Effects of propofol, desflurane and isoflurane on perioperative blood glucose level in intracranial mass operation
İntrakranial kitle operasyonu geçirecek hastalarda propofol, desfluran ve isofluranın perioperatif kan glukoz düzeyine etkileri
Keywords:
Blood glucose level, Brain neoplasms, Intravenous anethesiaAbstract
The aim of this study is to compare the effects of the propofol, desflurane and isoflurane on blood glucose levels in cranial surgery.
Ninety, ASA I-II patients aged between 18-60 years old were scheduled for study. Induction was performed with fentanyl, propofol and cisatracurium in all patients. Anaesthesia was maintained using propofol 4-6 mg/kg/h in propofol group (Group P), desflurane and isoflurane 0.5-1 MAC in group desflurane (Group D) and group isoflurane (Group I). Remifentanil infusion was applied 0.5 µg/kg/min in all groups. Plasma glucose (PG) levels, systolic arterial pressure (SAP), diastolic arterial pressure, mean arterial pressure and heart rate measured.
In the 1st, 2nd and 5th hour, PG levels were significantly lower in group P than group D. In the 2nd and 3rd hour, PG levels were significantly lower in group P than group I (p <0.05). In addition, SAP values in group D were found to be significantly lower than group P and group I.
With this study, it was concluded that total intravenous anesthesia with propofol infusion in intracranial mass surgery is more effective than inhalation anesthesia such as desflurane and isoflurane in preventing the hyperglycemic response caused by surgical stress.
ÖZET
Bu çalışmanın amacı intrakranial tümör cerrahisinde propofol, isofluran ve desfluranın kan şekeri düzeylerine etkilerini karşılaştırmaktır.
Bu çalışmaya yaşları 18-60 arasında 90 hasta dahil edildi. İndüksiyon tüm hastalarda fentanil, propofol ve cis-atracurium, ile uygulandı. Anestezi idamesi isofluran grubunda (Grup İ) 0.5-1 MAC konsantrasyonda isofluran, desfluran grubunda (Grup D) 6-8 MAC konsantrasyonda desfluran ve propofol grubunda (Grup P) 4-6 mg/kg propofol ile sağlandı. Tüm hastalara 0.5 µgr /kg/dk remifentanil infuzyonu uygulandı. Tüm hastaların kan şekeri düzeyleri, sistolik (SAB), diyastolik (DAB) ve ortalama (OAB) arter basınçları ve kalp atım hızları kaydedildi.
Kan şekeri düzeyleri karşılaştırıldığında grup P'nin değerleri grup D'ye göre operasyonun 1, 2, 3. ve 5. saatinde anlamlı derecede düşük bulundu. Operasyonun 2. ve 3.saatinde grup P'de grup I'ye göre anlamlı derecede düşük bulundu (p <0.05). Ayrıca grup D?de SAB değerleri grup P ve grup I?ye göre anlamlı derecede düşük bulundu.
Bu çalışma ile intrakraniyal kitle ameliyatlarında propofol infüzyonu ile yapılan total intravenöz anestezinin, cerrahi stresin neden olduğu hiperglisemik yanıtı önlemede desfluran ve izofluran gibi inhalasyon anestezisine göre daha etkili olduğu sonucuna varıldı.
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