Elektif sezaryen ameliyatlarında yapılan perioperatif uygulamaların ERAS protokolüne göre değerlendirilmesi

Amaç: Bu çalışma elektif sezaryen ameliyatlarında perioperatif uygulamaların Cerrahide Hızlı İyileşme Protokolüne (Enhanced Recovery After Surgery – ERAS) göre değerlendirilmesi amacıyla tanımlayıcı ve prospektif olarak yapılmıştır. Gereç ve Yöntem: Çalışma 01 Ağustos 2016 - 31 Mayıs 2017 tarihleri arasında bir Eğitim ve Araştırma Hastanesi Kadın Hastalıkları ve Doğum Kliniği’nde yürütülmüştür. Sezaryen ameliyatı planlanan, çalışmaya katılmayı kabul eden 100 kadın araştırma örneklemini oluşturmuştur. Veri toplamak amacı ile kadınların bazı tanıtıcı özellikleri ile ERAS protokolü önerilerini içeren, araştırmacılar tarafından oluşturulan veri toplama formu kullanılmıştır. Bulgular: Preoperatif katı gıda kısıtlama zamanı 12,17±3,37 saat, preoperatif sıvı kısıtlama zamanı 10,36±2,85 saat olarak hesaplanmıştır. Kadınların %77’sinde spinal anestezi, %23’ünde genel anestezi kullanıldığı, intraoperatif hipoterminin önlenmesi amacı ile bütün hastalarda ameliyat esnasında ısıtıcı alt şiltesi, uyandırma ünitesinde ise havalı battaniyeler kullanıldığı belirlenmiştir. Cerrahi kesi boyutu ortalama 15,83±0,81 cm olarak ölçülmüştür. Postoperatif üriner kateter çıkarılma zamanı 7,99±2,86 saat, gaz çıkış zamanı 15,29±6,36 saat ve katı gıdaya başlama zamanı 16,46±5,85 saat olarak hesaplanmıştır. Sonuç: Çalışmada elde edilen bulgulara göre çoğu uygulamanın ERAS protokollerine uygun olduğu değerlendirilmiştir. Farklı olan uygulamalarla ilgili; hastaların preoperatif dönemde hem sözel hem de yazılı materyallerle bilgilendirilmesi gerekir.

Anahtar Kelimeler:

Cerrahi sonrası hızlı iyileşme, , sezaryen, hemşirelik

Evaluation of perioperative practices according to ERAS protocol in elective Cesarean surgery

Purpose: This study was conducted as a descriptive and prospective study to evaluate perioperative practices in elective cesarean operations according to the Enhanced Recovery After Surgery (ERAS) protocol. Materials and Methods: The research was conducted between 01 August 2016 and 31 May 2017 at an Education and Research Hospital Obstetrics Clinic. The sample consisted of 100 volunteer women that planning elective cesarean surgery. Data collecting form consisted of some descriptive characteristics of women and ERAS protocol proposals. Results: Mean preoperative solid food restriction time was 12,17±3,37 hours, mean preoperative fluid restriction time was 10,36±2,85 hours. 77% of women was applied spinal anesthesia; 23% of them was applied general anesthesia; in order to prevent intraoperative hypothermia, all women underwent a heating under mattress and air blankets in the wake unit. Surgical incision size was found to be 15,83±0,81 cm. Postoperatively, it was calculated that the time of remove of urinary catheter was an average of 7,99±2,86, the time of release of gas was an average of 15,29±6,36 hours and the time to start solid food was an average of 16,46±5,85 hours. Conclusion: According to the findings obtained in the study, most of the practices were compatible with the ERAS protocols. About practices that are different; it is recommended that in the preoperative period women may be informed with both verbal and written materials.

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