Ömer Faruk BORAN, Fatih VATANSEVER, Bora BİLAL, Duran TOPAK

Lokal Anestezik Toksisitesinde Ortopedi Hekimlerinin Yaklaşımının Değerlendirilmesi

Amaç: Ortopedi hekimlerinin lokal anestezik toksisitesi sendromu (LATS) tanı, tedavi ve önlemleri ile ilgili bilgilerini gözden geçirerek bu konu ile ilgili farkındalığın artırılması amaçlanmıştır. Gereç- Yöntem: Türkiye’de farklı hastanelerde ve farklı akademik seviyede olan ortopedi hekimlerine demografik bilgileri, lokal anestezik ilaçlar ile ilgili genel bilgileri, toksisite ile ilgili genel bilgi ve güncel tedavi seçeneklerini sorgulayan 16 soruluk anketi cevaplamaları istendi. Bulgular: Toplamda 172 ortopedi hekiminin (%18,6‘sı ortopedi asistanı, %51,7’si ortopedi ve travmatoloji uzmanı, %29,7’si öğretim üyesi) katıldığı çalışmada hekimlerin %45,3’ü 10 yıldan fazla süredir ortopedi alanında çalışmakta olduğu görüldü. Lokal anestezik kullanım yerleri açısından en sık ameliyathane, daha sonra acil servis, poliklinik müdahale odası ve servis olarak sıralandığı tespit edild. LATS tedavisinde lipid kullanımı ile ilgili çalışmaya katılanların %59,6’sı lipid kullanımını daha önce hiç duymadıklarını, %29,8’i daha önce duyduklarını ama anımsamadıklarını, %5,3’ü lipid tedavisinin kullanım alanı ve şeklini bildiklerini belirtmiştir. Sonuç: LATS konusunda hekimlerin bilinçli olması ve bu komplikasyon konusunda hazırlıklı olmaları ile lokal anesteziklerin daha güvenli kullanımları sağlanabilir.

An Evaluation of the Approach of Orthopaedic Surgeons to Local Anaesthetic Toxicity

Aim: To review the knowledge of orthopaedic surgeons related to the diagnosis,treatment and prevention of local anaesthetic systemic toxicity (LAST) and to raiseawareness related to this subject.Material and Method: A 16-item questionnaire was applied to orthopaedicsurgeons of different academic levels in different hospitals in Turkey. The itemssought to questioned demographic information, general knowledge related to localanaesthetic drugs, general knowledge related to toxicity and current treatmentoptions.Results: The study included a total of 172 orthopaedic surgeons in Turkey, of which18.6% were orthopaedic residents, 51.7% orthopaedic and traumatology specialists,and 29.7% faculty members. Tenure in the orthopaedic area was determined to be>10 years in 45.3% of the participants. Local anaesthetic was seen to be used mostin the operating theatre, followed by the Emergency Department, polyclinicintervention rooms, and on the wards. Of the total participants, 59.6% stated thatthey had never heard of the use of lipids in the treatment of LAST, 29.8% had heardof it but did not use it and 5.3% knew about the manner and area of use of lipidtreatments.Conclusion: Awareness of physicians about LAST and preparedness for complications can ensure safer use of these local anaesthetics.

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