An evaluation of the effects of thoracal epidural anesthesia on hemodynamia, glucose and cortisol levels during thoracic surgery Göǧüs cerrahisinde torakal epidural analjezinin hemodinami, glukoz ve kortizol düzeyleri üzerine etkilerinin deǧerlendirilmesi
Anestezi Dergisi, cilt.13, sa.1, ss.31-36, 2005 (Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 13 Sayı: 1
- Basım Tarihi: 2005
- Dergi Adı: Anestezi Dergisi
- Derginin Tarandığı İndeksler: Scopus, TR DİZİN (ULAKBİM)
- Sayfa Sayıları: ss.31-36
- Anahtar Kelimeler: Pulmonary resection, Thoracal epidural anesthesia, Thoracic surgery, Total intravenous anesthesia
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
We aimed to compare the effects of total intravenous anesthesia (TIVA) with a thoracal epidural anesthesia (TEA) and TIVA combination on hemodynamia, glucose and cortisol levels during thoracic surgery. Thirty cases scheduled for pulmonary resection were divided into two groups randomly. In all cases, 0.05 mg kg-1 midazolam, 2 μg kg-1 fentanyl, 2 mg kg-1 propofol and 0.1 mg kg-1 vecuronium were given for induction and 6-7 mg kg-1 hr-1 propofol, fentanyl and vecuronium bolus were used in maintenance. ECG, heart rate, peripheric oxygen saturation and arterial blood pressure were monitored and double-lumen tubes were inserted. Anesthesia was maintained by propofol infusion (TIVA) in both groups. The patients in Group I also received 0.375 % bupivacaine (6 mL hr-1) following 6-10 mL 0.5 % bupivacaine bolus epidurally (TIVA+TEA). In the preoperative, intraoperative and postoperative periods, the hemodynamic parameters, glucose and cortisol levels were measured 11, 5 and 3 times respectively. Supplemental fentanyl, atropine and efedrine requirements were recorded. In Group I, the hemodynamic values and fentanyl requirement (Group I: 25.7±39.9 μg, Group II: 170.7±73.1 μg) were found to be significantly lower (p<0.05). Compared to initial values, the increase in the plasma glucose level was statistically significant in both groups (p<0.05). The difference between the plasma cortisol levels of the two groups was not significant (p>0.05). Increases in the levels of glucose and cortisol were limited in Group I. Compared to TIVA, the TEA and TIVA combination was thought to decrease hemodynamic responses and analgesic requirements while inducing a similar response to stress.