Turkiye Klinikleri Journal of Anesthesiology Reanimation

.: ORIGINAL RESEARCH
Comparing Effects of Midazolam and Dexmedetomidine Sedation on Ultrasound Guided Infraclavicular Nerve Block for Upper Extremity Orthopedic Surgeries
Ultrasonografi Kılavuzluğunda İnfraklaviküler Blok ile Üst Ekstremite Ortopedi Cerrahisi Geçiren Hastalarda Midazolam ve Deksmedetomidin ile Sedasyonun Periferik Sinir Bloğu Üzerine Etkilerinin Karşılaştırılması
Fatih ÇİFTÇİa, Yasemin ALTANb
aClinic of Anesthesiology and Reanimation, Mehmet Akif İnan Training and Research Hospital, Şanlıurfa, TURKEY
bClinic of Anesthesiology and Reanimation, University of Health Sciences Kanuni Sultan Süleyman Training and Research Hospital, İstanbul, TURKEY
Turkiye Klinikleri J Anest Reanim. 2019;17(1):8-15
doi: 10.5336/anesthe.2019-64922
Article Language: EN
Full Text
ABSTRACT
 Objective: Sedation is an important step of regional anesthesia, the effects of sedative agents on nerve block characteristics are often subjects of scientific researches. In our study, we aimed to compare the effects of dexmedetomidine and midazolam sedation on sensory and motor onset and termination time after infraclavicular nerve block. Material and Methods: After local ethics committee approval and patients written informed consents were obtained, 60 patients between the ages of 18-65 years, with an American Society of Anesthesiologists (ASA) classification I-II who received infraclavicular nerve block randomized into two groups. Group D received 0.8 μg/kg bolus continued with 0.2-0.7 μg/kg/h of maintenance dose of dexmedetomidine group M received 0.05mg/kg bolus continued with 0.02-0.2 mg/kg/h of maintenance dose of midazolam. The patient's demographic data heart rate pulse, mean arterial pressure, sensory and motor block onset and termination time were analyzed. Results: Heart rate and mean arterial pressure were lower in dexmedetomidine group. Sensory (Group D: 8.6±2.4 Group M: 16.2±1.8) and motor block onset time (Group D: 14.2±1.6, Group M: 21.4±2.3) was shorter in dexmedetomidine group. Sensory (Group D: 715.4±41.1 min Group M: 518.1±44.2 min) and motor block termination time (Group D: 613.6±38.1 min Group M: 421.3±37.2 min) were longer in dexmedetomidine group. Conclusion: The use of dexmedetomidine for sedation on patients who received ultrasound-guided infraclavicular block for upper extremity surgeries resulted earlier onset time to sensory and motor block and prolonged sensory and motor block termination time.

Keywords: Dexmedetomidine; midazolam; infraclavicular nerve block
ÖZET
 Amaç: Rejyonel anestezinin önemli bir basamağı olan sedasyon amacıyla kullanılan sedatif ajanların sinir bloğu karakteristiğine etkileri sıklıkla bilimsel araştırmalara konu olmaktadır. Çalışmamızda, deksmedetomidin ve midazolam ile sedasyonun infraklaviküler sinir bloğu başlama ve sonlanma zamanına etkilerini karşılaştırmayı amaçladık. Gereç ve Yöntemler: Yerel etik kurul onayı ve yazılı bilgilendirilmiş onam formu alındıktan sonra, 18-65 yaş aralığında, Amerikan Anesteziyologlar Birliği (ASA) I-II grubu İnfraklaviküler blok yapılacak 60 hasta randomize edilerek iki gruba ayrıldı. Grup D'ye sedasyon amacıyla 0,8 μg/kg deksmedetomidin bolus sonrasında 0,2-0,7 μg/kg/saat idame tedavi verildi, Grup M'ye 0,05 mg/kg midazolam bolus sonrasında 0,02-0,2 mg/kg/saat idame tedavi verildi. Hastaların demografik verileri, kalp tepe atımı, ortalama arteriyel basınç, duyusal ve motor blok başlama ve sonlanma zamanı analiz edildi. Bulgular: Grupların demografik verileri benzerdir, kalp tepe atımı ve ortalama arteriyel basınç deksmedetomidin grubunda daha düşük bulundu. Duyusal (Grup D: 8,6±2,4 dk, Grup M: 16,2±1,8 dk) ve motor blok başlama zamanı (Grup D: 14,2±1,6 dk, Grup M: 21,4±2,3 dk) Deksmedetomidin grubunda midazolam grubuna göre daha kısa, duyusal (Grup D: 715,4±41,1 dk, Grup M: 518,1±44,2 dk) ve motor blok sonlanma zamanı (Grup D: 613,6±38,1 dk, Grup M: 421,3±37,2 dk) ise daha uzun olarak bulundu. Sonuç: Ultrasonografi kılavuzluğunda infraklaviküler blok yapılmış hastalarda sedasyon amacıyla deksmedetomidin kullanılması midazolama kıyasla, blok başlama süresini kısaltıp, blok sonlanma süresini uzatmaktadır.

Anahtar Kelimeler: Deksmedetomidin; midazolam; infraklaviküler sinir bloğu
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