20.500.12556/DKUM-75101 Primerjava rokuronija z leptosukcinom za hitro vstavljanje dihalne cevke pri bolnikih z ileusom Rocuronium versus succinylcholine for rapid sequence intubation in patients with bowel obstruction Uvod: Namen randominizirane kontrolirane raziskave je bil primerjava pogojev za vstavitev dihalne cevke s hitrim zaporedjem med uvodom v anestezijo pri bolnikih z ileusom med uporabo rokuronija ali leptosukcina. Registracija klinične raziskave: Retrospektivna registracija (4.12.2015): ISRCTN-registry: ISRCTN11777647 (https://www.isrctn.com/ISRCTN11777647) Metode: V raziskavo je bilo vključenih 30 odraslih bolnikov z ileusom, ki so bili urgentno operirani. Bolniki so bili naključno razvrščeni v dve skupini; S-skupina bolnikov, ki je za mišično relaksacijo prejela leptosukcin (1,5 mg/kg), in R-skupina bolnikov, ki je prejela rokuronij (1,2 mg/kg). Pogoji za vstavitev dihalne cevke so bili ocenjeni z uporabo točkovnega sistema po Viby-Morgensonu. Intubacijske pogoje smo ocenjevali eno minuto po vbrizganju mišičnega relaksanta. Beležili smo še srčni utrip, krvni tlak in pulzno oksimetrijo ter določali koncentracijo kalija in mioglobina v krvi. Rezultati: Pri vseh bolnikih je bila dihalna cevka vstavljena v prvem poskusu. Med uvodom v anestezijo nismo zabeležili bruhanja ali vdihanja želodčne vsebine v pljuča. Pogoji za vstavitev dihalne cevke so bili v S-skupini statistično značilno boljši kot v R-skupini. Po vstavitvi dihalne cevke smo opazili statistično značilno znižanje krvnega tlaka v obeh skupinah in statistično značilno znižanje srčnega utripa v v S-skupini. Po vstavitvi dihalne cevke je bil nivo kalija v serumu v S-skupini značilno višji v primerjavi z R-skupino; nivo mioglobina v serumu je bil v S-skupini neznačilno višji in statistično značilno nižji v R-skupini. Sklep: Rezultati kažejo, da rokuronij omogoča pri bolnikih z ileusom klinično enako dobre pogoje za vstavitev dihalne cevke s hitrim zaporedjem med uvodom v anestezijo in enako tveganje za vdihanje želodčne vsebine; zato lahko priporočamo, da se leptosukcin nadomesti z rokuronijem in se tako izognemo številnim možnim stranskim učinkom. Introduction: The aim of the randomized controlled study was to determine intubation conditions in the patients receiving rocuronium in comparison to succinylcholine for rapid sequence intubation (RSI) during the induction of anesthesia for operative management of bowel obstruction. Trial registration: Retrospective registration (4.12.2015): ISRCTN-registry: ISRCTN11777647 (https://www.isrctn.com/ISRCTN11777647) Methods: In the randomized controlled study 30 adult patients with bowel obstruction undergoing urgent surgery were randomly allocated in two groups. For muscle relaxation the S-group of patients received succinylcholine (1.5 mg/kg) and the R-group rocuronium (1.2 mg/kg). Intubation conditions were evaluated using a grading system according to Viby-Morgenson. Primary outcomes were intubation conditions 1 minute after the application of a muscle relaxant. Secondary outcome measures were heart rate, blood pressure, and pulse oximetry; potassium and myoglobin serum level. Results: All patients were orotracheally intubated in the first attempt. During induction we didn’t observe vomiting or aspiration. Overall intubation conditions in the S-group were statistically significantly better than in the R-group. After RSI there was a statistically significant decrease in systolic and diastolic blood pressure in both groups and statistically significant decrease in heart rate in the S-group. After RSI the potassium level in the S-group was significantly higher in comparison to the R-group and serum myoglobin level non-significantly increased in the S-group and statistically significantly decreased in the R-group. Conclusion: The results show that rocuronium in RSI patients with bowel obstruction enables the same intubation conditions as succinylcholine and the same risk of aspiration which allows succinylcholine replacement and avoidance of its side effects. Rokuronij leptosukcin vstavitev dihalne cevke s hitrim zaporedjem ileus pogoji za vstavitev dihalne cevke Rocuronium succinylcholine rapid sequence intubation bowel obstruction intubation conditions true true false Slovenski jezik Angleški jezik Doktorsko delo/naloga 2019-09-21 16:21:18 2020-01-14 07:21:30 2022-08-09 09:58:23 2020-01-15 03:21:27 2019 0 Maribor 0 0000-00-00 NiDoloceno NiDoloceno NiDoloceno 0000-00-00 0000-00-00 0000-00-00 303334912 URN:SI:UM:DK:2CARFTLQ DOK_Persa_Lidija_2019.pdf DOK_Persa_Lidija_2019.pdf 1 2086D7D03D0ABB5DD1551865230870E2 008aae7062440c87472c86c91bcf578f5ddd8c064749e07857a4b3c8fe55a3fe 296edfc6-7c11-11eb-bb7a-00155d0001ca 20.500.12556/dkum/1d65e0bc-a9f1-4bd2-a551-8b2e6f37913d https://dk.um.si/Dokument.php?lang=slv&id=139879 Medicinska fakulteta 0 0 0