Hüseyin Fatih SEZER, Tülay ÇARDAKÖZÜ, Aykut ELİCORA

Çocuk Yaş Grubu Yabancı Cisim Aspirasyonu Tedavisinde Kullanılan Rijit Bronkoskopi Esnasında Uygulanan İki Anestezi Tekniğine Cerrahi Bir Bakış

Amaç: Çalışmamızda genel anestezi altında rijit bronkoskopi ile trakeabronşiyal yabancı cisim çıkarılan çocuk hastalarda anestezi idamesinde inhalasyon ve intravenöz anestezi tekniğinin birbirlerine olan avantaj ve dezavantajlarını literatürden farklı olarak hem anestezi ve hem de cerrahi bakış açılarıyla ortaya koymayı amaçladık. Yöntem: Hastaların anestezi idamesi sevofluran inhalasyonu ile veya propofol infüzyonuyla yapılanlar olmak üzere 34’er kişiden oluşan iki grup oluşturuldu. Hastalara ait demografik özellikler, başvuru semptomları, radyolojik incelemeler, anestezi ve cerrahi işlemler bağlı özellikler, komplikasyonlar analiz edildi. Ayrıca kurumumuz tecrübelerinden oluşturulan cerrahi zorluk ve cerrahi konfor skalaları kullanıldı. Elde edilen sonuçlarla idamede kullanılan inhalasyon ve intravenöz anesteziklerinin işlem süresi, klinik, hemodinami, cerrahi konfor üzerine etkileri karşılaştırıldı. Bulgular: İşlem esnasında vital bulgular her iki grupta benzerdi. Bronkoskopi süresi intravenöz anestezi grubunda istatistiksel olarak anlamlı şekilde daha kısaydı (p=0.014) buna sekonder olarak anestezi süresi inhalasyon anestezisi grubunda anlamlı derecede uzundu (p=0.027). Cerrahi zorluk skalası her iki grupta benzer iken, cerrahi konfor skalası intravenöz anestezi grubunda anlamlı şekilde daha yüksekti (p=0.017). İntraoperatif komplikasyonlar, postoperatif komplikasyonlar her iki grupta benzerdi. Sonuç: Sevofluranla idame anestezisi bronkoskopi süresini uzatmakta ve buna sekonder olarak anestezi süresi uzamaktadır ayrıca işlem süresinden bağımsız olarak cerrahi memnuniyet azaltmaktadır. Bu nedenlerle çocukluk çağı yabancı cisim aspirasyonlarının çıkartılmasında rijit bronkoskopi yapılırken anestezi idamesinde propofolün tercih edilebilerek daha kısa işlem süresi ve daha yüksek cerrahi memnuniyet elde edileceğini düşünüyoruz.

Anahtar Kelimeler:

Rijit Bronkoskopi, Cerrahi konfor skalası, Cerrahi zorluk skalası

A Surgical Perspective on Two Anesthesia Techniques, Using During Rigid Bronchoscopy For Child Age Group Foreign Body Aspiration Treatment

Objective: In our study, we aimed to reveal the advantages and disadvantages of inhalation and intravenous anesthesia techniques in the maintenance of anesthesia in pediatric patients whose tracheobronchial foreign body was removed by rigid bronchoscopy under general anesthesia, from both anaesthesia and surgical perspectives, different from the literature. Methods: The patients were divided into two groups, each consisting of 34 individuals, whose anaesthesia was maintained with sevoflurane inhalation or propofol infusion. Demographic characteristics of the patients, symptoms at presentation, radiological examinations, anaesthesia and surgical procedures, complications were analyzed. In addition, surgical difficulty and surgical comfort scales created from the experiences of our institution were used. The results obtained and the effects of inhalation and intravenous anaesthetics used in maintenance on the duration of the procedure, clinical, hemodynamic and surgical comfort were compared. Results: Vital signs during the procedure were similar in both groups. was similar. The duration of bronchoscopy was statistically significantly shorter in the intravenous anaesthesia group (p=0.014), and secondarily, the duration of anaesthesia was significantly longer in the inhalation anaesthesia group (p=0.027). While the surgical difficulty scale was similar in both groups, the surgical confort scale was significantly higher in the intravenous anesthesia group (p=0.017). Intraoperative, postoperative complications were similar in both groups. Conclusion: Anaesthesia maintenance with sevoflurane prolongs the duration of bronchoscopy and accordingly the duration of anaesthesia, and also reduces surgical satisfaction independent of processing time. For these reasons, we think that while rigid bronchoscopy is performed for the removal of childhood foreign body aspirations, propofol can be preferred for anaesthesia maintenance, resulting in a shorter procedure time and higher surgical satisfaction.

Keywords:

Rijit Bronkoskopi, Cerrahi konfor skalası, Cerrahi zorluk skalası,

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