Publication: Kas gevşetici ajan kullanımında, sinir kas kavşak monitörizasyonunun rolü
Abstract
Bu çalışma ile; periferik sinir stimülasyonu kullanılanılıp kullanılmamasının, veküronyum bromid tüketimine etkisi olup olmadığının bulunması amaçlanmıştır. ASA I-II grubunda, 20-60 yaş arasında, periferik elektif cerrahi uygulanan, kas gevşetici ajan olarak veküronyum bromid, inhalasyon anestezik olarak isofluran ya da sevofluran ve havayolu sağlama yöntemi olarak endotrakeal entübasyon ya da laringeal maske kullanılan toplam 251 hastanın anestezi formları geriye dönük olarak değerlendirilmiştir. Hastalar: Grup I (n=104); sinir kas stimülatörü kullanılan hastalar, Grup II (n=147); sinir kas stimülatörü kullanılmayan hastalar olmak üzere iki ana gruba ayrılmışlardır. Her iki ana grup kullanılan inhalasyon anestezik ajanının (isofluran/sevofluran) ve havayolu devamlılığı sağlama yönteminin (endotrakeal entübasyon/laringeal maske) veküronyum tüketim hızına olan etkilerini araştırmak için 2 ayrı alt gruba ayrılmıştır. Veküronyum tüketim hızı µg kg-1 dk-1 olacak şekilde hesaplanıp, gruplar arasında veküronyum tüketimi açısından farklılık olup olmadığı istatistiksel olarak karşılaştırılmıştır. Sonuç olarak: veküronyum tüketim hızı sinir kas kavşak monitörizasyonu uygulanan hastalarda kullanılmayanlara oranla belirgin olarak yüksek bulunmuştur (1.38±0.18 / 1.09±0.23 µg kg-1 dk-1) (p<0.05). Alt gruplar karşılaştırıldığında veküronyum tüketim hızları arasında istatistiksel fark saptanamamıştır (p<0.05). Periferik sinir stimülasyonu uygulamasının mutlak kas gevşekliği gerektirmeyen durumlarda, veküronyum tüketim hızını artırabileceği kanısına vardık.
The Role of Neuromuscular Monitorisation in the Use of Muscle Relaxants In this study; our goal was to find out if there was any difference in consumption of vecuronium bromide depending on whether a peripheral nerve stimulation was used or not. Anesthesia reports of 251 patients, ASA physical status I-II, 20-60 yr old, who were underwent peripheral elective surgery, vecuronium bromide used for muscle relaxation, isoflurane or sevoflurane used as an inhalational anesthetic, and endotracheal intubation or laryngeal mask used for airway providing method were analysed retrospectively. Patients were divided into 2 main groups: Group I (n=104); peripheral nerve stimulation used, Group II (n=147); peripheral nerve stimulation not used. Both groups were also divided into 2 subgroups to research the effect of inhalational anesthetics (isoflurane and sevoflurane) and airway providing methods (endotracheal intubation and laringeal mask airway) on vecuronium bromide consumption. Consumption rate of vecuronium bromide was calculated as µg kg-1 dk-1 min and, both groups and subgroups were compared according to the consumption of vecuronium bromide statistically. As a result; vecuronium bromide consumption rate was found significantly higher when peripheral nerve stimulation used (1.38±0.18 µg kg-1 min-1) compared to not used (1.09±0.23 µg kg-1 min-1) (p<0.05). There was no significant differance in vecuronium consuption rate between subgroups (p<0.05). We concluded that usage of a peripheral nerve stimulation might increase vecuronium consumption rate when absolute muscle relaxation is not required.
The Role of Neuromuscular Monitorisation in the Use of Muscle Relaxants In this study; our goal was to find out if there was any difference in consumption of vecuronium bromide depending on whether a peripheral nerve stimulation was used or not. Anesthesia reports of 251 patients, ASA physical status I-II, 20-60 yr old, who were underwent peripheral elective surgery, vecuronium bromide used for muscle relaxation, isoflurane or sevoflurane used as an inhalational anesthetic, and endotracheal intubation or laryngeal mask used for airway providing method were analysed retrospectively. Patients were divided into 2 main groups: Group I (n=104); peripheral nerve stimulation used, Group II (n=147); peripheral nerve stimulation not used. Both groups were also divided into 2 subgroups to research the effect of inhalational anesthetics (isoflurane and sevoflurane) and airway providing methods (endotracheal intubation and laringeal mask airway) on vecuronium bromide consumption. Consumption rate of vecuronium bromide was calculated as µg kg-1 dk-1 min and, both groups and subgroups were compared according to the consumption of vecuronium bromide statistically. As a result; vecuronium bromide consumption rate was found significantly higher when peripheral nerve stimulation used (1.38±0.18 µg kg-1 min-1) compared to not used (1.09±0.23 µg kg-1 min-1) (p<0.05). There was no significant differance in vecuronium consuption rate between subgroups (p<0.05). We concluded that usage of a peripheral nerve stimulation might increase vecuronium consumption rate when absolute muscle relaxation is not required.