CELALEDDİN SOYALP, Ayşenur DOSTBİL, Mine ÇELİK, ALİ AHISKALIOĞLU, MEHMET AKSOY, İLKER İNCE, Muhammet Ahmet KARAKAYA

Desfluran ve remifentanil anestezisi ile desfluran'a kombine edilmiş lomber epidural analjezinin derlenme üzerine olan etkileri

Amaç: Bu çalışmadaki primer amacımız, alt batın cerrahisi geçirecek olgularda, desfluran ve remifentanil anestezisi ile desflurana kombine edilen lomber epidural analjezi uygulamalarının postoperatif derlenme üzerine olan etkilerini karşılaştırmaktı. Yöntemler: Bu çalışma elektif alt batın cerrahisi planlanan 240 hasta üzerinde gerçekleştirildi. Hastalar Grup DR (desfluran+remifentanil n=120) ve Grup DL (desfluran + lomber epidural analjezi n=120) olarak rastgele iki gruba ayrıldı. Grup DRde genel anestezi desfluran ve remifentanil ile sağlandı. Grup DLye ise preoperatif epidural katater takıldıktan sonra desfluran kullanılarak genel anestezi uygulandı. Olguların ekstübasyon, göz açma, başını 5 sn yukarıda tutma ve cerrahi süreleri ile postoperatif yan etkiler kaydedildi. Hastaların anesteziden derlenmesini değerlendirmek için modifiye aldrete skorlama sistemi kullanıldı. Bulgular: Ekstübasyon, göz açma, başını 5 saniye yukarda tutma süresi ve modifiye Aldrete skoru 10 oluncaya kadar geçen ortalama süre, DL grubunda DR grubuna göre istatistiksel olarak anlamlı olarak daha kısa idi (sırasıyla p=0,002, p

The effects of desflurane and remifentanyl anaesthesia compared to lumbar epidural analgesia combined with desflurane on recovery

Objective: Our primary objective in this study is to compare the effects of the applications of desflurane and remifentanyl anaesthesia, along with lumbar epidural analgesia combined with desflurane on postoperative recovery in the cases who undergoing lower abdominal surgery. Methods: This study performed 240 patients who undergoing elective lower abdominal surgery. Patients were divided into two random groups as Group DR (desflurane + remifentanyl n=120) and Group DL (desflurane +Lumbar Epidural Analgesia n=120).The general anaesthesia in Group DR was performed through the use of desflurane and remifentanyl. Group DL was administered a general anaesthesia through a pre-operative epidural catheter insertion and an application of desflurane. Extubation, eye opening, head lift for 5 seconds, and the surgical durations of the patients as well as the postoperative side-effects were recorded. Modified Aldrete Scoring System was used to assess the recovery of the patients from anaesthesia. Results: According to the inter group comparison results between Group DR and Group DL, the duration of extubation, eye opening, head lift for 5 seconds and the average amount of elapsed time until the modified Aldrete Scoring reached 10 were found statistically and significantly shorter in Group DL than Group DR( respectively p=0.002, p<0.001, p<0.001, p<0.001).The duration of the first analgesic need was statistically and significantly longer in Group DL compared to Group DR (p<0.001). The postoperative patient satisfaction in Group DL was statistically and significantly higher than that in Group DR (p=0.010). Conclusion: The Epidural analgesia included in the general anaesthesia in lower abdominal surgery is considered by us to be the beneficial and efficient method of analgesia which leads to an earlier recovery of the patients without affecting the intraoperative hemodynamic stability and which boosts the patient satisfaction by providing a more efficient analgesia during the postoperative period.

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