Comparison of anesthetic effect between 0.375 % ropivacaine and 0.375 % ropivacaine plus (+) S-ketamine in intravenous regional anesthesia for forearm surgery Önkol cerrahisinde % 0.375 ropivakain ve % 0.375 ropivakain + (+)S-ketamin ile oluşturulan rejyonel i̇ntravenöz anestezinin klinik etkilerinin karşilaştirilmasi
Turk Anesteziyoloji ve Reanimasyon Dernegi Dergisi, cilt.36, sa.2, ss.90-97, 2008 (Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 36 Sayı: 2
- Basım Tarihi: 2008
- Dergi Adı: Turk Anesteziyoloji ve Reanimasyon Dernegi Dergisi
- Derginin Tarandığı İndeksler: Scopus, TR DİZİN (ULAKBİM)
- Sayfa Sayıları: ss.90-97
- Anahtar Kelimeler: IVRA, Ropivacaine, S(+)-ketamine
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Regional Intravenous Anesthesia (RIVA) is a frequently applied method in patients who will undergo upper extremity surgical operations, for its ease of use, rapid effectiveness and short hospitalization period. Different drug combinations have been used to overcome some systemic adverse effects and to increase the post-operative analgesic effectiveness. In our study, we aimed to compare the properties of Ropivacaine (group R) and (+)S-Ketamine plus Ropivacaine (group RK) in IVRA method. 40 objects selected from ASA I-II40 patients have been randomized into two groups. Patients in GroupR received 0.5 mL kg-1 of 0.375 % ropivacaine and group RK 0.5 mL kg-1 of 0.375 % ropivacaine and 0.8 mg kg-1 of (+)S-ketamine. Heart rate (HR), systolic arterial pressure (SAP), diastolic arterial pressure (DAP), mean arterial pressure (MAP) and SpO2 were measured 2.5 minutes after local anesthesic injection, at the beginning and 5, 10, 15, 20, 30 and 45 minutes after the operation and 1,5, 10 and 15 minutes after the tourniquet has been released. Tourniquet-operation, sensory-motor block periods, intraoperative anesthesia-analgesia quality, tourniquet tolerance, tourniquet pain (VAS), additional analgesic requierement, patient-surgeon-anesthesist satisfaction, post-operative anesthesia quality, post-operative anesthesia duration side effects-drug reactions were recorded. There was no difference between two groups by means of tourniquet and operation period. Also, there was no intraoperative difference by means of hemodynamic data, sensory-motor blok times, anesthesia and analgesia quality, patient-surgeon-anesthesist satisfaction and additional analgesic requirements. Tourniquet pain and tolerance were significantly better in group RK (p<0.05). In group RK, while the post-operative SAP, DAP, MAP levels were significantly higher (p<0.05) and post-operative anesthesia quality was significantly longer (p<0.05), the post-operative analgesia duration was very long (p<0.001). There were no intraoperative adverse effect or post-operative drug reaction in both groups, however some post-operative adverse effects (sedation in 18 and nystagmus in 6 patients) have been observed. As a result, have concluded mat sufficient intraoperative anesthesia and analgesia can be achieved via using IVRA method performed with either 0.375 % Ropivacaine or 0.375 % Ropivacaine plus (+)S-Ketamine and in some cases, (+)S-Ketamine may contribute to tourniquet tolerance and post-operative analgesia duration.