Dergiler / Selçuk Tıp Dergisi / 2001 / Cilt: 17 - Sayı: 1
Midazolam-fentanil ve sevofluran anestezilerinin geriatrik olgularda anestezi indüksiyonu, idamesi, derlenme dönemi ve kognitif fonksiyonlara etkilerinin karşılaştırılması
- Dergi
- Selçuk Tıp Dergisi
- Sayfa
- 7–15
- DOI
- —
Özet
Bu çalisma midazolam - fentanil kombinasyonu ile olusturulan TIVA, ve sevofluran inhalasyonu ile saglanan VIMA uygulamalarinin geriatrik yas grubunda anestezi indüksiyonu, idamesi, derlenme dönemi ve kognitif fonksiyonlar üzerindeki etkilerini arastirmak amaci ile planlanmistir. Bu amaçla, transuretral prostatektomi (TUR-P) uygulanacak olgular Grup S ve Grup M olarak ayrildi. Anestezi indüksiyonu Grup S olgularda sevofluran inhalasyonu, Grup M olgularda midazolam ve fentanil iv uygulanmasi ile saglandi. Her iki grupta da maske toleransi, indüksiyon zamani, solunum refleksleri; ekstübasyon, göz açma ve adini söyleme süreleri; ve yan etkiler kaydedildi. Operasyon süresince ortalama arter basinci ( OAB ) ve kalp atim hizi ( KAH ) kaydedildi. Operasyondan önce; 2 ve 24 saat sonra olgularin hemoglobin (Hg) ve oksijen saturasyonu (SpO2) degerleri not edildi; mental durum testi uygulandi. Grup M olgularda, Grup S olgulara göre indüksiyon zamani uzun, göz açma ve adini söyleme süreleri anlamli olarak kisa bulundu ( p 0.05 ). Sonuç olarak her iki anestezi yönteminin de bu yas grubunda, stabil hemodinami saglamasi, hizli ve rahat derlenme bulgulari ile uygun birer tercih olabilecegi, erken dönem kognitif fonksiyonlar üzerine birbirlerinden farkli etkileri olmadigi kanisina varildi.
Abstract
The comparison of anaesthesia induction, maintenance, recovery and cognitive fonctions in geriatric patients during midazolam-fentanly and sevoflurane anaesthesia. This study has been planned for investigating the effects of TIVA, which is formed by the combination of midazolam-fentanyl and VIMA with inhalation of sevoflurane on the induction and maintenance of anesthesia, recovery period and cognitive functions of anesthesia in geriatric age. Patients undergoing to transurethral prostatectomy ( TUR-P ) were randomly divided two groups as Group M and S. Induction was performed with midazolam and fentanyl in group M and inhalation in Group S. Mask tolerance, induction time, reflexes of respiration, extubation, eye-opening time and time for telling his/her name, and advers effects were examined in both groups. The mean arterial blood pressure and heart rate were also recorded during the operation. The hemoglobin and O2 saturation values were recorded before the operation, 2 and 24 hours after the operation. The mental status test was applied. The induction time of Group M was found to be longer and eye-opening time and time for telling name were significantly shorter than Group S ( p<0.05 ). Heart rate was significantly lower in group M 2 minutes after operation starts and at 30th minute of the operation ( p<0.05 ). The mental status test showed no difference between two groups in every mental status examining period ( p>0.05 ). There was no difference between the preoperative values and postoperative 24 hours' values.In conclusion, each of the anesthesia methods can be a choice for this group of age by providing a heamodynamically stable anesthesia, fast and comfortable recovery. In addition, the effects of these methods on early cognitive functions did not differ from each other.