Low Dose Hypobaric Bupivacaine In Unilateral Spinal Anesthesia For Endovenous Radiofrequency Ablation

Year 2015, , 205 - 209, 01.09.2015

Mesut Erbaş Hasan Ali Kiraz Ali Ümit Yener Tuncer Şimşek Tuğba Doğu Hüseyin Toman Hasan Şahin M Turgut Alper Özkan

https://doi.org/10.5505/abantmedj.2015.18209

Abstract

OBJECTIVE: We aimed to investigate the effects of low dose hypobaric bupivacaine usage in unilateral spinal anesthesia for the treatment of varicose veins with RFA radiofrequency ablation .METHODS: This retrospective study was performed by Çanakkale 18 Mart Medical Faculty Department of Anesthesiology and Reanimation with the method of elective endovenous radiofrequency catheter ablation, scanning the file information of patients retrospecively. 40 patients in the 18-55 year old range and who are in the ASA I-II risk group were included in the study. Patients intrathecally received 4,5 mg 3 ml hypobaric bupivacaine 0.5% plain bupivacaine 1.5mL+3.5 ml of distilled water . This final dose of bupivacaine at 37°C 1 was confirmed as hypobaric by literature. Motor blockade, sensorial blockade and hemodynamic parameters were assessed every 2.5 minutes during the first 15 minutes after spinal injection and then every 5 minutes until the end of operation The side effects during the operation time, such as hypotension, bradycardia, nausea, vomiting, pain, respiratory depression were also documented. The operative time was recorded.RESULTS: Of the patients included in our study were 18 male and 22 were females. We were observed in 2 patients bradycardia and in 2 patients nausea / vomiting patients. While is Patients achieving maximum sensorial block was observed that the mean duration of 9,18 min. The average time to reach the maximum motor block was observed that 11.3 min.CONCLUSION: In conclusion, unilateral spinal anesthesia provide effective anesthesia, minimal side effects thus by shortening the hospital stay maximized the satisfaction of patients undergoing elective endovenous radiofrequency catheter ablation treatment of bilateral varicose veins.

Keywords

Hypobaric, low dose, spinal anesthesia

Mini Doz Hipobarik Unilateral Spinal Anestezi İle Endovenöz Radyofrekans Tedavisi

Abstract

AMAÇ: Bu çalışma ile alt ekstremite yüzeyel venöz yetmezlik ve buna bağlı gelişen varislerin RFA radyofrekans ablasyon ile tedavisinde unilateral spinal anestezi sırasında kullanılan mini doz hipobarik bupivakainin günübirlik cerrahideki etkinliğini araştırmayı hedefledik.YÖNTEMLER: Bu çalışma 2012-2013 yılları arasında Çanakkale Onsekiz Mart Üniversitesi Tıp Fakültesi Hastanesi Anesteziyoloji ve Reanimasyon Anabilim Dalı bünyesinde Kalp ve Damar Cerrahisi ameliyathanesinde elektif endovenöz radyofrekans ablasyon yöntemi ile tek taraflı varis tedavisi yapılan hastaların dosya bilgilerinin retrospektif olarak incelenmesi ile gerçekleştirildi. Çalışmaya ASA I-II risk grubundaki 18-55 yaş aralığında 40 hasta dahil edildi. Çalışmaya alınan hastalara 1,5 mL %1 izobarik bupivakain “Marcaine® %0,5 flakon, Eczacıbaşı” + 3,5 mL distile su karışınımın 3 mL’si 4,5 mg olarak intratekal verildi. Bu dozdaki ilacın son hali 37 °C’de hipobarik olduğu 1 literatür bilgileri ile doğrulandı. Spinal anestezinin duyusal blok seviyesi, motor blok derecesi ve hemodinamik göstergelerden olan kalp atım hızı KAH , ortalama arter basıncı OAB ve SpO2 değerleri spinal anestezi yapıldıktan sonra 15 dk boyunca her 2,5 dk’da bir, daha sonra ameliyat bitimine kadar her 5 dk’da bir kaydedildi. Hastalar ameliyat süresince hipotansiyon, bradikardi, bulantı, kusma, ağrı, titreme, huzursuzluk, solunum depresyonu gibi yan etkiler bakımından izlendi ve oluşan komplikasyonlar kaydedildi.BULGULAR: Çalışmamıza 18’ierkek 22’si kadın olmak üzere 40 hasta dahil edildi. Hastaların 2’sinde bulantı/kusma, 2’sinde de bradikardi gözlemledik. Maksimum duyusal blok oluşma süresi 9,18 dk iken maksimum motor blok oluşma süresi 11,3 dk olarak gözlendi.SONUÇ: Sonuç olarak elektif endovenöz radyofrekans ablasyon yöntemi ile tek taraflı varis tedavisi yapılan hastalarda unilateral spinal anestezinin etkin bir anestezinin yanında minimal düzeyde yan etki oluşturup ve hasta memnuniyetini artırarak erken taburculuk süresi sağlar.

Keywords

Hipobarik, düşük doz, spinal anestezi

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