Yıl: 2021 Cilt: 29 Sayı: 2 Sayfa Aralığı: 132 - 139 Metin Dili: Türkçe DOI: 10.5222/jarss.2021.53825 İndeks Tarihi: 10-01-2022

Granisetronun Spinal Anestezi Kaynaklı Hipotansiyona Etkisi

Öz:
Amaç: Bulantı kusma profilaksisi için kullanılan intravenöz granisetronun spinal anestezi kaynak- lı hipotansiyon ve bradikardi üzerine etkisinin değerlendirilmesi amaçlandı. Yöntem: Spinal anestezi altında elektif opere edilen, ASA 1-2 sınıfında olan 120 hasta rastgele olarak Grup G (Granisetron; n=60) ve Grup P (Plasebo; n=60) gruplarına ayrıldı. Spinal anestezi- den 5 dk önce, G grubuna 10 mL %0.9 serum fizyolojikle seyreltilmiş 1 mg intravenöz granisetron ve P grubuna ise 10 mL intravenöz %0.9 serum fizyolojik uygulandı. İki gruptaki tüm hastalara 15 mg hiperbarik bupivakain %0.5 ile L4-5 seviyesinden spinal anestezi yapıldı. Motor blok derecesi ve seviyesi, sensoryal blok seviyesi ve hemodinamik veriler, anesteziden önce bir kez ve sonra ise 20 dk boyunca her 5 dk’da bir kaydedildi. Bulgular: Her iki grubun demografik verilerinde anlamlı fark yoktu. İlk değerlere göre hemodina- mik verilerde her iki grupta da düşme görülse de G grubunda sistolik, diastolik ve ortalama kan basıncı ölçümleri istatistiksel olarak anlamlı derecede daha yüksekti. Kalp atım hızında anlamlı fark gözlenmedi. Sonuç: İntravenöz olarak uygulanan granisetron spinal anestezi sonrası gelişen hipotansiyonu azaltır, ancak kalp atım hızı üzerine belirgin etkisi yoktur.
Anahtar Kelime:

Effects of Granisetron on Spinal Anesthesia-Induced Hypotension

Öz:
Objective: It was aimed to evaluate the effect of intravenous (IV) granisetron used for nausea and vomiting prophylaxis on hypotension and bradycardia caused by spinal anesthesia. Methods: 120 ASA 1-2 patients undergoing elective surgery under spinal anesthesia were randomly divided into Group G (Ganisetron; n=60) and Group P (Placebo; n=60) groups. Five minutes before spinal anesthesia, Group G received 1 mg intravenous granisetron diluted in 10 mL of isotonic sodium chloride solution and Group P received 10 mL of isotonic sodium chloride solution. Spinal anesthesia with hyperbaric bupivacaine 0.5%, 15 mg at the level of L4-5 was applied for both groups. Hemodynamic data, sensory and motor block parameters were recorded before and after spinal anaesthesia every 5 minutes during 20 minutes of surgery. Results: There was no difference in the demographic data of both groups. Although hemodynamic data showed a decrease in both groups according to initial values, blood pressure measurements in group G were significantly higher than the first measure values. There was no significant difference in heart rate values between the groups. Conclusion: Intravenous granisetron reduces hypotension after spinal anesthesia, but it has no significant effect on heart rate.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Campagna JA, Carter C. Clinical relevance of the Bezold-Jarisch reflex. Anesthesiology. 2003;98:1250- 60. https://doi.org/10.1097/00000542-200305000-00030
  • 2. Tuncer Uzun S, Reisli R, Santral Sinir Blokları, Güldoğuş F, Gürkan Y, Rejyonal Anestezi. İstanbul, NobelTıp Kitabevleri, 2013;93-120.
  • 3. Liu SS, McDonald SB. Current issues in spinal anesthe- sia. Anesthesiology. 2001;94:888-906. https://doi.org/10.1097/00000542-200105000-00030
  • 4. Carpenter RL, Caplan RA, Brown DL, Stephenson C, Wu R. Incidence and risk factors for side effects of spinal anesthesia. Anesthesiology. 1992;76:906-16. https://doi.org/10.1097/00000542-199206000-00006
  • 5. Morgan GE, Mikhail MS, Butterworth JF, Mackey DC, Wasnick JD. Klinik Anesteziyoloji (LANGE), Beşinci Baskı, Ankara, Güneş Kitabevi. 2015. s.937-75.
  • 6. Kayhan Z. Klinik Anestezi, Santral Bloklar Spinal ve Epidural Anestezi. İstanbul: Logos Yayıncılık 2004: 570- 86.
  • 7. Martinek RM. Witnessed asystole during spinal anest- hesia treated with atropine and ondansetron: a case report. Can J Anesthesia. 2004;51:226-30. https://doi.org/10.1007/BF03019100
  • 8. Veelken R, Sawin LL, DiBona GF. Epicardial serotonin receptors in circulatory control in conscious Sprague- Dawley rats. Am J Physiol. 1990;258:H466-H72. https://doi.org/10.1152/ajpheart.1990.258.2.H466
  • 9. Veelken R, Hilgers KF, Leonard M, et al. A highly selec- tive cardiorenal serotonergic 5-HT3-mediated reflex in rats. Am J Physiol. 1993;264:H1871-H7. https://doi.org/10.1152/ajpheart.1993.264.6.H1871
  • 10. White CM, Chow MS, Fan C, Kluger J, Bazunga M. Efficacy of Intravenous Granisetron in Suppressing the Bradycardia and Hypotension Associated with a Rabbit Model of the Bezold-Jarisch Reflex. J Clin Pharmacol. 1998;38:172-7. https://doi.org/10.1002/j.1552-4604.1998.tb04407
  • 11. Owczuk R, Wenski W, Polak-Krzeminska A, Twardowski P, Arszulowicz R, Dylczyk-Sommer A, et al. Ondansetron given intravenously attenuates arterial blood pressure drop due to spinal anesthesia: adouble-blind, placebo- controlledstudy. Reg Anesth Pain Med. 2008;33:332-9.
  • 12. Kelsaka E, Baris S, Karakaya D, Sarihasan B. Comparison of ondansetron and meperidine for prevention of shi- vering in patients undergoing spinal anesthesia. Reg Anesth Pain Med. 2006;31:40-5. https://doi.org/10.1016/j.rapm.2005.10.010
  • 13. Sahoo T, SenDasgupta C, Goswami A, Hazra A. Reduction in spinal-induced hypotension with ondan- setron in parturients undergoing caesarean section: a double-blind randomised, placebo-controlled study. Int J Obstet Anesth. 2012;21:24-8. https://doi.org/10.1016/j.ijoa.2011.08.002
  • 14. Hartmann B, Junger A, Klasen J, et al. The incidence and risk factors for hypotension after spinal anesthesia induction: an analysis with automated data collection. Anesth Analg. 2002;94:1521-9. https://doi.org/10.1213/00000539-200206000-00027
  • 15. Critchley L, Stuart J, Short T, Gin T. Haemodynamic effects of subarachnoid block in elderly patients. Br J Anaesth. 1994;73:464-70. https://doi.org/10.1093/bja/73.4.464
  • 16. Gyermek L. Pharmacology of serotonin as related to anesthesia. J Clin Anesth. 1996;8:402-25. https://doi.org/10.1016/0952-8180(96)00093-1
  • 17. Villalón CM, Centurión D. Cardiovascular responses produced by 5-hydroxytriptamine: a pharmacological update on the receptors/mechanisms involved and therapeutic implications. Naunyn-Schmiedebergs Archs Pharmacol. 2007;376:45-63. https://doi.org/10.1007/s00210-007-0179-1
  • 18. Mao HZ, Li Z, Chapleau MW. Platelet activation in caro- tid sinuses triggers reflex sympathoinhibition and hypotension. Hypertension. 1996;27:584-90. https://doi.org/10.1161/01.HYP.27.3.584
  • 19. Schadt JC, Ludbrook J. Hemodynamic and neurohumo- ral responses to acute hypovolemia in conscious mam- mals. Am J Physiol. 1991;260:H305-18. https://doi.org/10.1152/ajpheart.1991.260.2.H305
  • 20. Zucker IH, Cornish KG. Reflex cardiovascular and respi- ratory effects of serotonin in conscious and anestheti- zed dogs. Circ Res. 1980;47:509-15. https://doi.org/10.1161/01.RES.47.4.509
  • 21. Saxena PR, Mylecharane EJ, Heiligers J. Analysis of the heart rate effects of 5-hydroxytryptamine in the cat; mediation of tachycardia by 5-HT1-like receptors. Naunyn Schmiedebergs Arch Pharmacol. 1985;330:121-9. https://doi.org/10.1007/BF00499904
  • 22. Tsikouris JP, Kluger J, Chow MS, White CM. Usefulness of intravenous granisetron for prevention of neurally mediated hypotension upon head upright tilt testing. Am J Cardiol. 2000;85:1262-4. https://doi.org/10.1016/S0002-9149(00)00743-8
  • 23. Chatterjee A, Gudiwada B, Mahanty PR, et al. Effectiveness of Granisetron in Prevention of Hypotension Following Spinal Anaesthesia in Patients Undergoing Elective Caesarean Section. Cureus. 2020;12:e12113. Published. 2020 Dec 16. https://doi.org/10.7759/cureus.12113
  • 24. Rout C, Akoojee S, Rocke D, Gouws E. Rapid administ- ration of crystalloid preload does not decrease the incidence of hypotension after spinal anaesthesia for elective caesarean section. Br J Anaesth. 1992;68:394-7. https://doi.org/10.1093/bja/68.4.394
  • 25. Bhagwanjee S, Rocke D, Rout C, Koovarjee R, Brijball R. Prevention of hypotension following spinal anaesthe- sia for elective caesarean section by wrapping of the legs. Br J Anaesth. 1990;65:819-22. https://doi.org/10.1093/bja/65.6.819
  • 26. Somboonviboon W, Kyokong O, Charuluxananan S, Narasethakamol A. Incidence and risk factors of hypo- tension and bradycardia after spinal anesthesia for cesarean section. J Med Assoc Thai. 2008;91:181.
  • 27. Çelikyürek D. Spinal Anesteziye Bağlı Gelişen Hipotansiyonun Önlenmesinde Kristaloid, Kolloid ve Kristaloid+Kolloid Önyüklemesinin Karşılaştırılması. Uzmanlık Tezi. İstanbul - 2007.
  • 28. Tarkkıla PJ, Kaukınen S. Complications during spinal anesthesia: a prospective study. Reg Anesth. 1991;16:101-6.
  • 29. Kyokong O, Charuluxananan S, Sriprajittichai P, Poomseetong T, Naksin P. The incidence and risk fac- tors of hypotension and bradycardia associated with spinal anesthesia. J Med Assoc Thai. 2006;89:58-64.
  • 30. Manal MR, Manal S. Farmavy.effects of intravenous ondansetron and granisetron on hemodynamic chan- ges and motor and sensory blockade induced by spinal anesthesia in parturients undergoing cesarean section. Egyptian Journal of Anaesthesia. 2013;29:369-74. https://doi.org/10.1016/j.egja.2013.04.00
APA çataroğlu C, alptekin a, Gezer A, Sayin M, Donmez A (2021). Granisetronun Spinal Anestezi Kaynaklı Hipotansiyona Etkisi. , 132 - 139. 10.5222/jarss.2021.53825
Chicago çataroğlu Cem koray,alptekin alp,Gezer Aysel,Sayin Murat,Donmez Asli Granisetronun Spinal Anestezi Kaynaklı Hipotansiyona Etkisi. (2021): 132 - 139. 10.5222/jarss.2021.53825
MLA çataroğlu Cem koray,alptekin alp,Gezer Aysel,Sayin Murat,Donmez Asli Granisetronun Spinal Anestezi Kaynaklı Hipotansiyona Etkisi. , 2021, ss.132 - 139. 10.5222/jarss.2021.53825
AMA çataroğlu C,alptekin a,Gezer A,Sayin M,Donmez A Granisetronun Spinal Anestezi Kaynaklı Hipotansiyona Etkisi. . 2021; 132 - 139. 10.5222/jarss.2021.53825
Vancouver çataroğlu C,alptekin a,Gezer A,Sayin M,Donmez A Granisetronun Spinal Anestezi Kaynaklı Hipotansiyona Etkisi. . 2021; 132 - 139. 10.5222/jarss.2021.53825
IEEE çataroğlu C,alptekin a,Gezer A,Sayin M,Donmez A "Granisetronun Spinal Anestezi Kaynaklı Hipotansiyona Etkisi." , ss.132 - 139, 2021. 10.5222/jarss.2021.53825
ISNAD çataroğlu, Cem koray vd. "Granisetronun Spinal Anestezi Kaynaklı Hipotansiyona Etkisi". (2021), 132-139. https://doi.org/10.5222/jarss.2021.53825
APA çataroğlu C, alptekin a, Gezer A, Sayin M, Donmez A (2021). Granisetronun Spinal Anestezi Kaynaklı Hipotansiyona Etkisi. Anestezi Dergisi, 29(2), 132 - 139. 10.5222/jarss.2021.53825
Chicago çataroğlu Cem koray,alptekin alp,Gezer Aysel,Sayin Murat,Donmez Asli Granisetronun Spinal Anestezi Kaynaklı Hipotansiyona Etkisi. Anestezi Dergisi 29, no.2 (2021): 132 - 139. 10.5222/jarss.2021.53825
MLA çataroğlu Cem koray,alptekin alp,Gezer Aysel,Sayin Murat,Donmez Asli Granisetronun Spinal Anestezi Kaynaklı Hipotansiyona Etkisi. Anestezi Dergisi, vol.29, no.2, 2021, ss.132 - 139. 10.5222/jarss.2021.53825
AMA çataroğlu C,alptekin a,Gezer A,Sayin M,Donmez A Granisetronun Spinal Anestezi Kaynaklı Hipotansiyona Etkisi. Anestezi Dergisi. 2021; 29(2): 132 - 139. 10.5222/jarss.2021.53825
Vancouver çataroğlu C,alptekin a,Gezer A,Sayin M,Donmez A Granisetronun Spinal Anestezi Kaynaklı Hipotansiyona Etkisi. Anestezi Dergisi. 2021; 29(2): 132 - 139. 10.5222/jarss.2021.53825
IEEE çataroğlu C,alptekin a,Gezer A,Sayin M,Donmez A "Granisetronun Spinal Anestezi Kaynaklı Hipotansiyona Etkisi." Anestezi Dergisi, 29, ss.132 - 139, 2021. 10.5222/jarss.2021.53825
ISNAD çataroğlu, Cem koray vd. "Granisetronun Spinal Anestezi Kaynaklı Hipotansiyona Etkisi". Anestezi Dergisi 29/2 (2021), 132-139. https://doi.org/10.5222/jarss.2021.53825