Akademik Veri Yönetim Sistemi
Gogus-Kalp-Damar Anestezi ve Yogun Bakim Dernegi Dergisi, cilt.15, sa.1, ss.13-19, 2009 (Scopus)
Objectives: Parasternal block to provide postoperative analgesia in open heart surgery was first described by McDonald et al (1). They used levobupivacaine as a local anesthetic in their placebo controlled study and showed that parasternal block reduced postoperative opioid consumption. The aim of our study was to compare the postoperative analgesic effects of equal volumes and concentrations of levobupivacaine with those of bupivacaine when used for parasternal block combined with infiltration anesthesia in open heart surgery. Material and Methods: A prospective, controlled, double-blind study was conducted on 40 ASA class I-II patients undergoing elective open heart surgery under general anesthesia. Patients were randomized to receive either 50 mL of 0.25 % bupivacaine (Group B) or 0.25 % levobupivacaine (Group LB). Parasternal block was performed by the surgeon before insertion of the sternal wires. The measurements of relevant to efficacy included VAS scores (at rest and cough), and additional bolus tramadol doses. Results: VAS rest and VAS rough scores were similar in both groups. In Group B, mean additional tramadol doses in the first 8 hours and in the first 24 hours were 80.95±18.9 mg and 90.0±22.36 mg whereas in Group LB, these were 82:1±17.5 mg and 92.9±12.2 mg respectively and there were no significant differences between the two groups (p: 0.39). Conclusions: Levobupivacaine had an equivalent efficacy and safety profile compared with bupivacaine with parasternal block. Therefore, levobupivacaine may be an alternative to bupivueaine for parasternal block and infiltration unesthesia.