Sigara Kullanımının Total İntravenöz Anestezi Uygulamasında Rokuronyum Bromidin Farmakodinamiğine Etkisi
Abstract
Amaç: Bu çalışmanın amacı nöromusküler monitörizasyon ve anestezi derinliği monitorizasyonu yapılan hastalarda sigara içimi ile nondepolarizan bir nöromusküler bloker olan rokuronyum bromidin etki süresindeki değişimin araştırılmasıdır.
Materyal ve metod: Çalışmaya, her grupta 29 olmak üzere toplam 58 hasta dahil edildi. Hastalar, hiç sigara kullanmayan hastalar (n=29) ve bir günde en az 10 adet sigarayı en az 2 yıl süreyle devamlı kullanan hastalar (n=29) olmak üzere iki gruba ayrıldı. Tüm hastalarda hedef kontrollü infüzyon yöntemi ile total intravenöz anestezi yöntemi uygulandı. Hastaların intraoperatif hemodinamik parametreleri ve BİS değerleri takip edildi. Doz ihtiyaci, “lag time”, “onset time”, “derin nöromusküler blok süresi”, “T1 %10 süresi”, “klinik etki süresi”, “derlenme indeksi”, “komplet derlenme aralığı” değerleri her hasta için kaydedildi.
Bulgular: Çalışmamızda lag-time değerlerinde sigara içmeyenler ve sigara içenler arasında anlamlı fark gözlenmedi (60±17 saniye ve 60±11saniye, p>0.05). Onset-time değerleri sigara içmeyen ve içenlerde 105±34 saniye ve 120±46 saniye iken , derin nöromusküler blok zamanı yine sigara içmeyen ve içenlerde 28±13.7 dakika ve 33.7±9.3 dakika idi. T1 10% suresi ve klinik etki suresi değerleri de sigara içmeyen ve sigara içenlerde 15.5±7.6/17.2±5.8 dakika ve 16.5±11.1/18.25±7.3 dakika idi (p>0.05). Benzer şekilde derlenme indeksi de sigara içmeyenler (12.7±7.3) ve içenler (12.4±6.6) arasinda anlamlı fark göstermedi.
Sonuç: Çalışmamızda "lag-time", "onset-time", "derin nöromusküler blok süresi", "klinik etki süresi", "T1 %10 süresi", "derlenme indeksi", "komplet derlenme aralığı" değerleri karşılaştırıldığında gruplar arasında istatistiksel olarak anlamlı bir fark saptanmadı.
References
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- 14. Baurain MJ, Hennort DA, Godschalx A, Huybrechts I, Nasrallah G, Hollander AA, Contraire F. Visual evaluation of residual curarization in anesthetized patients using 100 Hertz, 5 second tetanic stimulation at the adductor pollicis muscle. Anesth Analg. 1998; 87:185-9.
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Abstract
References
- 1. Naguib M, Lien CA. Pharmacology of Muscle Relaxants and Their Antagonists. In: Miller RD, ed. Miller’s Anesthesia. 6th Edition, Philadelphia: Churchill Livingstone, 2005: 481-572.
- 2. Rodrigo C. The Effects Of Cigarette Smoking on Anesthesia. The American Dental Society Of Anesthesiology. 2000; 47:143-50.
- 3. Sweeney BP, Grayling M. Smoking and anaesthesia: the pharmacological implications. Anaesthesia. 2009; 64:179–86.
- 4. Crul JF. Clinical aspects of rocuronium bromide. Data on file, Organon Teknika 1998: pages 1-6, 19-26, 29-34, 37-42.
- 5. Tsai CC, Chung HS, Chen PL, Yu CM, Chen MS, Hong CL. Postoperatif residual curarization: Clinical observation in the postanesthesia care unit. Chang Gung Med J. 2008; 31:364-8.
- 6. Nelskyla KA, Yli-Hankala AM, Puro PH, Korttila KT. Sevoflurane titration using bispectral index decreases postoperative vomiting in phase II recovery after ambulatory anesthesia. Anesth Analg. 2001; 93:1165-9.
- 7. Teiriä H, Rautoma P, Yli-Hankala A. Effect of smoking on dose requirements for vecuronium. Br J Anaesth. 1996; 76(1):154-5.
- 8. Latorre F, de Almeida MC, Stanek A, Kleemann PP. The interaction between rocuronium and smoking. The effect of smoking on neuromuscular transmission after rocuronium. Anaesthesist.1997; 46: 493–5.
- 9. Stitzel. Genetic regulation of Nicotine related behaviour and Brain Nicotine receptors. in Clementi, Fornasari, Gotti eds. Neuronal Nicotine receptors. Springer -Verlog 2000; 563-83.
- 10. Puura AI, Rorarius MG, Laippala P, Baer GA, Does abstinence from smoking or a transdermal nicotine system influence Atracurium-induced neuromuscular block? Anesth Analg. 1998; 87:430-3.
- 11. Pühringer FK, Keller P, Löckinger A, Kleinsasser A, Scheller A, Raedler C, et al. Smoking does not alter the dose-requirements and the pharmacodynamics of rocuronium. Can J Anesth. 2000; 47:347–9.
- 12. Salihoglu Z, Karaca S. Effects Of Smoking On Neuromuscular Blockade For Rocuronium. Int J Anesth. 2007; 14:1-4.
- 13. Liu N, Wang F, Zhou Q, Shen M, Shi J, Zou X. The Effects of Cigarette Smoking on Steroidal Muscular Relaxants and Antibiotics Used: A Prospective Cohort Study. Front Pharmacol. 2021; 12:573832.
- 14. Baurain MJ, Hennort DA, Godschalx A, Huybrechts I, Nasrallah G, Hollander AA, Contraire F. Visual evaluation of residual curarization in anesthetized patients using 100 Hertz, 5 second tetanic stimulation at the adductor pollicis muscle. Anesth Analg. 1998; 87:185-9.
- 15. Bock M, Klippel K, Nitsche B, Bach A, Martin E, Motsch J. Rocuronium potency and recovery characteristics during steady-state desflurane, sevoflurane, isoflurane or propofol anaesthesia. Br J Anaesth. 2000; 84(1):43-7.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Clinical Sciences |
| Journal Section | Research Article |
| Authors | |
| Publication Date | April 28, 2022 |
| Submission Date | February 9, 2022 |
| Acceptance Date | April 7, 2022 |
| Published in Issue | Year 2022 Volume: 19 Issue: 1 |
Harran Üniversitesi Tıp Fakültesi Dergisi / Journal of Harran University Medical Faculty