Title
Komparativna analiza niske doze bupivakaina u kombinaciji sa različitim dozama fentanila na spinalni blok kod bolesnika tokom ugradnje veštačkog kuka
Creator
Jović, Marija, 1980-
CONOR:
54719241
Copyright date
2023
Object Links
Language
Serbian
Cobiss-ID
Theses Type
Doktorska disertacija
description
Datum odbrane: 09.10.2023.
Other responsibilities
Academic Expertise
Medicinske nauke
University
Univerzitet u Nišu
Faculty
Medicinski fakultet
Alternative title
Comparative analysis of effects of three different doses of fentanyl and standard dose of bupivacaine on a spinal block in patients with hip endoprothesis surgery
Publisher
[M. M. Jović]
Format
169 lista
description
Biografija autora: list [169].
Bibliografija: listovi 155-168.
description
Anesthesiology, reanimatology and intensive care
Abstract (en)
Introduction: Spinal anaesthesia is often used for hip endoprothesis surgery. Significant surgical stress response consisting of hormonal, metabolic and inflamatory changes can be initiated by the hip replacement surgery. Intratecal opioids, as adjuvants to local anesthetics, make spinal block sufficient even with lower doses of the local anesthetics, and the incidence of the side effects reduce to minimum.
Materials and Methods: This study included 162 patients of either sex, ASA 1-2, scheduled for total hip arthroplasty. The patients had spinal anaesthesia with 10mg of 0.5% bupivacaine with 20µg (Group I), or 25µg (Group II) or 30µg fentanyl intrathecally (Group III).
Result: Mean time to achieve maximum motor and sensory blockade was with no significant difference among the groups. Time of motor block duration was shorter in Group III. Four hours after the operation, patients in the Group II had significantly higher cortisol serum levels. Blood glucose levels were with no significant difference among the groups. Levels of CRP increased remarkably postoperatively in the Group I. Incidence of hypotension, bradycardia, nausea and vomiting was significantly higher in the Group III. Pruritus and shivering were not recorded among the groups. The first time an analgesic was needed postoperatively was the longest in Group III.
Conclusion: The dose of 10mg of bupivacaine combined with 25µg fentanyl was the optimal option to achive haemodynamic stability, sufficient sensory and motor blockade, and reduce the stress response incidence of the opioids side effects.
Authors Key words
spinalna anestezija, bupivakain, fentanil, postoperativna analgezija
Authors Key words
spinal anaesthesia, bupivacaine, fentanyl, postoperative analgesia
Classification
616-089.5:615.21(043.3)
Subject
B590
Type
Tekst
Abstract (en)
Introduction: Spinal anaesthesia is often used for hip endoprothesis surgery. Significant surgical stress response consisting of hormonal, metabolic and inflamatory changes can be initiated by the hip replacement surgery. Intratecal opioids, as adjuvants to local anesthetics, make spinal block sufficient even with lower doses of the local anesthetics, and the incidence of the side effects reduce to minimum.
Materials and Methods: This study included 162 patients of either sex, ASA 1-2, scheduled for total hip arthroplasty. The patients had spinal anaesthesia with 10mg of 0.5% bupivacaine with 20µg (Group I), or 25µg (Group II) or 30µg fentanyl intrathecally (Group III).
Result: Mean time to achieve maximum motor and sensory blockade was with no significant difference among the groups. Time of motor block duration was shorter in Group III. Four hours after the operation, patients in the Group II had significantly higher cortisol serum levels. Blood glucose levels were with no significant difference among the groups. Levels of CRP increased remarkably postoperatively in the Group I. Incidence of hypotension, bradycardia, nausea and vomiting was significantly higher in the Group III. Pruritus and shivering were not recorded among the groups. The first time an analgesic was needed postoperatively was the longest in Group III.
Conclusion: The dose of 10mg of bupivacaine combined with 25µg fentanyl was the optimal option to achive haemodynamic stability, sufficient sensory and motor blockade, and reduce the stress response incidence of the opioids side effects.
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