Adnan AY, Ezgi ERKILIÇ, Elvin KESİMCİ, Tülin GÜMÜŞ, Orhan KANBAK

PREOPERATİF ANKSİYETENİN ENTROPİ MONİTORİZASYONU ALTINDA PROPOFOL TÜKETİMİ ÜZERİNE ETKİSİ

Amaç: Preoperati f anksiyete; intraoperati f anestezik gereksinimi, hemodinami, nöroendokrin değifliklikler ve postoperati f dönemde iyileflme, ağrı tedavisi üzerine olumsuz etkilere sahiptir. Çalıflmamızda anestezi derinliğinin entropi ile standardize edildiği kadın hastalarda; preoperati f anksiyetenin, hemodinami ve anestezik tüketimine olan etkisini değerlendirmeyi amaçladık. Yöntem: Etik Kurul izni ve bilgilendirilmifl hasta onamı alındıktan sonra çalıflmaya dahil edilen 50 hastaya, durumluk-sürekli kaygı ölçeği (STAIFORM TX-1/2) uygulandı. Anestezi indüksiyonunda entropi değeri 40-60 arasında olacak flekilde propofol ve remi fentanil infüzyonlarına bafllandı. damede de entropi değerleri bu seviyede kalacak flekilde infüzyonlara devam edildi. Operasyon süresince hemodinamik parametreler ve operasyon sonunda da tüketilen anestezik ajan miktarı kaydedildi. Bulgular: Hastaların Durumluk ve Sürekli Anksiyete skorları sırasıyla 39.4±11.2 ve 42.5±8.8 olarak tespit edildi. Durumluk ve Sürekli Anksiyete skorlarına göre düflük ve yüksek anksiyete gruplarında entropinin 40-60 olma süresi ve tüketilen propofol miktarları arasında istatistiksel olarak anlamlı farklılık görülmedi. Anksiyetesi yüksek veya düflük olan hastalarda hemodinamik parametrelerin seyrinde de farklılık yoktu (p>0.05). Sonuç: Bu çalıflmada Durumluk ve Sürekli Anksiyete skorlarındaki farklılıkların uyuma süresini, anestezi indüksiyon ve idamesinde kullanılan anestezik miktarını, hemodinamik parametreleri etkilemediğini tespit ettik. Literatürde bu konuyu inceleyen çalıflmalarda, farklı sonuçlar bildirildiği için, anestezi derinliğinin monitorize edildiği daha fazla sayıda klinik çalıflmanın anksiyete ile anestezik ajan gereksinimi arasındaki iliflkiye ıflık tutacağı kanısındayız

THE EFFECT OF PREOPERATIVE ANXIETY ON PROPOFOL CONSUMPTION UNDER ENTROPY MONITORIZATION

Objective: Preoperative anxiety is associated with adverse effects on intraoperative anesthetic requirement, hemodynamic, neuroendocrine changes and postoperative recovery and pain. In this study, we aimed to evaluate the effects of preoperative anxiety on hemodynamics and anesthetic requirement in female patients under general anesthesia whose anesthetic depth is monitorized by entropy. Method: After approval of the ethics committee and informed consent of patients; ''STAI FORM TX-1/2'' was administered to 50 patients. Propofol and remi fentanil infusions were administered at induction and during maintenance; so as to keep entropy between 40-60. Hemodynamic parameters and total anesthetic agent consumption were recorded throughout the study. Results: Levels of Trait anxiety and State anxiety were 39.4±11.2 and 42.5±8.8, respectively. Time to have entropy 40-60; and the amount of propofol consumption were not statistically di fferent between high and low anxiety groups. The hemodynamic parameters did not change signi ficantly in either high or low anxiety groups (p>0.05). Conclusion: We determined that the di fferences between Trait and State anxiety levels did not affect anesthesia induction time, anesthetic agent consumption and hemodynamic parameters. However, more clinical studies with monitorization of anesthetic depth are required to lighten the contradictory results obtained from the studies investigating this subject in the literature

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