PAPAVERİN ISISININ İNTERNAL MAMMARİA ARTERİ KAN AKIMI ÜZERİNE ETKİSİ

OZET Papaverin, bircok merkezde rutin olarak internal mammariya arteri (IMA) greftinin kan akimini arttirmak ve cikarilmasi esnasinda meydana gelebilecek spazmi ortadan kaldirmak amaciyla kullanilmaktadir. Bu calisma papaverin isisinin IMA kan akimindaki rolunu arastirmak amaciyla yapilmistir. Elektif koroner arter bypas greftlemesi (CABG) geciren 10'ar kisilik 2 grup hastada farkli isilardaki papaverin solusyonlarinin IMA'daki kan akim artisi uzerinde ki etkisi arastirildi. 1. gruptaki 10 hastada IMA kan akimi greft cikarildiktan hemen sonra ve vucut isisindaki (37-38°C) dilue papaverin solusyonunun (60mg/i 50ml. normal serum fizyolojik ile hazirlanmis) periarteriyal olarak dokuya enjeksiyonu uygulandiktan sonra olculdu. 2. grupta ise oda isisindaki (18-20°C) dilue papaverin solusyonu dokuya enjekte edildi. Vucut isisindaki papaverin solusyonu verilen grupta IMA kan akiminda ortalama % 251'lik bir artis olurken, 2. grupta % 172'lik bir artis bulundu. IMA hazirlanmasinda ozellikle vucut isisinda uygulanan papaverinin IMA kan akimini artirarak ve spazm olusmasini onleyerek faydali oldugu saptanmistir. Anahtar kelimeler: Internal mammarian arter, koroner arter bypass cerrahisi, papaverin. EFFECT OF PAPAVERIN TEMPERATURE ON BLOOD FLOW OF THE INTERNAL MAMMARIAN ARTERY SUMMARY: Papaverine that is routinely used in many centers to increase the blood flow of the IMA and to resolve the graft spasm occurred during harvesting. The aim of this study is to investigate the role of Papaverine temperature on blood flow of the IMA. In 20 patients who undervvent elective coronary artery bypass grafting was made to find out the effect of different temperature Papaverine on blood flow of the IMA. In the first group we measured the blood flow of IMA right after harvesting and after injected periarterial diluted Papaverine solution (60 mg. in 50 ml. normal saline) at body temperature (37-38°C). In the second group diluted Papaverine solution at room temperature (18-20°C) was administered. In the group which Papaverine solution at body temperature injected the mean increase of blood flow of IMA was 251% while in the second group it was 172%. The use of Papaverine especially at the body temperature is ascertained beneficial preventing spasm and increasing blood flow in IMA for the preparation of IMA. Key words: internal mammarian artery, coronary artery bypass grafting, Papaverine.