ISSN: 1300-0292
İndekslendiği Dizinler: SCIENCE CITATION INDEX EXPANDED
CINAHL, Index Copernicus,
Chemical Abstracts (CA),
Excerpta Medica / EMBASE
Dil: Türkçe, İngilizce
İçerik: Orijinal Araştırma, Derleme, Editöre Mektup, Olgu Sunumu, Tıp Eğitimi, Tıbbi Kitap İncelemeleri
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ORIGINAL RESEARCH ARTICLES |
Sedation In Regional Anesthesia: Remifentanil And Propofol Infusions
Gonca TUNCEL*, Serpil ŞAVLI*, Gülçin ÖZALP*, Türker ŞEN, Nihal KADIOĞULLARI*
* MD, Department of Anesthesiology, Ankara Oncology Hospital, Ankara, TURKEY
We compared the safety and effectiveness of remifentanil and propofol infusions used for sedation in bladder or prostate cancer patients undergoing TUR with spinal anesthesia in this studyASA I-II (aged 50-82 years), 42 male patients were randomly allocated into two groups, Propofol (n=22) and Remifentanil (n=20). Patients received 0.5 mg/kg propofol bolus followed by 3 mg/kg/h infusion in Propofol group and 0.5 mg/kg remifentanil bolus followed by 6 mg/kg/h infusion in Remifentanil group. Arterial blood pressure, heart rate, respiratory rate and oxygen saturation were recorded. Sedation level was followed by ‘Observer’s Assessment of Alertness/Sedation Scale’. When oversedation or safety end-points are reached, infusion rates were reduced by steps of 0.75 mg/kg/h for propofol and 1.5 mg/kg/h for remifentanil. Spinal block was performed by using 2 ml of 0.5 % hyperbaric bupivacain. Intraoperative and postoperative adverse effects were observed and treated as needed.More infusion rate decreases were needed in Propofol group to obtain required sedation level (p<0.05). Hemodynamic parameters were lower in Propofol group. Mean time to return to alertness was found 4.7 ± 2.7 min in Propofol group, 2.8 ± 2.0 min in Remifentanil group (p<0.05). Intraoperative bradycardia incidence was higher in Propofol group (p<0.05). Intraoperative respiratory depression and desaturation were both found to be more in Remifentanil group. One patient in Propofol group, 6 patients in Remifentanil group were desaturated in the postoperative period (p<0.05). Intraoperative nausea and postoperative nausea-vomiting incidences were higher in Remifentanil group (p<0.05). The patient and anesthetist satisfaction were similar in both techniques.Remifentanil and propofol can be used for sedation during spinal anesthesia, but high incidences of respiratory depression, nausea and vomiting at sedative doses may restrict the clinical use of remifentanil.Keywords: Regional anesthesia, Sedation; Remifentanil, PropofolTurkiye Klinikleri J Med Sci 2002, 22:179-184
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