Öz
Objective: We aimed to compare general anesthesia applied with the combination of propofoldesfluran and single-sided spinal anesthesia with regards to hemodynamic parameters and discharge criteria. in patients undergoing daily arthroscopic knee surgery Methods: Cases were divided randomly into two groups. Group 1 (n: 20) is specified as general anesthesia group and Group 2 (n: 20) is specified as spinal anesthesia group. General anesthesia with propofol-desfluran has been applied to patients of Group 1 and spinal anesthesia with 10 mg 0.5% hyperbaric bupivacaine has been applied to the patients of Group 2. Results: Modified Aldrete Scores related to the patients of Group 2 were statically significantly lower than Group 1 because of the ongoing motor block. PADSS and Emesis Scores were similar in both groups. Starting of pain was statistically within a longer period in patients with Group 2 when compared to group 1 due to the ongoing organoleptic block. The differences in hemodynamic parameters between two groups were in concordance with the anesthesia method applied. Conclusion: It is concluded that one-sided spinal anesthesia provided with low dosed 0.5% hyperbaric bupivacaine intrathecal injection may be a good alternative to general anesthesia with propfol-desfluran. in patients undergoing daily arthroscopic knee surgery when its significant contribution to analgesia in postoperative period is considered
Anahtar Kelimeler
General anesthesia spinal anesthesia hemodynamic parameters discharge criteria
Kaynakça
- 1. Morgan GE, Mikhail MS, Murray MJ. Çev. Tulunay M, Cuhruk H. Klinik anesteziyoloji 2008; 4: 856.
- 2. Borghi B, Stagni F, Bugamelli S, Paini M, Nepoti M, Montebugnoli M, Casati A. Unilateral spinal block for outpatient knee artroscopy: A dose finding study. Journal of Clinical Anesthesia 2003; 15: 351-6.
- 3. Bridenbaugh OP, Grene MN, Brull SJ, Spinal Neural Blockade. In. Neural Blockade in Clinical Anesthesia and Management of Pain: Eds. Cousins MJ, Bridenbaugh OP. Third Edition. PhiladelphiaNew York: Lippincott-Raven publishers 1998; 203-41.
- 4. Mulroy MF, Larkin KL, Hadgson PS. A comparison of spinal, epidural, and general anesthesia for outpatient anesthesia. Anesth Analg 2000; 91: 860-4.
- 5. Pavlin DJ, Rapp SE, Poissar NL. Factors affecting discharge time in adult outpatients. Anesth Analg 1998; 87: 816-26.
- 6. Chan VW, Peng P, Chinyanga H, Lazarou S,Weinbren J, Kaszas Z. Determining minimum effective anesthetic concentration of hyperbaric bupivacaine for spinal anesthesia. Anesth Analg 2000; 90: 1135-40.
- 7. Ben-David B, Levin H, Solomon E. Spinal bupivacaine in ambulatory surgery: the effect of saline dilution. Anesth Analg 1996; 83: 716-20.
- 8. Biboulet P, Deschodt J, Aubas P. Continuous spinal anaesthesia: does low-dose plain or hyperbaric bupivacaine allow the performance of hip surgery in the elderly? Reg Anaesth 1993; 18: 170-5.
- 9. Enk D. Unilateral spinal anaesthesia: gadget or tool? Curr Opin Anaesthesiology 1998; 11: 511-5. 10. Toker K, Müezzinoğlu S, Canatay H, Kılıçkan L, Gürkan Y. Artroskopik diz cerrahisinde farklı anestezi yöntemlerinin karşılaştırılması. Türk Anest Rean Cem Mecmuası 2002; 30: 408-12.
- 11. Bhat R, Malhotra SK, Dhillon MS. A prospective, randomized comparison of low dose bupivacaine spinal anaesthesia versus local anaesthesia with propofol infusion for knee arthroscopy. Anaesth Pain&Intensive Care 2012; 16: 24- 30.
- 12. Korhonen MA, Valanne VJ, Jokela MR, Ravaska P, Korttila TK. A comparison of selective spinal anesthesia with hyperbaric bupivacaine and general anesthesia with desflurane for outpatient knee arthroscopy. Anesth Analg 2004; 99: 1668-73.
- 13. Koltka K, Abdülkerimov V, Küçükay S, Şentürk M, Pembeci K. Diz artroskopilerinde unilateral spinal anestezi ve genel anestezi uygulamalarının derlenme özellikleri açısından karşılaştırılması. Türk Anest Rean Der Dergisi 2008; 36: 310-6.
- 14. Korhonen M A, Valanne V, Jokela M R, Ravaska P, Korttila K. Intrathecal hyperbaric bupivacaine 3 mg + fentanyl 10 µg for outpatient knee arthroscopy with tourniquet. Acta Anaesthesiol Scand, 2003; 47: 342-346.
- 15. Borghi B, Anelati D, Berti M, Torri G. Regionel anaesthesia for outpatient knee arthroscopy: A randomized clinical comparison of two different anaesthetic techniques. Acta Anaesthesiol Scand 2000; 44: 543-7.
- 16. Korhonen M A, Valanne V, Jokela M R, Ravaska P, Korttila K. Intrathecal hyperbaric bupivacaine 3 mg + fentanyl 10 µg for outpatient knee arthroscopy with tourniquet. Acta Anaesthesiol Scand 2003; 47: 342-6.
- 17. Harsten A, Kehlet H, ToksvigLarsen S. Recovery after total intravenous general anaesthesia or spinal anaesthesia for total knee arthroplasty: A Randomized Trial. Br J Anaesth 2013; 111: 391-9
Comparison of general anesthesia with spinal application in arthroscopic knee surgery regarding hemodynamic parameters
Öz
SUMMARY
Objective: We aimed to compare general anesthesia applied with the combination of propofol-desfluran and single-sided spinal anesthesia with regards to hemodynamic parameters and discharge criteria. in patients undergoing daily arthroscopic knee surgery
Methods: Cases were divided randomly into two groups. Group 1 (n: 20) is specified as general anesthesia group and Group 2 (n: 20) is specified as spinal anesthesia group. General anesthesia with propofol-desfluran has been applied to patients of Group 1 and spinal anesthesia with 10 mg 0.5% hyperbaric bupivacaine has been applied to the patients of Group 2.
Results: Modified Aldrete Scores related to the patients of Group 2 were statically significantly lower than Group 1 because of the ongoing motor block. PADSS and Emesis Scores were similar in both groups. Starting of pain was statistically within a longer period in patients with Group 2 when compared to group 1 due to the ongoing organoleptic block. The differences in hemodynamic parameters between two groups were in concordance with the anesthesia method applied.
Conclusion: It is concluded that one-sided spinal anesthesia provided with low dosed 0.5% hyperbaric bupivacaine intrathecal injection may be a good alternative to general anesthesia with propfol-desfluran. in patients undergoing daily arthroscopic knee surgery when its significant contribution to analgesia in postoperative period is considered.
Keywords: General anesthesia, spinal anesthesia, hemodynamic parameters, discharge criteria
ÖZET
Amaç: Günübirlik artroskopik diz cerrahisi uygulanan hastalarda spinal anestezi ile genel anestezinin hemodinamik parametreler ve taburculuk kriterleri açısından karşılaştırılmasını amaçladık.
Yöntem: Olgular randomize olarak iki gruba ayrıldı. Grup 1 (n: 20) genel anestezi grubu, Grup 2 (n:20) spinal anestezi grubu olarak belirlendi. Grup 1 hastalarına propofol-desfluran ile genel anestezi, Grup 2 hastalarına ise 10 mg %0,5 hiperbarik bupivakain ile spinal anestezi uygulanmıştır.
Bulgular: Grup 2’deki hastaların devam eden motor blok nedeniyle Modifiye Aldrete Skorları, Grup 1’deki hastalardan istatistiksel olarak anlamlı derecede düşüktü. PADSS ve Emezis Skorları ise her iki grupta benzerdi. Grup 2’deki hastalarda devam eden duyusal blok nedeniyle Grup 1’deki hastalara göre ağrı başlama zamanları istatistiksel olarak ileri derecede uzundu. İki grup arasındaki hemodinamik parametrelerdeki farklılıklar uygulanan anestezi şekliyle uyumluydu.
Sonuç: Günübirlik artroskopik diz cerrahisi uygulanan hastalarda düşük doz %0,5 hiperbarik bupivakainin intratekal enjeksiyonu ile sağlanan tek taraflı spinal anestezi uygulamasının özellikle postoperatif dönemdeki analjeziye olan önemli katkısı göz önünde tutulunca propofol-desfluran ile sağlanan genel anestezi uygulamasına iyi bir alternatif olabileceği kanaatine varıldı.
Anahtar sözcükler: Genel anestezi, spinal anestezi, hemodinamik parametreler, taburculuk kriterleri
Anahtar Kelimeler
Genel anestezi spinal anestezi hemodinamik parametreler taburculuk kriterleri
Kaynakça
- 1. Morgan GE, Mikhail MS, Murray MJ. Çev. Tulunay M, Cuhruk H. Klinik anesteziyoloji 2008; 4: 856.
- 2. Borghi B, Stagni F, Bugamelli S, Paini M, Nepoti M, Montebugnoli M, Casati A. Unilateral spinal block for outpatient knee artroscopy: A dose finding study. Journal of Clinical Anesthesia 2003; 15: 351-6.
- 3. Bridenbaugh OP, Grene MN, Brull SJ, Spinal Neural Blockade. In. Neural Blockade in Clinical Anesthesia and Management of Pain: Eds. Cousins MJ, Bridenbaugh OP. Third Edition. PhiladelphiaNew York: Lippincott-Raven publishers 1998; 203-41.
- 4. Mulroy MF, Larkin KL, Hadgson PS. A comparison of spinal, epidural, and general anesthesia for outpatient anesthesia. Anesth Analg 2000; 91: 860-4.
- 5. Pavlin DJ, Rapp SE, Poissar NL. Factors affecting discharge time in adult outpatients. Anesth Analg 1998; 87: 816-26.
- 6. Chan VW, Peng P, Chinyanga H, Lazarou S,Weinbren J, Kaszas Z. Determining minimum effective anesthetic concentration of hyperbaric bupivacaine for spinal anesthesia. Anesth Analg 2000; 90: 1135-40.
- 7. Ben-David B, Levin H, Solomon E. Spinal bupivacaine in ambulatory surgery: the effect of saline dilution. Anesth Analg 1996; 83: 716-20.
- 8. Biboulet P, Deschodt J, Aubas P. Continuous spinal anaesthesia: does low-dose plain or hyperbaric bupivacaine allow the performance of hip surgery in the elderly? Reg Anaesth 1993; 18: 170-5.
- 9. Enk D. Unilateral spinal anaesthesia: gadget or tool? Curr Opin Anaesthesiology 1998; 11: 511-5. 10. Toker K, Müezzinoğlu S, Canatay H, Kılıçkan L, Gürkan Y. Artroskopik diz cerrahisinde farklı anestezi yöntemlerinin karşılaştırılması. Türk Anest Rean Cem Mecmuası 2002; 30: 408-12.
- 11. Bhat R, Malhotra SK, Dhillon MS. A prospective, randomized comparison of low dose bupivacaine spinal anaesthesia versus local anaesthesia with propofol infusion for knee arthroscopy. Anaesth Pain&Intensive Care 2012; 16: 24- 30.
- 12. Korhonen MA, Valanne VJ, Jokela MR, Ravaska P, Korttila TK. A comparison of selective spinal anesthesia with hyperbaric bupivacaine and general anesthesia with desflurane for outpatient knee arthroscopy. Anesth Analg 2004; 99: 1668-73.
- 13. Koltka K, Abdülkerimov V, Küçükay S, Şentürk M, Pembeci K. Diz artroskopilerinde unilateral spinal anestezi ve genel anestezi uygulamalarının derlenme özellikleri açısından karşılaştırılması. Türk Anest Rean Der Dergisi 2008; 36: 310-6.
- 14. Korhonen M A, Valanne V, Jokela M R, Ravaska P, Korttila K. Intrathecal hyperbaric bupivacaine 3 mg + fentanyl 10 µg for outpatient knee arthroscopy with tourniquet. Acta Anaesthesiol Scand, 2003; 47: 342-346.
- 15. Borghi B, Anelati D, Berti M, Torri G. Regionel anaesthesia for outpatient knee arthroscopy: A randomized clinical comparison of two different anaesthetic techniques. Acta Anaesthesiol Scand 2000; 44: 543-7.
- 16. Korhonen M A, Valanne V, Jokela M R, Ravaska P, Korttila K. Intrathecal hyperbaric bupivacaine 3 mg + fentanyl 10 µg for outpatient knee arthroscopy with tourniquet. Acta Anaesthesiol Scand 2003; 47: 342-6.
- 17. Harsten A, Kehlet H, ToksvigLarsen S. Recovery after total intravenous general anaesthesia or spinal anaesthesia for total knee arthroplasty: A Randomized Trial. Br J Anaesth 2013; 111: 391-9
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Bölüm | Cerrahi Tıp Bilimleri Araştırma Yazıları |
| Yazarlar | |
| Yayımlanma Tarihi | 1 Temmuz 2015 |
| Yayımlandığı Sayı | Yıl 2015Cilt: 37 Sayı: 2 |