Retrograt intrarenal cerrahi planlanan olgularda iki farklı rokuronyum dozunun intraoperatif hipotermi ve postoperatif titreme üzerine etkisi
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Date
2021
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Hatay Mustafa Kemal Üniversitesi
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info:eu-repo/semantics/openAccess
Abstract
Amaç: Bu çalışmada retrograt intrarenal cerrahilerde anestezi indüksiyonu sırasında roküronyumun iki farklı doz uygulamasının, intraoperatif hipotermi ve postoperatif titreme üzerine etkisinin araştırılması amaçlandı. Yöntem: Retrograt intrarenal cerrahi yapılacak, 18-60 yaş, ASA skoru I-III olgular çalışmaya alındı. Olgular randomize olarak iki gruba ayrıldı. Olgulara operasyon odasına alındıklarında aksiller sıcaklık probu ve entübasyon sonrası özefagus sıcaklık probu yerleştirildi. Perioperatif vücut sıcaklığı takip edildi. Grup A da olgulara standart doz roküronyum (0,6 mg/kg), Grup B yüksek doz (1,0 mg/kg) rokuronyum verildi. İntraoperatif nöromusküler monitörizasyon yapılarak blok deriniliği takip edildi. Kas gevşetici etkisini geri döndürmek için sugammedex 4 mg/kg verildi. Postoperatif titreme 5 puanlı bir skala ile değerlendirildi. Olguların derlenme ünitesinde uyanıklık durumları MAS(Modifiye aldret skoru) ve ağrıları VAS(vizüel analog skala) ile takip edildi. Bulgular: Gruplar arasında demografik ve hemodinamik veriler arasında anlamlı bir farklılık yoktu. Yüksek doz rokuronyum alan grup B de intraoperatif aksiller ve özefagus vücut sıcaklığı T3 ve T4 de anlamlı derecede daha düşük bulundu(p<0,05.) Grup B de postoperatif titreme sıklığı ve titreme düzeyi anlamlı derecede daha fazla idi(p<0,05). Sonuç: Genel anestezi sırasında kullanılan kas gevşeticiler intraoperatif hipotermi ve postoperatif titremeyi arttırabilir. Bununla ilgili etki mekanizmalarının araştırıldığı kapsamlı çalışmalara ihtiyaç vardır
Background and aim: In this study, it is aimed to investigate the effect of two different doses of rocuronium on intraoperative hypothermia and postoperative shivering during anesthesia induction in retrograde intrarenal surgery. Methods: Patients who will undergo retrograde intrarenal surgery, aged 18-60, ASA score I-III were included in the study. The cases were randomly divided into two groups. The axillary temperature probe was placed in the cases when they were taken to the operation room and the esophageal temperature probe after intubation. perioperative body temperature was monitored. Group A received standard dose rocuronium (0.6 mg / kg) and Group B high dose (1.0 mg / kg) rocuronium. Block depth was followed by intraoperative neuromuscular monitoring. Sugammedex 4 mg / kg was administered to reverse its muscle relaxant effect. Postoperative tremor was assessed on a 5-point scale. In the recovery unit, the wakefulness state of the patients was monitored with MAS and their pain with VAS. Results: There was no significant difference in demographic and hemodynamic data between the groups. In group B who received high dose rocuronium, intraoperative axillary and esophageal body temperature was found to be significantly lower at T3 and T4 (P <0.05). Postoperative shivering frequency and shivering level were significantly higher in Group B (p <0, 05). Conclusion: Muscle relaxants used during general anesthesia may increase intraoperative hypothermia and postoperative shivering. Comprehensive studies are needed to investigate the mechanisms of action related to this. Keyword: Hypothermia, postoperative shivering, dose rocuronium
Background and aim: In this study, it is aimed to investigate the effect of two different doses of rocuronium on intraoperative hypothermia and postoperative shivering during anesthesia induction in retrograde intrarenal surgery. Methods: Patients who will undergo retrograde intrarenal surgery, aged 18-60, ASA score I-III were included in the study. The cases were randomly divided into two groups. The axillary temperature probe was placed in the cases when they were taken to the operation room and the esophageal temperature probe after intubation. perioperative body temperature was monitored. Group A received standard dose rocuronium (0.6 mg / kg) and Group B high dose (1.0 mg / kg) rocuronium. Block depth was followed by intraoperative neuromuscular monitoring. Sugammedex 4 mg / kg was administered to reverse its muscle relaxant effect. Postoperative tremor was assessed on a 5-point scale. In the recovery unit, the wakefulness state of the patients was monitored with MAS and their pain with VAS. Results: There was no significant difference in demographic and hemodynamic data between the groups. In group B who received high dose rocuronium, intraoperative axillary and esophageal body temperature was found to be significantly lower at T3 and T4 (P <0.05). Postoperative shivering frequency and shivering level were significantly higher in Group B (p <0, 05). Conclusion: Muscle relaxants used during general anesthesia may increase intraoperative hypothermia and postoperative shivering. Comprehensive studies are needed to investigate the mechanisms of action related to this. Keyword: Hypothermia, postoperative shivering, dose rocuronium
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Keywords
Anestezi ve Reanimasyon, Anesthesiology and Reanimation, Hipotermi, titreme, retrograt intrarenal cerrahi, doz rokuronyum, Hypothermia, postoperative shivering, dose rocuronium
