Akademik Veri Yönetim Sistemi
Gogus-Kalp-Damar Anestezi ve Yogun Bakim Dernegi Dergisi, cilt.9, sa.1, ss.16-23, 2003 (Scopus)
In this prospective study, we combined induction with sevoflurane inhalation without neuromuscular blocking drugs, with thoracic epidural anesthesia for myasthenia gravis (MG) patients planed for transsternal thymectomy. We aimed to assess and present the procedure, respiratory and hemodynamic effects of this combination and our experiences during the intraopertative and postoperative periods. Inhalation induction with sevoflurane was performed in 7 MG patients with previous pulmonary function testing, following insertion of thoracic epidural catheters. Intubation was performed without neuromuscular blocker drugs. Sevoflurane and thoracic epidural analgesia were used together for maintenance. In all patients, arterial blood gases were monitored beside hemodynamic and respiratory parameters. End tidal sevoflurane concentrations which provides anesthetic depth was recorded. Continuous epidural analgesia was provided in the postoperative period in all patients. Paired t test, chi-square and Wilcoxon-match paired-tests were used for statistical analysis. All patients well tolerated induction with inhalation and intubation. The hemodynamic and respiratory parameters showed similar changes. The mean end tidal sevoflurane concentration of the patients for surgical anesthesia was 2.4±0.4 %. Postoperative pulmonary complications or respiratory depression were not encountered in any patient. As a conclusion, induction and maintenance with sevoflurane, combined with thoracic epidural anesthesia may be preferred in MG patients undergoing thymectomy. It was considered that, thoracic epidural anesthesia as a good choise for the stabilization of the postoperative period.