Turkiye Klinikleri Journal of Anesthesiology Reanimation

.: ORIGINAL RESEARCH
Retrospective Comparison of the Effects of Total Intravenous Anesthesia and Sevoflurane Anesthesia on the Clinical Duration of Action of Rocuronium in Diabetic and Non-Diabetic Patients: Retrospective Observational Study
Diyabetik ve Non-Diyabetik Hastalarda Total İntravenöz Anestezi ve Sevofluran Anestezisinin Rokuronyumun Klinik Etki Süresi Üzerine Olan Etkilerinin Retrospektif Olarak Karşılaştırılması: Retrospektif Gözlemsel Çalışma
Dostali ALİYEVa, Sacide DEMİRALPb, Tuğba MERTc
aClinic of Algology, TOBB ETU Hospital, Ankara, Türkiye
bDepartment of Anesthesiology and Reanimation, Ankara University Faculty of Medicine İbn-i Sina Hospital, Ankara, Türkiye
cDepartment of Nursing, Division of Management in Nursing, Ardahan University Faculty of Health Sciences, Ardahan, Türkiye
Turkiye Klinikleri J Anest Reanim. 2022;20(3):105-10
doi: 10.5336/anesthe.2022-92249
Article Language: EN
Full Text
ABSTRACT
 Objective: Due to the decrease in nerve conduction velocity, the clinical effect of rocuronium may be prolonged in diabetic patients receiving inhalation anesthesia, and its postoperative residual muscle relaxant effect may lead to complications. We compared the effects of total intravenous anesthesia and sevoflurane anesthesia on the clinical duration of action of rocuronium in diabetic and nondiabetic patients. Material and Methods: Patients between the ages of 18-65, who underwent general anesthesia for elective surgery in the general surgery department of our hospital (0.6 mg of rocuronium was used for tracheal intubation), with Type 2 diabetes and with the American Society of Anesthesiologists Physical Condition Classification (ASA) I-II were included in the study. Non-diabetic patients (ASA I-II) of the same age were included in the study as the control group. The duration of the clinical effect of rocuronium between the time of administration of the first dose of rocuronium and the time of administration of the additional rocuronium dose (time recorded in TOFcount 2-TOFc2) was evaluated. Results: The clinical duration of action of rocuronium was longer in both diabetic groups than in nondiabetic groups (p=0.000). When the diabetic patient groups were compared, the clinical duration of action of rocuronium was longer in the diabetic sevoflurane group than in the diabetic group that received total intravenous anesthesia (p=0.012). Conclusion: It was determined that the duration of rocuronium action was longer in diabetic patients who were administered sevoflurane anesthesia than in patients who received total intravenous anesthesia and in non-diabetic patients.

Keywords: Rocuronium; sevoflurane; diabetes mellitus; neuromuscular monitoring
ÖZET
 Amaç: İnhalasyon anestezisi alan diyabetik hastalarda, sinir iletim hızındaki azalma nedeniyle rokuronyumun klinik etkisi uzayabilmekte ve postoperatif rezidüel kas gevşetici etkisi komplikasyonlara neden olabilmektedir. Diyabetik ve diyabetik olmayan hastalarda total intravenöz anestezi ve sevofluran anestezisinin rokuronyumun klinik etki süresi üzerindeki etkilerini karşılaştırdık. Gereç ve Yöntemler: Hastanemiz genel cerrahi bölümünde, elektif cerrahi için genel anestezi uygulanan (trakeal entübasyon için 0,6 mg rokuronyum kullanılan) 18-65 yaşları arasında Tip 2 diyabetli, Amerikan Anesteziyologlar Derneği Fiziksel Durum Sınıflandırması [American Society of Anesthesiologists Physical Condition Classification (ASA)] II olan hastalar çalışmaya dâhil edildi. Aynı yaş aralıklı non-diyabetik hastalar (ASA Ⅰ-Ⅱ) kontrol grubu olarak çalışmaya dâhil edildi. İlk doz rokuronyum uygulama zamanı ile ek rokuronyum dozunun uygulama zamanı (TOFcount 2'de-TOFc2 kaydedilen süre) arasındaki rokuronyumun klinik etkisinin süresi değerlendirildi. Bulgular: Rokuronyumun klinik etki süresi her iki diyabetik grupta diyabetik olmayan gruplara göre daha uzun bulundu (p=0,000). Diyabetik hasta grupları karşılaştırıldığında, diyabetik sevofluran grubunda rokuronyumun klinik etki süresi diyabetik total intravenöz anestezi almış gruba göre daha uzundu (p=0,012). Sonuç: Sevofluran anestezisi uygulanan diyabetik hastalarda, rokuronyum etki süresinin total intravenöz anestezi uygulanan hastalara ve diyabetik olmayanlara göre daha uzun olduğu saptandı.

Anahtar Kelimeler: Rokuronyum; sevofluran; diabetes mellitus; nöromusküler monitörizasyon
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