Seden EMİNFERZANE, Hanife ALTUNKAYA, HİLAL AYOĞLU, Yetkin ÖZER, Osman YAPAKLI, IŞIL ÖZKOÇAK TURAN

Premedikasyonda deksmedetomidin veya midazolam kullanımının spinal anestezide anksiyete ve hemodinamik parametreler üzerine etkisi

Amaç: Spinal anestezi premedikasyonunda deksmedetomidinin ve midazolamın anksiyete ve hemodinami üzerine etkisi karşılaştırıldı. Gereç ve Yöntem: Minör cerrahi geçirecek 60 (ASA I-II) olguya operasyondan bir gece önce durumluluk-süreklilik kaygı envanter testi (STAI) uygulandı. Hemodinamik veriler premedikasyon öncesi ve sonrasında beşer dakika aralar ile kaydedildi. Rasgele iki gruba ayrılan olgulardan Grup D’ye 1µg kg-1 iv deksmedetomidin, Grup M’ye 0.03 mg kg-1 iv. midazolam uygulandı. 15 dk sonra STAI testi yeniden uygulandı. Spinal anestezi uygulanırken VAS değerleri kaydedildi. Cerrahi başladıktan sonra Ramsey sedasyon skorları değerlendirildi. Bulgular: Her iki grupta da premedikasyon sonrası STAI testinin durumluluk gösteren skorlarında azalma saptandı (p

Anahtar Kelimeler:

Deksmedetodimin, Anestezi, spinal, Kaygı, Premedikasyon, Midazolam, Hemodinamikler

The effects of dexmedetomidine and midazolam for premedication on anxitey and hemodynamic parameters during spinal anesthesia

Objective: The effects of midazolam and dexmedetomidine on anxiety are compared during premedication for spinal anesthesia. Methods: State Trait Anxiety Inventory questionnaire is applied one night before to 60 patients in ASA risk group I-II planned for minor elective surgery. Hemodynamic values are recorded at five minutes intervals before and after premedication. After randomly divided into two groups, Group D received dexmedetomidine 1µg kg-1 , Group M received midazolam 0.03 mg kg-1 iv. STAI test is repeated after 15 minutes. VAS scores are recorded during spinal anesthesia. Ramsey sedation scores were evaluated after surgery started. Results: The state anxiety scores of STAI test reduced in both groups (p<0.05). There was no difference between the STAI sco- res of the groups. VAS scores of Group D were lower (p<0.05). Ramsey sedation scores were similar in both groups. Mean arteri- al pressure values were compared before and after premedication and found to be lower in both groups (p<0.05). This reduction was more significant after spinal anesthesia in Group D (p<0.05). Heart rate values were compared before and after premedi- cation and found to be reduced in Group D (p<0.05), the reduction in Group M was 10 min after drug application. The heart rate reduction after spinal anesthesia was more significant in Group D (p<0.05). Mouth dryness is determined in 10 patients in Group D (p<0.05). Conclusion: Premedication with dexmedetomidine during spinal anesthesia may provide similar sedation and anxiolysis as midazolam application but careful hemodynamic follow-up is thought to be appropriate.

Keywords:

Dexmedetomidine, Anesthesia, Spinal, Anxiety, Premedication, Midazolam, Hemodynamics,

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