مجله علوم پزشکی پارس

مقایسه ی اثر دو داروی پرومتازین و افدرین بر ثبات علایم حیاتی بیماران تحت عمل آرتروپلاستی (تعویض مفصل) با بی‌حسی نخاعی به همراه مصرف سیمان

نویسندگان

1 رزیدنت بیهوشی و مراقبت های ویژه، دانشگاه علوم پزشکی جهرم،جهرم،ایران

2 دانشیاردانشگاه علوم پزشکی جهرم،بخش بیهوشی و مراقبت های ویژه، دانشگاه علوم پزشکی جهرم،جهرم،ایران

3 دانشیاردانشگاه علوم پزشکی جهرم،بخش بیهوشی و مراقبت های ویژه،دانشگاه علوم پزشکی جهرم،جهرم،ایران

4 مربی، گروه بیهوشی، دانشگاه علوم پزشکی جهرم،جهرم،ایران

چکیده

مقدمه: درعمل های جراحی تعویض مفصل به علت مصرف سیمان، به دلایل متعدد بی‌حسی نخاعی بر بیهوشی عمومی ترجیح داده می‌شود. اثرات جانبی سیمان بر سیستم قلب و عروق بیماران می‌تواند فاجعه‌بار باشد، یافتن روش های درمانی مناسب به منظور کاهش عوارض سیمان ضروری است.
 روش کار: در این کارآزمایی بالینی 90 نفر از بیماران کاندیدای عمل  تعویض مفصل به سه گروه سی نفره تقسیم شدند. گروه اول 25میلی‌گرم پرومتازین وریدی، گروه دوم 10 میلی‌گرم افدرین وریدی و گروه کنترل معادل حجم دو گروه موردمطالعه‚ آب مقطر وریدی 10 دقیقه قبل از تزریق سیمان دریافت کردند.علائم حیاتی بیماران بدو ورود به اتاق عمل، بعد از بی‌حسی نخاعی، بلافاصله قبل از تزریق دارو، بعد از تزریق، پنج دقیقه و ده دقیقه بعد از تزریق سیمان ثبت شد. تحلیل داده ها به روش آمار توصیفی و استنباطی انجام شد.
یافته ها: بین گروه‌های پرومتازین، افدرین و کنترل از نظر فشارخون سیستول در زمان‌های بعد از تزریق دارو،  پنج و ده دقیقه بعد از سیمان و فشارخون دیاستول نیز در ده دقیقه بعد از سیمان تفاوت آماری معناداری مشاهده شد (0.05>p ). همچنین بین گروه‌های مورد مطالعه از لحاظ ضربان قلب در پنج دقیقه بعد از سیمان تفاوت معنادار بود (0.041=p )، اما از نظر اکسیژن خون شریانی تفاوت معنادار نبود (0.09=p ).
نتیجه‌گیری: براساس نتایج پژوهش درهنگام عمل جراحی تعویض مفصل به همراه تزریق سیمان، استفاده از افدرین و پرومتازین می‌تواند بر ثبات علائم حیاتی بیماران مؤثر بوده و به پایداری فشارخون سیستول (افدرین) و فشارخون دیاستول و ضربان قلب (پرومتازین) کمک کند تا عوارض این دسته عمل های جراحی به حداقل برسد.

کلیدواژه‌ها

عنوان مقاله [English]

Comparison of the effect of promethazine and ephedrine on the stability of vital signs in patients undergoing arthroplasty (joint replacement) with spinal anesthesia with cement

نویسندگان [English]

  • Azin Hamidi 1
  • Mohammad Radmehr 2
  • Reza Sahraei 3
  • navid kalani 4
  • Mohammad Sadegh Sanie Jahromi 3

1 Resident anesthesia and intensive care, Jahrom University of Medical Sciences, Jahrom, Iran

2 Associate Professor of Anesthesiology, Anesthesiology, Critical care and pain management research center, Jahrom University of Medical Sciences, Jahrom, Iran

3 Associate Professor of Anesthesiology, Anesthesiology, Critical care and pain management research center, Jahrom University of Medical Sciences, Jahrom, Iran

4 Tutor, Anesthesiology, Anesthesiology, Critical care and pain management research center, Jahrom University of Medical Sciences, Jahrom, Iran

چکیده [English]

Introduction: In arthroplasty, spinal anesthesia was preferred to general anesthesia for a variety of reasons due to the
use of cement. The side effects of cement on the cardiovascular system of patients, which can be catastrophic, it's necessary to find appropriate treatment methods to reduce side effects of cement.
Materials and Methods: In this clinical trial, 90 patients were arthroplasty candidates divided into three groups. The first group 25 mg intravenous promethazine, the second 10 mg intravenous ephedrine and the control group the equivalent volume of distilled intravenous water 10 minutes before cement injection received. Hemodynamic symptoms of patients entering the operating room, after spinal, immediately before injection. The drug was recorded after injection, five and ten minutes after cement injection. Data analysis by descriptive and inferential levels.
Results: Promethazine and ephedrine and control groups in systolic blood pressure at the time after drug injection and five and ten minutes after cement and diastolic blood pressure at 10 minutes after cement were significant(p<0.05). There was a significant difference between the study groups in heart rate at five minutes after cementing (p=0.041) but no significant difference in terms of O2 SAT at time of arrival (p=0.09).
Conclusion: According to the results of the study, in patients with arthroplasty by injection of cement due to hemodynamic changes, the use of ephedrine and promethazine can affect the hemodynamic stability of patients and help stabilize systolic blood pressure (ephedrine) and diastolic blood pressure and heart rate (promethazine) to minimize the complications of these surgeries.

کلیدواژه‌ها [English]

  • Arthroplasty
  • Cement
  • Ephedrine
  • Promethazine
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مجله علوم پزشکی پارس
دوره 20، شماره 1
فروردین 1401
صفحه 14-21