Fatma Kavak Akelma, Eşref Kemal Erdoğan, Hülya Kaşıkara, Fulya Eser

Endovasküler Aort Onarımında Anestezi Tipinin Mortalite’ye Etkisi

Amaç: Aort anevrizmalarında endovasküler yöntemler ilk olarak genel anestezi altında uygulandı. İlerleyen dönemde lokal ve bölgesel anestezi yöntemlerinin kullanımı giderek arttı. Bu çalışmanın amacı, hastanemizde 2015-2018 yılları arasında elektif ve acil endovasküler aort rekonstrüksiyonu yapılan hastalarda kullanılan anestezi yöntemlerinin mortalite, postoperatif komplikasyonlar, yoğun bakım ve yatış üzerine etkilerini değerlendirmektir. Yöntem: Hastanemizde 2015-2018 yılları arasında endovasküler aort tamiri yapılan hastaların verileri geriye dönük olarak incelendi. Hastaların demografik verileri, ASA skoru, acil/elektif operasyon durumu, aort patolojisinin tipi ve lokalizasyonu, operasyon için tercih edilen anestezi yöntemi, anestezi süresi, operasyondan ekstübe/entübe çıkışı, hastanede ve yoğun bakım ünitesinde kalış süreleri kaydedildi. Elde edilen verilerin 30 günlük mortaliteye etkisi araştırıldı. Bulgular: 70 hastanın verileri analiz edildi. Hastaların yaşı, işlemin süresi, uygulanan anestezi yöntemi, operasyondan ekstübe/entübe çıkışı, hastanede ve yoğun bakımda kalış süreleri ile mortalite arasında anlamlı bir ilişki yoktu. Koroner arter hastalığı olan hastalarda mortalitenin anlamlı olarak arttığı bulundu (p=0.044). Acil şartlarda ameliyata alınan hastalarda mortalitenin anlamlı olarak arttığı bulundu (p=0.002). Sonuç: Endovasküler aort onarımı nedeniyle acil şartlarda operasyona alınan hastaların mortalite oranları artmaktadır. Anestezi yöntemindeki farklılıklar mortaliteyi etkilememektedir. Bu nedenle her hastaya özel en uygun anestezi yönteminin tercih edilmesi gerektiği kanaatindeyiz.

Effect of Anesthesia Type on Mortality in Endovascular Aortic Repair

Objective: In aortic aneurysms, endovascular methods were first applied under general anesthesia. The use of local and regional anesthesia methods were gradually increased in the following period. The aim of this study is to evaluate the effects of anesthesia methods used in patients who underwent elective and emergency endovascular aortic reconstruction between 2015-2018 on mortality, postoperative complications, intensive care and hospitalization. Methods: The data of patients who underwent endovascular aortic repair between the years 2015 and 2018 were reviewed retrospectively. Demographic data of the patients, ASA score, emergency/elective operation status, type and localization of aortic pathology, preferred anesthesia method, duration of anesthesia, extubation/intubation from the operation, length of stay in hospital and intensive care unit were recorded. The effect of the obtained data on 30-day mortality was investigated. Results: Data from 70 patients were analyzed. There was no significant relationship between the age of the patients, the duration of the intervention, the anesthesia method applied, the intubation or extubation situation following the procedure, the length of stay in the hospital and intensive care unit, and mortality. Mortality also increased significantly in patients with coronary artery disease (p=0.044). It was found that mortality increased significantly in patients who were operated under emergency conditions (p=0.002). Conclusion: Mortality rates are increasing in patients who are operated under emergency conditions for endovascular aortic repair. Different types of anesthesia method do not affect mortality. For this reason, we believe that the most appropriate anesthesia method should be preferred for each patient.

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