Laparoskopik kolesistektomi operasyonlarında uygulanan genel anestezi ile torakal epidural anestezinin stress hormonları üzerine etkisinin karşılaştırılması
Küçük Resim Yok
Tarih
2016
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Bolu Abant İzzet Baysal Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Çalışmamızda laparoskopik kolesistektomi operasyonu olan hastalarda anestezi yöntemi olarak uygulanan genel anestezi ve torakal epidural anestezinin stres yanıta olan etkilerini karşılaştırmayı amaçladık. Etik kurul ve hastaların yazılı onayı alındıktan sonra laparoskopik kolesistektomi operasyonu olacak, 18-75 yaş aralığındaki, ASA I-II riskindeki 40 hasta çalışmaya dahil edildi. Hastalar Grup G ( Genel Anestezi Grubu) ve Grup E ( Epidural Anestezi Grubu ) olmak üzere rastgele 2 gruba ayrıldı. Grug G'de bulunan hastalara standart genel anestezi uygulandı. Grup E'de bulunan hastalara ise T7-8 intervertebral aralığından torakal epidural anestezi uygulanarak intraoperatif propofol infüzyonu verildi. Uygulanan anestezi yöntemlerinin stres yanıta olan etkilerini karşılaştırmak amacıyla çalışmaya dahil edilen hastalardan preoperatif, insizyon sonrası 30. dakikada ve postoperatif 30. dakikada ACTH, kortizol ve adrenalin plazma düzeyleri çalışmak amacıyla kan örnekleri alındı. Çalışmamızda gruplar arasında demografik ve anestezi verileri istatistiksel olarak anlamlı bir farklılık yoktu.ACTH, kortizol ve adrenalin seviyeleri her iki grupta da preoperatif değere göre intraoperatif ve postoperatif değerleri istatistiksel olarak anlamlı yüksek bulundu (p<0,05). ACTH ve adrenalin seviyeleri Grup E'de Grup G'ye göre intraoperatif ve postoperatif değerleri istatistiksel olarak anlamlı düşük bulundu (p<0,05). Kortizol seviyesinin ise her iki grupta preoperatif, intraoperatif ve postoperatif istatistiksel olarak anlamlı fark göstermediği saptandı (p>0,05).Sonuç olarak laparoskopik kolesistektomi operasyonu geçiren hastalarda torakal epidural anestezinin genel anesteziye göre stres yanıtı daha iyi baskıladığı düşüncesindeyiz. Anahtar Kelimeler: Laparoskopik Kolesistektomi, Torakal Epidural Anestezi, Stres Yanıt
At this study we aimed to compare the effects of general anesthesia and thoracic epidural anesthesia on stress response in patients with laparoscopic cholecystectomy surgery. Following approval from the local ethics committee and written informed consent for study participation was obtained, 40 patients ,aged between 18 and 75 years, ASA status of I-II and going on laparoscopic cholecystectomy surgery, were included in the study. Patients were randomly divided into 2 groups as Group G ( General Anesthesia Group) and Group E ( Epidural Anesthesia Group). Patients in Group G received standard general anesthesia. Patients in Group E received thoracic epidural anesthesia that applied at Th 7-8 space and propofol infusion. To compare effects of anesthesia methods on stress response, blood samples were taken at preoperative, 30 minutes after incision and after 30 minutes last suture at postoperative period for the assesment plasma ACTH, cortisol and adrenaline levels. There was no statistically significant difference in demographic and anesthesia data between groups. Intraoperative and postoperative ACTH, cortisol and adrenaline levels was statistically significant higher compared with preoperative levels in both groups (p<0,05). Intraoperative and postoperative ACTH and adrenaline levels were significantly lower in the Group E (p<0,05). There were no statistically significant difference in intraoperative and postoperative cortisol levels between groups (p>0,05). In conclusion, we conclude that thoracic epidural anesthesia may reduce stress response compared with general anesthesia in laparoscopic cholecystectomy. Keywords: Laparoscopic Cholecystectomy, Thoracic Epidural Anesthesia, Stress Response
At this study we aimed to compare the effects of general anesthesia and thoracic epidural anesthesia on stress response in patients with laparoscopic cholecystectomy surgery. Following approval from the local ethics committee and written informed consent for study participation was obtained, 40 patients ,aged between 18 and 75 years, ASA status of I-II and going on laparoscopic cholecystectomy surgery, were included in the study. Patients were randomly divided into 2 groups as Group G ( General Anesthesia Group) and Group E ( Epidural Anesthesia Group). Patients in Group G received standard general anesthesia. Patients in Group E received thoracic epidural anesthesia that applied at Th 7-8 space and propofol infusion. To compare effects of anesthesia methods on stress response, blood samples were taken at preoperative, 30 minutes after incision and after 30 minutes last suture at postoperative period for the assesment plasma ACTH, cortisol and adrenaline levels. There was no statistically significant difference in demographic and anesthesia data between groups. Intraoperative and postoperative ACTH, cortisol and adrenaline levels was statistically significant higher compared with preoperative levels in both groups (p<0,05). Intraoperative and postoperative ACTH and adrenaline levels were significantly lower in the Group E (p<0,05). There were no statistically significant difference in intraoperative and postoperative cortisol levels between groups (p>0,05). In conclusion, we conclude that thoracic epidural anesthesia may reduce stress response compared with general anesthesia in laparoscopic cholecystectomy. Keywords: Laparoscopic Cholecystectomy, Thoracic Epidural Anesthesia, Stress Response
Açıklama
Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Ana Bilim Dalı
Anahtar Kelimeler
Anestezi ve Reanimasyon, Anesthesiology and Reanimation
