General Anesthesia Or Combined Spinal-Epidural Anesthesia With Ketofol Sedation in Colon Cancer Surgery?
Ayça Tuba Dumanlı Özcan, Serhat Ocaklı, Kudret Yasemin Yalnız, Sadettin Er, Eda Uysal Aydın, Cengiz Ceylan, Handan Güleç
Ankara Şehir Hastanesi Anesteziyoloji ve Reanimasyon Kliniği
Giriş: Risk factors such as advanced age, concomitant diseases and additional drugs may cause various difficulties in anesthesia applications.Studies in which high combined-spinal regional anesthesia was applied in various gastrointestinal surgeries have shown early postoperative recovery, effective analgesia, and decreased rates of mortality and morbidity.We aimed to evaluate the effects of spinal epidural application on peroperative bleeding, postoperative pain scores, oral intake, mobilization, drain and catheter withdrawal, discharge times, renal functions, and cost in patients who were planned for colon surgery compared to those who received general epidural.
Gereç ve Yöntem: The case controlled study was performed thirtyfive patients ASA I–II patients aged 25–65 and scheduled for colon canser surgery were included in the study. Patients were divided into two group as;GroupI and GroupII. Spinal anesthesia was applied to GroupI and general anesthesia to GroupII. Ketofol (1:1) was administered to the combined spinal-epidural Group, with a Ramsay sedation score of 3 after spinal block. Patients' intraoperative hemodynamic parameters, bleeding amounts, colloid, crystalloid, and blood products were recorded.
Bulgular: There was no difference between the groups in terms of demographic characteristics and there was a statistical difference between the preoperative saturation values of the patients. The clinics of these patients were also found suitable for regional anesthesia.The bleeding was statistically significantly lower in Group I than in the general anesthesia patients. There was no difference between the groups regarding oral intake, drain withdrawal, mobilization, discharge times, and costs.
Tartışma ve Sonuç: Carli et al. showed that thoracic epidural analgesia(TEA) reduces the use of anesthetic drugs, systemic opioids, neuromuscular blocking agents, and the catabolic response to stress.According to the results of our study the regional anesthesia applications facilitate compliance with routine mobilization, discharge procedures and prevent complications in abdominal surgery and its positive preoperative effects in patients with poor respiratory parameters, poor general condition, and high comorbidity in advanced age.
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