The comparison of sevoflurane-remifentanyl and propofol-remifentanyl in robotic prostatectomies Robotik prostatektomilerde sevofluran-remifentanil ile propofol-remifentanil'in karşılaştırılması
Journal of Clinical and Analytical Medicine, cilt.4, sa.4, 2013 (Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 4 Sayı: 4
- Basım Tarihi: 2013
- Doi Numarası: 10.4328/jcam.1018
- Dergi Adı: Journal of Clinical and Analytical Medicine
- Derginin Tarandığı İndeksler: Scopus, TR DİZİN (ULAKBİM)
- Anahtar Kelimeler: Balanced General Anesthesia, Propofol, Remifentanyl, Robotic Prostatectomy, Sevoflurane, TIVA
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Aim: Robotic surgery is an effective and common surgery technique in radical prostatectomies. There isn't any standart anesthesia technique for robotic surgery so both inhalation and intravenous anesthetics are used. In this study we aimed that compared the clinical effects of balanced general anesthesia and total intravenous anesthesia. Material and Method: After Ethical Commitee and patient approval, 42 consecutive patients undergoing robotic radical prostatectomy were included in this randomised-controlled study. Patients were divided in two equal group. We used sevoflurane (%1-2 MAC) - remifentanyl (0.04-0.2 μgkg -1min-1) in Group S (n=21) and propofol (4-8mgkg -1h-1) - remifentanyl (0.04-0.2μgkg -1min-1) in Group P(n=21) and O2 - Air (%40-%60) in two groups. Haemorespiratuar dynamics (HR, MAP, SPO2, ETCO2), Aldrete Recovery Score (ARS), nausea-vomiting score and patient satisfaction were evaluated. Result: Heart Rate(HR) and Mean Arterial Pressure (MAP) decreased in the two groups (p<0.05). End tidal CO2 (ETCO2) values significantly increased for two groups comparison with the initial values (p>0.05). pH was lower in Group P than Group S (p<0.01). PCO2 values significantly increased in group P than group S in 2nd h and in group S than group P in 4th h (p<0.05). pH significantly decreased (p<0.01) and PCO2 increased for both two intra-groups comparison (p<0.05). ARS was higher in group P for 1st, 2nd, 3rd h and nausea-vomiting was lower for group P in first two hours. Patient satisfaction was higher and wasn't different in two groups. Discussion: TIVA for robotic prostatectomy supply early and better recovery and side-effects (nausea-vomiting) are less than balanced general anesthesia. But trendelenburg position and CO2 insuflation increases the risk of asidosis. In this issue there is need more studies.