VOLKAN BAYTAŞ, M. Soner ÖZCAN, Serdar ÇATAV, Cumhur BAŞARAN, Asuman UYSALEL, G. Enver ÖZGENCİL

Jinekolojik malignitelerde anestezi ve temel ilkeler

Kadınlar için önemli bir sağlık sorunu jinekolojik malignitelerdir. Hastaların önemli bir kısmı bu tümörler nedeniyle kaybedilmektedir. Jinekolojik malign tümörlerin tedavisi birçok disiplinin kombinasyonunu gerektirmektedir. Bu vakalar için üç temel tedavi yöntemi; cerrahi, kemoterapi ve radyoterapidir. Temel tedavi yönteminin birinci basamağı invazif cerrahidir. Anesteziyologlar jinekolojik cerrahi için hasta seçiminde perioperatif anestezi yönetiminde ve postoperatif bakımda önemli birçok role sahiptir. Tüm hastalar cerrahi ve anestezi ile ilgili olası problemler açısından operasyon öncesi değerlendirilmelidir. Medikal durumlar ayrıntılı olarak araştırılmalı ve hasta cerrahi öncesi en uygun hale getirilmelidir. Operasyon öncesi hastalar ayrıntılı anamnez ve fizik muayene ile birlikte laboratuar testleri ve radyolojik tetkikler ile değerlendirilmelidir. Elektif cerrahide risk faktörleri yaş (>50 yaş), kardiyovasküler ve pulmoner hastalıklar, diabetes mellitus, renal disfonksiyon ve hematolojik sorunlardır. Doğru preoperatif değerlendirme ile intraoperatif ve postoperatif komplikasyonlar azaltılabilir. Bu tür cerrahi müdahalelerde genel anestezi en popüler tekniktir. Epidural anestezi genel anestezi ile birlikte güvenle uygulanabilir. Bu da postoperatif analjezi açısından parenteral opioidlerden daha iyi ağrı kontrolü sağlar.

Anesthesia and basic principles for gynecologic malignancies

Gynecological malignancies are a vital health problem for women. Many patients lose their lives because of these tumors. The treatment of gynecological malignancies requires combination of various disciplines. Three basic treatment methods for these malignancies include surgery, chemotherapy and radiotherapy. Surgery is the first basic treatment method for invasive gynecologic diseases. Anesthesiologists have an important role in gynecologic surgery in terms of patient selection, management of perioperative anesthesia, and postoperative nursing. All patients should be examined before operation for the problems concerning surgery and anesthesia. Their medical conditions should be analyzed in detail and the patient should be in her best condition preoperatively. The patients should be evaluated prior-to surgery via detailed history taking and physical examination together with laboratory tests and radiological studies. In elective surgery, risk factors are ages above 50, cardiovascular and pulmonary diseases, diabetes mellitus, renal dysfunction and hematological disorders or problems. With the help of correct preoperative evaluation, it is possible to reduce intraoperative and postoperative complications. General anesthesia is a very popular technique in these types of surgical interventions. Epidural anesthesia can be securely applied with the general anesthesia. In terms of postoperative anesthesia, this ensures a better pain controlling than the parenteral opioids do.

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