Research Information System
Thesis Type: Expertise In Medicine
Institution Of The Thesis: Gazi University, Tıp Fakültesi, Turkey
Approval Date: 2010
Thesis Language: Turkish
Student: DENİZ AKBAY
Supervisor: ÖMER KURTİPEK
Abstract:EFFECTS OF SEVOFLURANE AND PROPOFOL ANESTHESİA ON THE CEREBRAL FUNCTIONS OF PATİENTS HAVİNG CARDİOPULMONARY BYPASS SURGERY In our study, the effects of propofol and sevoflurane anesthesia on the cerebral circulation of the 30 patients having CPB was investigated by using cerebral oxygen saturation levels and biochemical markers in serum. MMSE applied one day before the surgery to the all patients which has no exclusion criteria. On the morning of the operation central venous catheter was inserted by using local anestehesia and another cathetere was inserted to the bulbus of juguler vein in general anestehesia. Before the induction remifentanly infusion was performed with the dose of 1 μg/kg-1 for 1 minute and after the induction, remifentaly dose was reduced to 0,2 μg/kg-1/dk-1. 0,3 mg/kg-1 etomidate was used for induction and when the BİS rate was decreased to 60, 0,1 mg/kg-1 pancuronuium was given. At the propofol group anesthesia was maintained with propofol infusion of 6 mg/kg-1/hr-1 and at the sevoflurane group anesthesia was maintained with 2% concentration of sevoflurane. The rates of HR, SAP, DAP, MAP, SpO2, BIS, Hg, Hct, CVP were scaled before induction, 1 min after the induction, 1 min after intubation and also at each 5 min intervals till the 30th min during the intubation. Then the scales were recorded with the intervals of 15 mins. . For measurement of NSE, S-100 beta protein and SjVO2 levels blood samples were collected in the begeninig of the anesthesia, after the aortic suturation following the pump and at the 24th postoperative hour. At the 24th postoperative hour and 7th postoperative day MMSE was also applied. Due to the variation up to the time the comparison of the pre&postoperative MMSE results revealed significant difference between the groups. As a result of our study propofol provided a better protection for focal ischemia and cerebral circulation against to the sevoflurane. Also at the propofol group postoperative MMSE values returned to the control level earlier than the sevoflurane group.