FİLİZ ÜZÜMCÜGİL, AYSUN ANKAY YILBAŞ, BAŞAK AKÇA, Aysu Hayriye TEZCAN, AYŞE HEVES KARAGÖZ, BİLGE ÇELEBİOĞLU

RADYOTERAPİ ALAN ÇOCUK HASTALARDA TEKRARLAYAN PROPOFOL UYGULAMALARI

Amaç: Ardışık günlerde anestezi altında radyoterapi uygulanan çocuk hastalarda aynı klinik etkiyi oluşturmak için gerekenpropofol dozlarında bir değişim olup olmadığını, değişim varsa, bunun artma ya da azalma yönünde olup olmadığını araştırmayıamaçladık. Yöntem: Mart 2014 - Mart 2015 tarihleri arasında anestezi altında radyoterapi uygulanmış olan çocuk hastaların anestezikayıtları retrospektif olarak incelenmiştir. Tedavi süresince her tedavi seansının başlatılabilmesi için gereken toplam propofoldozlarındaki değişim birincil parametre olarak incelenmiştir. Doz karşılaştırılması için radyoterapi süreleri haftalara ayrılıp, herhaftaya ait ortalama propofol dozları hesaplanmıştır. Bu şekilde her haftaya ait ortalama propofol dozları karşılaştırılmıştır. Herhaftaya ait propofol dozları aynı zamanda tedavinin 1. gününe ait doz ile de karşılaştırılmıştır.Bulgular: 22 çocuk hastanın 421 tedavi seansına ait propofol dozları analize alınmıştır. Propofol dozlarında, 1. güne göreartış olduğu izlenmiştir; ortalama dozlardaki artış, 1. hafta 0.206 mg kg-1(95% CI; -0.063-0.476), 2. hafta 0.271 mg kg-1(95% CI;0.034-0.508), 3. hafta 0.368 mg k-1(95% CI; 0.013-0.723) ve 4. hafta 0.657 mg kg-1(95% CI; 0.232-1.082) şeklinde olmuştur(p

REPETITIVE USE OF PROPOFOL IN CHILDREN UNDERGOING RADIATION THERAPY

Objective: Our aim was to investigate the alterations of propofol requirements in children undergoing long-term radiotherapyunder anesthesia on consecutive days, to conceive the trend towards rise or fall, during repetitive use of propofol. Method: The anesthesia records of children who received radiotherapy under deep sedation between March 2014-March2015 were obtained. The primary outcome was the alteration in total induction dose of propofol needed for each session duringtreatment. The radiotherapy periods were divided into weeks and mean propofol doses for each week were used for comparisons.The mean dose of each week was also compared to the first day.Results: 421 treatment sessions of 22 children were analyzed. The propofol doses altered by mean doses of 0.206 mg kg-1(95% CI; -0.063-0.476) within the 1st, 0.271 mg kg-1(95% CI ;0.034-0.508) within the 2nd, 0.368 mg kg-1(95% CI; 0.013-0.723)within the 3rd and 0.657 mg kg-1(95% CI; 0.232-1.082) within the 4th weeks of treatment periods compared to 1st day (p<0.05).The doses fluctuated revealing a difference of 1.16±0.83 mg kg-1between minimum and maximum doses (95% CI; 0.80-1.53).50% of patients had higher doses in 1st week, 68.2% in 2nd, 53.3% in 3rd and 78.6% in 4th week compared to 1st day. Conclusion: The induction doses of propofol fluctuated during long-term repetitive use on consecutive days with a trendtowards rise.

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