Kolonoskopi sırasında uygulanan iki farklı sedoanaljezi yönteminin dikkat, öğrenme, eve gönderme zamanı ve uyuma süreleri açısından karşılaştırılması

Giris ve Amac: Bircok merkezde gastrointestinal sistemin endoskopik is- lemlerinde sedoanaljezi kullanimi rutin hale gelmistir. Bu amacla kullanilan ilaclar, islem sonrasi takip suresinde uzamaya ve gecici bir sure dikkat ve ogrenmede bozulmalara neden olduklarindan, hastalara gun icinde dikkat gerektiren isler yapmamasi onerilir. Biz bu calismada; sedoanaljezi amaci ile kullanilan iki farkli protokolun hasta dikkat ve ogrenme testleri uzeri- ne etkisini ve her iki grup icin ve islem sonrasindaki 24 saatte hastalarin uykuda gecirdigi sureleri karsilastirmayi amacladik. Gerec ve Yontem: Ko- lonoskopi yapilmak uzere unitemize basvuran hastalar sedoanaljezi tipine gore midazolam-meperidin ve meperidin-propofol gruplarina randomize edildi. Hastalara islem oncesi, islem sonrasi uyanma odasina alindiklarinda ve islem bitiminden 30 dakika sonra toplam uc defa olmak uzere, ayni noro- loji uzmani tarafindan ogrenme ve dikkat testleri (iz surme, Stroop ve Rey testleri) uygulandi ve sonuclar sayisal veriler olarak not edildi. Calismanin sonunda her iki grubun eve gonderilme zamanlari ve islemden sonraki ilk 24 saatte uykuda gecirdikleri sure karsilastirildi. Bulgular: Calismaya 32'si midazolam-meperidin ve, 19'u meperidin-propofol grubuna randomize edi- len toplam 51 hasta alindi. Calisma grubumuzun ortanca yasi 51 olup, 25 hasta kadin idi. Her iki grupta eve gonderilme zamanlari ve 24 saatte uykuda gecen sure benzer idi (p=0.617 ve p=0.242). Her iki grup icin baslangic test- lerine gore degerlendirildiginde islem sonrasi dikkat ve ogrenmede anlamli bozulma oldugu izlendi (p<0.001). Dikkat ve ogrenmedeki bozulma duzeyi her iki grupta benzerdi. Sonuc: Kolonoskopi sirasinda midazolam-meperi- din ve meperidin-propofol protokolleri ile uygulanan sedoanaljezi dikkat ve ogrenme uzerine ayni duzeyde olumsuz etki yapmaktadir. Anahtar kelimeler: Kolonoskopi, sedoanaljezi, dikkat testleri, ogrenme test- leri, derlenme zamani Background and Aims: Sedoanalgesia usage has become routine for gastro- intestinal endoscopic procedures in many centers. Since the drugs used for this purpose may lengthen the recovery time or cause a temporary deteriora- tion in learning and attention after the procedure, patients are cautioned to not undertake activities during the day that require their attention. In this study, we aimed to compare the effects of two sedoanalgesia protocols on learning and attention, discharge time, and sleep time over postoperative 24 hours in two groups. Materials and Methods: All patients referring to our unit for colonoscopy had been randomized prior to the procedure to either the midazolam-meperidine or meperidine-propofol group. Protocols were administered to all patients by the same neurology specialist three times (pre-procedural, immediately after being taken to the recovery room, and 30 minutes after the end of the procedure). Results were noted as numerical values. At the end of the study, the two groups were compared with respect to the discharge time and time asleep over 24 hours post-procedure. Re- sults: Fifty-one patients were recruited to the study; 32 were randomized to the midazolam-meperidine and 19 to the meperidine-propofol group. The mean age of the study group was 51 years, and 25 patients were fe- male. Both groups were similar regarding the discharge time and the sleep duration over 24 hours post-procedure (p=0.617 and p=0.242). When the two groups were assessed in comparison to the onset, learning and attention tests were shown to have deteriorated significantly after colonoscopy in each group (p<0.001). The deterioration in both attention and learning levels was similar between the two groups. Conclusions: Both midazolam-meperidine and midazolam-propofol sedoanalgesia protocols during colonoscopy dem- onstrated similar negative effects on learning and attention.