Comparision of different sedative protocols for patients undergoing carotid surgery Karotis Endarterektomisi Operasyonlarmda Farkli Sedasyon Protokollerinin Karşilaştirilmasi

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Karadeniz M. S., Aksoy Ö., SİVRİKOZ N., Demircan F., Sayin Ö., SUNGUR Z., ...Daha Fazla

Gogus-Kalp-Damar Anestezi ve Yogun Bakim Dernegi Dergisi, cilt.22, sa.4, ss.138-144, 2016 (Scopus)

Özet

Objective: Regional anesthesia in carotid endarterectomy (CKA) is the preferred approach becausc of it provides realtime neurological monitorization. We aimed to compare the effects of sedation we achieved with different sedative agents on hemodynamic parameters and anesthesia related complications CEA under cervical plexus block (CPU). Material and Methods: After ethical committee approval, patients undergoing CKA under CPH i the operating room of Cardiovascular Surgery between January 2011 and December 2014 were included in this retrospective clinical study. Subsequent to midazolam premedication (0.01-0.03 mglkg/hr), all subjects underwent CPU. All through the operation, depth of sedation was adjusted as Ramsay scule II or III. Group I was under dexmedetomidine sedation with an infusion rate of 0.4-0.7 pgfkg/h; whereas Group II had a bolus of 1-2 pgikg fentanyl subsequent to initial midazolam dose and additional doses if required. Group III received an infusion of remifenta- nil of 1.5-3 pg/kgfh. Hemodynamic parametres were retrieved from patients' medical files. Complications (hemodynamic, respiratory or neurological), cross-clamp time, shunt requirement were all recorded. Results: We enrolled 80 patients in this study with 33 (41%) in GI, 35 (44%) in GU and 12 (15%) in GIII. Any intergroup difference was not seen as for demographic, and operative characteristics of the patients. Any statistically significant intra-, and intergroup changes in systolic blood pressures were not found at all time points (p >0.05). Statistically significantly intergroup changes at all timepoints, and tntragroup changes with time were not detected in heart rates (p >0.05). Hemodynamic complications or interventions were not statistically significantly different between groups. Hypotension was seen in 4 patients in GI, 2 in Gll and 1 in GIII. Bradycardia was present in 4 patients in GI, 2 in Gil whereas hypertension was noted in only 1 patient in Gil. Conclusion: During CEA operations performed under regional anesthesia, dexmedetomidine, midazolam+fentanyl or remi- fentanyl provide safe sedation with similar minimal hemodynamic side effects without affecting patients∗ cooperation.