Enver ÖZGENCİL, Başak Ceyda ORBEY, Sacide DEMİRALP

Bronşiyal astımlı hastada anestezi

Bronşiyal astım, her geçen gün prevalansı, morbiditesi ve mortalitesi artan önemli bir toplum sağlığı problemidir. Astımlı hastalarda artan havayolu hassasiyeti havayollarında yapısal değişikliklere ve bunun sonucunda önemli perioperatif ve postoperatif solunum komplikasyonlarına neden olabilmektedir. Bu risklerin önlenmesinde iyi bir preoperatif hazırlık ve uygun farmakolojik ajanların ve anestezi tekniklerinin seçimi çok önemlidir. Hastalar gerek medikal tedavi gerekse solunum fizyoterapisi ile hazırlandıktan ve uygun ajanlarla premedikasyon yapıldıktan sonra mümkün olduğu kadar rejyonel teknikler seçilmeli ve uygulanan ajanların bronkokonstrüksiyon oluşturmamalarına dikkat edilmelidir. Yine gerekli görülen olgularda bronkodilatatör tedavi planlanmalıdır. Ayrıca postoperatif dönemlerde yeterli analjezi sağlanması ve solunum terapisinin uygulanması postoperatif komplikasy onların azaltılmasında önemlidir.

Anesthesia in bronchial asthma

Bronchial asthma, with the increasing prevalance, morbidity and mortality rates is an important public health problem. The increased airway sensitivity of asthmatic patients can lead to structural changes in the airway which will be the cause of perioperative and postoperative respiratory complications. In order to avoid these risks, a good preoperative preparation, and choise of appropiate pharmacological agents and anaesthesic techniques are very important. The preoperative medical therapies and respiratory physiotherapy along with premedication by appropiate agents should be provided to patients. When feasible, regional anaesthesia should be considered and attention should be given to the agents used to avoid bronchoconstriction. When necessary., bronchodilator therapy should be planned. Furthermore, to decrease the postoperative compliactions sufficient analgesia and respiratory therapies should be provided during postoperative period.

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