Orofaringeal cerrahi uygulanan çocuklarda obstrüktif uyku apnesi skorunun anestezi indüksiyon zorluğu ve postoperatif endtidal CO2 düzeyi ile ilişkisi
Küçük Resim Yok
Tarih
2021
Yazarlar
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Yayıncı
Tekirdağ Namık Kemal Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Çalışmamızda Tekirdağ Namık Kemal Üniversitesi Tıp Fakültesi Anesteziyoloji ve Reanimasyon Anabilim Dalı'nda orofaringeal cerrahi uygulanan çocuklarda obstrüktif uyku apnesi skorunun anestezi indüksiyon zorluğu ve postoperatif endtidal CO2 düzeyi ile ilişkisini araştırdık. Çalışmamızda 2-15 yaş arası, orofaringeal cerrahi olacak, ASA I-II sınıflamasında bulunan, preoperatif muayenede modifiye STOP-Bang anketi uygulanmış toplam 90 hasta çalışmaya dahil edildi. Modifiye STOP-Bang anketinin sonucunda obstrüktif uyku apnesi skoru belirlendi ve hastalar düşük, orta ve yüksek olarak 30'ar kişilik 3 gruba ayrıldı. Hastaların demografik verileri (yaş, kilo, boy, cinsiyet), ameliyat tipi, ASA sınıflaması, vücut kitle indeksi, kan basıncı, boyun çevresi ve modifiye STOP-Bang anketinin cevapları ( horlama, yorgunluk, apne, öğrenme güçlüğü ) kaydedildi. Intraoperatif dönemde indüksiyon zorluk derecesi not edildi. Operasyon bitiminde hasta ekstübe edildikten sonra 0. dk., 3. dk., 5. dk., 10. dk., 15. dk. endtidal CO2 değerleri ve hastanın spazma girip girmediği kaydedildi. Yaş, ASA sınıflaması ve ameliyat tipi açısından gruplar arasında fark yoktu. Modifiye STOP-Bang anketindeki 8 parametreden, horlama ve öğrenme güçlüğü hariç diğer 6 parametre için gruplar arasında anlamlı farklılık olduğu saptandı. İndüksiyon zorluk derecesi ile gruplar arasında anlamlı farklılık saptandı. Ekstübasyon sonrası endtidal CO2 değerlerinde farklı dakikalardaki ölçümlerde ve gruplar arası karşılaştırmada anlamlı farklılık saptanmadı. Postoperatif spazm gelişimininde obstrüktif uyku apnesi skoru anlamlı değildi. Sonuç olarak modifiye STOP-Bang anketi çocuklarda preoperatif muayenede kullanılabilir ve intraoperatif dönemde indüksiyon zorluk derecesi ile ilgili anestezistlere öngörü oluşturabilir. Çalışmamızda istatiksel olarak anlamlı bulunmasa da postoperatif takipte ETCO2 monitörizasyonunu hasta konforu ve güvenliği açısından önermekteyiz. Anahtar Kelimeler: Obstrüktif uyku apnesi sendromu, Modifiye STOP-Bang anketi, indüksiyon zorluk derecesi, Endtidal CO2
In this study, we investigated the relationship between obstructive sleep apnea score and anesthesia induction difficulty and postoperative endtidal CO2 level in children who underwent oropharyngeal surgery in Tekirdağ Namık Kemal University Faculty of Medicine, Department of Anesthesiology and Reanimation. A total of 90 patients, aged 2-15 years, who will undergo oropharyngeal surgery, classified as ASA I-II, and who have undergone modified STOP-Bang questionnaire at preoperative examination, were included in the study. Obstructive sleep apnea score was determined according to the modified STOP-Bang questionnaire, and the patients were divided into 3 groups of 30, as low, medium and high risk groups. Demographic data of the patients (age, weight, height, gender), type of surgery, ASA classification, body mass index, blood pressure, neck circumference, and answers to the modified STOP-Bang questionnaire (snoring, fatigue, apnea, learning disability) were recorded. Induction difficulty level was noted in the intraoperative period. At the end of the operation, endtidal CO2 values at 0, 3, 5, 10, 15 minutes after the patient was extubated and whether the patient had spasm were recorded. There was no difference between the groups in terms of ASA classification, age and type of surgery. Among the 8 parameters in the modified STOP-Bang questionnaire, it was found that there was a significant difference between the groups for the other 6 parameters except snoring and learning disability. The degree of induction difficulty increased significantly as the obstructive sleep apnea score progressed from the low group to the high group. There was no significant difference in endtidal CO2 values after extubation in the measurements at different minutes and in the comparison between the groups. Obstructive sleep apnea score was not significant in the development of postoperative spasm. In conclusion, the modified STOP-Bang questionnaire can be used in preoperative examination in children and can provide a prediction for anesthesiologists regarding the degree of difficulty in induction in the intraoperative period. Although our study was not statistically significant, we recommend ETCO2 monitoring in postoperative follow-up for patient comfort and safety. Keywords: Obstructive sleep apnea syndrome, Modified STOP-Bang questionnaire, induction difficulty level, Endtidal CO2
In this study, we investigated the relationship between obstructive sleep apnea score and anesthesia induction difficulty and postoperative endtidal CO2 level in children who underwent oropharyngeal surgery in Tekirdağ Namık Kemal University Faculty of Medicine, Department of Anesthesiology and Reanimation. A total of 90 patients, aged 2-15 years, who will undergo oropharyngeal surgery, classified as ASA I-II, and who have undergone modified STOP-Bang questionnaire at preoperative examination, were included in the study. Obstructive sleep apnea score was determined according to the modified STOP-Bang questionnaire, and the patients were divided into 3 groups of 30, as low, medium and high risk groups. Demographic data of the patients (age, weight, height, gender), type of surgery, ASA classification, body mass index, blood pressure, neck circumference, and answers to the modified STOP-Bang questionnaire (snoring, fatigue, apnea, learning disability) were recorded. Induction difficulty level was noted in the intraoperative period. At the end of the operation, endtidal CO2 values at 0, 3, 5, 10, 15 minutes after the patient was extubated and whether the patient had spasm were recorded. There was no difference between the groups in terms of ASA classification, age and type of surgery. Among the 8 parameters in the modified STOP-Bang questionnaire, it was found that there was a significant difference between the groups for the other 6 parameters except snoring and learning disability. The degree of induction difficulty increased significantly as the obstructive sleep apnea score progressed from the low group to the high group. There was no significant difference in endtidal CO2 values after extubation in the measurements at different minutes and in the comparison between the groups. Obstructive sleep apnea score was not significant in the development of postoperative spasm. In conclusion, the modified STOP-Bang questionnaire can be used in preoperative examination in children and can provide a prediction for anesthesiologists regarding the degree of difficulty in induction in the intraoperative period. Although our study was not statistically significant, we recommend ETCO2 monitoring in postoperative follow-up for patient comfort and safety. Keywords: Obstructive sleep apnea syndrome, Modified STOP-Bang questionnaire, induction difficulty level, Endtidal CO2
Açıklama
Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Ana Bilim Dalı
Anahtar Kelimeler
Anestezi ve Reanimasyon, Anesthesiology and Reanimation
