Majör abdominal cerrahi uygulanan yüksek riskli hastalarda total intravenöz anestezi ile kombine epidural analjezinin etkileri

Abstract

Objectives: The aim of this study is to investigate the effects of combined epidural analgesia with total intravenous anaesthe- sia and only total intravenous anaesthesia on the different clinical parameters. Methods: Sixty high risk patients undergoing a major abdominal surgical procedure were included in this prospective, dou- ble blind, randomized study. Induction of anaesthesia was performed with IV remifentanil 0.5µg/kg and propofol titrated toachieve bispectral index score between 40 and 50. after intubation; in Group E, 0.1% bupivacaine and 2 µg/mL fentanyl wereadministered by an infusion rate at 0.15 ml/kg/h via the epidural catheter and Group C received epidural normal saline as sameinfusion rate. Results: In group E, intraoperative MAP values were significantly lower than those in group C (p<0.05). Time of extubation,time of eye opening with audible warning and time of verbal response was significantly lower in group E than those in groupC. Total anaesthetic drug consumption was significantly higher in group C than those in group E (p<0.05). Conclusion: Based on lower requirements for propofol and remifentanil as well as the favourable effects on clinical param- eters; we conclude that bispectral index score guided combined epidural with total intravenous anaesthesia is superior tosolely total intravenous anaesthesia in this type of surgery.