Comparison of Effects of Calcium Channel Blockers and Beta Blockers on Tourniquet-Induced Hypertension During Intravenous Regional Anesthesia

Abstract

A AB BS S TTR RA AC CT T O Ob bj je ec ct ti iv ve e: : To investigate the efficacy of calcium channel and beta blockers for controlling tourniquet induced blood pressure increase in patients undergoing carpal tunnel operations with intravenous regional anesthesia (IVRA). M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : Files of patients who have been operated under IVRA in orthopedics clinics between January 2009 and January 2010 were retrospectively investigated. A total of 312 patients, 164 patients with carpal tunnel syndrome and 148 patients with trigger finger have been operated under IVRA. Out of 164 patients who have been operated due to carpal tunnel syndrome, 50 patients in which either calcium channel blockers or beta blockers were used for treatment of critical blood pressure increase after tourniquet inflation and in which whole data were obtained, were included to the study.The patients with systolic blood pressure above to 150 mmHg following tourniquet inflation and in which bolus dose of calcium channel blocker 10 mg (Group I) or beta blocker 0.5 mg/kg (Group II) have been administered by intravenous route constituted the study groups. The ages of the patients, onset of sensorial block, duration of sensorial block, surgery and tourniquet durations, and the tourniquet pressures were recorded from the patient files. R Re es su ul lt ts s: : There was no difference between groups in terms of demographical variables and hemodynamic parameters (p<0.05). The efficacy of both calcium channel and beta blockers for controlling tourniquet-induced hypertension were similar (p<0.05). C Co on nc cl lu us si io on n: : Although both calcium channel blockers and beta blockers were found to be equally effective in treatment of tourniquet-induced hypertension, there is need of large scale prospective studies in this subject. K Ke ey y W Wo or rd ds s: : Hypertension; carpal tunnel syndrome; anesthesia, conduction Ö ÖZ ZE ET T A Am ma aç ç: : İntravenöz rejyonel anestezi (IVRA) ile karpal tünel operasyonu geçiren hastalarda turnike ile indüklenen kan basıncı artışı üzerine kalsiyum kanal bloker ve beta blokerlerin etkinliğinin araştırılmasıdır. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Üniversite Etik Komite onamı alındıktan sonra, Ocak 2009 ve Ocak 2010 tarihleri arasında ortopedi ameliyathanelerinde IVRA ile opere edilen karpal tünel sendromu hastalarının dosyaları retrospektif olarak incelendi. Karpal tünel nedeni ile opere edilen 164 hasta ve tetik parmak nedeni ile opere edilen 148 hasta olmak üzere toplam 312 hasta dosyası incelendi. Karpal tünel nedeni ile opere edilen 164 hasta içinden turnike sonrası kan basıncı artışı tedavisi amacıyla kalsiyum kanal blokeri veya beta bloker kullanılan ve dosya bilgilerine ulaşılan 50 hasta çalışmaya dahil edildi. Turnike şişirilmesi sonrası sistolik kan basıncı 150 mmHg üzerine çıkan ve bolus doz olarak 10 mg kalsiyum kanal blokeri verilen (Grup I) veya 0,5 mg/kg beta bloker (Grup II) verilen hastalar çalışma gruplarını oluşturdu. Hasta dosyaların...