amaç: Çalışmamızda, etomidatın propilen glikol ve lipid emülsiyon içinde çözünmüş formları ile bunların fentanil eklenmiş kombinasyonlarının entübasyona hemodinamik yanıt, venöz irritabilite ve miyoklonik aktivite üzerine etkilerinin karşılaştırılması amaçlandı.Gereç ve Yöntem: Elektif cerrahi geçirecek 80 hasta rasgele 4 gruba ayrıldı. İndüksiyonda; Grup I'e etomidat propilen glikol, Grup II'ye etomidat lipid emülsiyon, Grup III'e fentanil + etomidat propilen glikol, Grup IV'e fentanil+etomidat lipid emülsiyon uygulandı. İndüksiyon sırasında hastalara el sırtında ağrı, yanma, soğukluk ve kasılma olup olmadığı soruldu. Kooperasyon ve kirpik refleksi kaybolma zamanı ölçüldü ve bu sırada miyoklonik aktivite gelişip gelişmediği gözlendi. İndüksiyon sonrası SAB, DAB, OAB, KAH ve SPO2 ölçümleri yapıldı ve ölçümler 1., 5.,10., 15., ve 30. dk.'larda tekrarlandı. Hastalar 3 gün boyunca tromboflebit bulguları açısından izlendi.Bulgular: Gruplar arasında yaş, cinsiyet, ağırlık, ASA skorları, SPO2 değerleri, kooperasyon ve kirpik refleksi kaybolma zamanı benzerdi. Entübasyon sonrası 1. dk.'da SAB'da görülen artış propilen glikol ve lipid emülsiyon gruplarında ileri düzeyde anlamlıyken (p