Türk Nöroşirürji Dergisi 2003 , Vol 13 , Num 3
Yasemin GÜNEŞ1, Hakkı ÜNLÜGENÇ1, Murat GÜNDÜZ1, Tahsin ERMAN2, Hayri ÖZBEK1, Geylan IŞIK1
1Çukurova Üniversitesi Tıp Fakültesi Anesteziyoloji Anabilim Dalı
2Çukurova Üniversitesi Tıp Fakültesi Nöroşirürji Anabilim Dalı
Aim: Intravenous anesthesia had been used in wide variations of anesthesia practice because it provides hemodynamic stabilization and early recovery. In the present study, we aimed to evaluate the effects of propofol plus alfentanil and propofol plus alfentanil plus ketamine combinations on intraoperative hemodynamic variations, postoperative recovery and analgesia.

Methods: Thirty patients aged between 27 to 65 undergoing laminectomy by neurosurgery were included in the study. Following the monitorization, anesthesia was indueted by propofol(2- 3 mg/kg). Neuromuscular blockade was achieved by vecuronium bromide(O.l mg/kg),and then anesthesia was maintained by propofol(4-6 mg/kg/h) plus alfentanil (1 g/kg/min) in group I, and propofol (2-3 mg/kg/h) plus alfentanil (0.5 g/kg/min) plus ketamine (0.5 mg/kg/h) in group II. Hemodynamic variations( preoperatively, minutes after endotracheal intubation) and durations of the awakening and extubation, visual analogue scale (VAS) and side effects were recorded.

Results: There were no statistical significant differences recording demographic characteristic and hemodynamic variations between the groups(p>0.05). Durations of the extubation and awakening were higher in Group II (p<0.05). VAS values were lower in Group II at postoperatively 5 and 15. min (p<0.05).

Conclucion: We concluded that ketamine when added the propofol plus alfentanil used as intravenous anesthesia, provided hemodynamic stability and effective early postoperative analgesia, however it also prolonged durations of awakening and extubation. Anahtar Kelimeler : Ketamine, postoperative pain, propofol-alfentanil, recovery