Altan ŞAHİN, Tolga DOĞAN, M. Alper SALMAN, Özgür CANBAY, Ahmet GÖZAÇAN, Ülkü AYPAR

Kliniğimizde uygulanan fiberoptik trakeal entübasyonların retrospektif değerlendirilmesi

Fiberoptik entübasyon, zor entübasyonda seçilen bir yöntemdir. Birçok hastanede fiberoptik bronkoskobun rutin uygulamaya girmesiyle birlikte, zor havayolu olduğu bilinen veya beklenen hastalarda uyanık fiberoptik entübasyon uygulaması artık "altın standart" olmuştur. Biz bu çalışmamızda; ameliyathanemizde l Ağustos 1998 ile l Şubat 2002 tarihleri arasında çeşitli nedenlerden dolayı fiberoptik trakeal entübasyon uyguladığımız hastaları retrospektif olarak değerlendirmeyi amaçladık. Çalışmamızda, genel anestezi uygulanan hastalarda fiberoptik entübasyon süresini 3,42±10,87 dk. sedasyon uygulanan grupta ise 2,25±1,14 dk. olarak bulduk. Anestezi yöntemi incelendiğinde; genel anestezi grubunda %13, sedasyon grubunda ise %16 oranında komplikasyon gözlenmiştir. Entübasyon süresi, kompükasyonlar ve laringoskopik görünümde genel anestezi ve sedasyon grupları arasında istatistiksel olarak anlamlı bir fark bulamadık. Anestezi yöntemi ve vokal koraların görünümü, öksürük, çene gevşemesi ve ekstremite hareketleri karşılaştırıldığında genel anestezi grubundaki değerler anlamlı olarak daha iyi bulunmuştur. Sedasyonla altında gerçekleştirilen fiberoptik entübasyon, desatürasyon açısından daha güvenli olmakla birlikte; laringoskopinin kolaylığı, vokal kord açıklığı, öksürme, çene gevşekliği ve ekstremite hareketi değerlendirildiğinde genel anestezi ile gerçekleştirilen uygulamalar daha uygun bulunmuştur.

Anahtar Kelimeler:

Geriyedönük çalışma, Entübasyon, intratrakeal, Anestezi

Retrospective evaluation of fiberoptic intubations performed in our clinic

Fiberoptic intubation is an alternative method in the management of difficult airways. With the routine utilization of the fiberoptic bronchoscope, awake fiberoptic intubation has become the gold standard in patients known or predicted to have diffi-culty in airway management. In this study we aimed to evaluate fiberoptic endotracheal intubations performed in our clinic between August 1st 1998 and February 1st 2002 retrospectively. We found the time of fiberoptic tracheal intubation 3,42±10,87 min. in patients under general anesthesia and 2,25±1,14 min in sedated patients. The incidence of complications were 13% in patients under general anesthesia and 16% in sedated patients. There were no statistically significant differences in intubation time, complications and laryngoscopic visualization between general anesthesia and sedation groups. When the appearance of the vocal cords, coughing, jaw relaxation and extremity movements were compared, the conditions of patients under general anesthesia were found to be superior than the sedated patients with statistical significance. In terms of desaturation fiberoptic intubations performed with sedation were more safe. However better intubation conditions and less difficulties had been observed under general anesthesia.

Keywords:

Retrospective Studies, Intubation, Intratracheal, Anesthesia,

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