Sibel OBA, İnci PAKSOY, Surhan ÖZER, Dilek TEZAL, Melahat KARATMANLI

Kraniyotomilerde supin pozisyonda arteriyel ve end-tidal karbondioksit basıncı değişikliklerinin karşılaştırılması

Bu çalışmada intrakraniyal girişimlerde supin pozisyondaki hastalarda end-tidal karbondioksit basıncı (PETCO2,) takibinin arterial karbondioksit basıncı (PaCO2) değeri ile uyumluluk ve yeterliliğini araştırdık. Çalışma; elektif olarak supin pozisyonda kraniyotomi uygulanacak ASA I- II grubunda 30 olguda gerçekleştirildi. Anestezi yöntemi olarak, propofol, fentanil ve atrakuryum ile TIVA uygulandı. Tüm hastalar, operasyon boyunca PaCO2 değeri 30-35 mmHg olacak şekilde uygun tidal volüm ve solunum sayısı ile ventile edildi. Kan gazı örnekleri; indüksiyondan 15 dakika sonra ve takibindeki 1, 2., ve 3. saatlerde alındı. Bu dönemlerde P ETCO2, SpO2, kalp atım hızı, arter basınçları, tidal volüm, frekans, FiO2 kaydedildi. Aynı zaman dilimlerindeki PETCO2 ile PaCO2 değerleri arasındaki fark istatistiksel olarak anlamlı bulundu (p

Anahtar Kelimeler:

Kan gazı analizi, Kraniyotomi, Cerrahi işlemler, operatif, Karbon dioksit, Sırtüstü pozisyon

Comparison of arterial and end-tidal carbon dioxide pressure changes during craniotomy operations in the supine position

In this study, we investigated the validity and usefulness of PETCO2 to predict PaCO2 values in patients undergoing craniotomy operations in the supine position. The study was performed in 30 patients of ASA I, II undergoing elective craniotomy in the supine position. The TIVA technique with propofol, fentanyl and atracurium was applied in all patients. They were mechanically ventilated by an appropriate tidal volume and respiratory frequency in order to maintain PaCO2 pressure values at 30-35 mmHg. Arterial blood gases were measured 15 minutes after induction and at the subsequent first, second and third hours. PETCO2, SpO2, heart rate, arterial blood pressure, tidal volume, frequency and FiO2 were noted simultaneously. Differences between PETCO2, CO2 and PaCO2 values obtained 15 min after induction and at 1st, 2st, 3rd hours were statistically significant (p<0.001). Higher P(a-ET)CO2 values at the third hour were found to be statistically significant in comparison with 15th min and at first hour values (p<0.05). Heart rate and mean arterial blood pressure values were not statistically significant. Our study showed that changes in. PETCO2 did not always indicate P2CO2 precisely and the P(a-ET)CO2 could vary widely in long lasting operations. We decided that in craniotomy operations, capnography must be used in conjunction with arterial blood gas analysis.

Keywords:

Blood Gas Analysis, Craniotomy, Surgical Procedures, Operative, Carbon Dioxide, Supine Position,

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