Adenotonsillektomi Olgularında Ameliyat Öncesi ve Sonrası Diyafram Kalınlık Değerlerinin Karşılaştırılması

Amaç: Ultrasonografinin ameliyathanede kullanımı gün geçtikçe artmakta ve ultrasonografi diyafram kalınlığını değerlendirmek için kullanılan bir yöntemdir. Diyaframın kalınlığının ölçülmesi, mekanik ventilasyon ve ekstraksiyondan ayrılmadan önce karar vermek için kullanılabilecek bir parametredir. Ameliyat sonunda entübe edilen ve ekstübe edilen bu olgularda ekstübasyon öncesi son inspirum ve son ekspiryumda diyafram kas kalınlığının birbirine oranının incelenmesi planlanmıştır. Bu oranın belirlenmesinin ekstübasyon süresinin belirlenmesinde anlamlı olabileceği düşünülmektedir. Gereç ve Yöntem: Çalışmaya elektif adenotonsillektomi operasyonu planlanan 3-12 yaş aralığında fiziksel durumu ASA I ve II olan 60 hasta dahil edildi. Hastaların yaş, cinsiyet, vücut kitle indeksi (VKİ) ve operasyon süresi verileri kaydedildi. Ameliyat öncesi ve sonrası ultrasonografi ile inspiratuar ve ekspiratuar diyafram kalınlıkları ölçüldü. Son inspiryum ve son ekspirasyondaki diyafram kası kalınlıklarının oranı hesaplandı. Bulgular: Diyafram kalınlık ölçümlerinde ameliyat öncesi değerler ile ameliyat sonu değerleri arasında anlamlı fark yoktu. Laringospazm insidansı %1.5 idi. Sonuç: Ultrason ile diyafram kalınlığı ölçümlerinin birçok faydası vardır ancak daha ileri çalışmalara ihtiyaç vardır.

Anahtar Kelimeler:

diyafram, ultrason, pediatrik, anestezi

Comparison Of Diaphragm Thickness Values In Cases of Adenotonsillectomy Before And After The Operation

Aim: The ultrasonographic assessment in the operating room tends to increase daily, and ultrasonography is a method used to evaluate the thickness of the diaphragm. Measurement of the thickness of the diaphragm is a parameter that can be used to decide before separation from mechanical ventilation and extraction. In these cases where intubated and extubated at the end of the operation, it is planned to examine the ratio of the aperture muscle thickness to each other in the last inspirium and exprium before extubation. Determining the current ratio may be meaningful for determining the extubation time. Material and Method: In the study, 60 patients, who were in the physical state of ASA I and II, 3-12 age range, and who were scheduled for elective adenotonsillectomy operation were included. Age, gender, body mass index (BMI), and operation time data of patients were recorded. Before and after the procedure, inspiratory and exprituar diaphragm thicknesses were measured by ultrasonography. In addition, the ratio of the last inspirium and the diaphragm muscle thicknesses in the last expiration were also calculated. Results: There was no significant difference between the pre-operation values and the end of the operation in the diaphragm thickness measurements. The incidence of laryngospasm was 1.5 %. Conclusion: Diaphragm thickness measurements with ultrasound have many benefits but further studies are needed.

Keywords:

diaphragm, ultrasound, pediatric, anesthesia,

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