NAZOTRAKEAL ENTÜBASYON DENEYİMLERİMİZ

Amaç: Bu yazıda maksillofasiyal cerrahi olgularındaki nazotrakeal entübasyon deneyimlerimizi literatür bilgileri ışığında sunmayı amaçladık. Gereç ve Yöntem: 01.09.2015-01.11.2016 tarihleri arasında genel anestezi altında opere edilen ve tek anestezi hekiminin nazotrakeal entübasyon uyguladığı olguların anestezi kayıtları retrospektif olarak incelendi. Cinsiyet, boy, vücut ağırlığı, kullanılan nazotrakeal tüplerin numaraları, uygulanan operasyon ve operasyon süreleri, entübasyon sırasında karşılan güçlükler ve bu nedenle uygulanan manevralar ya da girişimler ile istenmeyen yan etkilere ait veriler değerlendirildi. Bulgular: Değerlendirilen 227 olgunun tümünün ba- şarı ile entübe edildiği saptandı. Kullanılan nazotrakeal tüp numaralarının 5.0 ile 8.0 arasında olduğu, entübasyon sonrası 8 olguda kanama gözlendiği, 46 olguda McCoy laringoskopu kullanıldığı saptandı. 14 olguda nazotrakeal tüpün yönlendirilemediği bu nedenle nazotrakeal tüpün ¼ oranında döndürüldüğü, 8 olguda bu manevra ile başarılı olunduğu 6 olguda ise Magill forcepsi kullanılarak nazotrakeal entübasyonun gerçekleştirildiği saptandı. Sonuç: Dikkatli bir preoperatif değerlendirme, doğru teknikle, uygun boyutta, özel tasarlanmış nazotrakeal entübasyon tüplerini kullanarak olası komplikasyonları minimalize ettiğimiz ve tüm olgularda nazotrakeal entübasyonu başarıyla gerçekleştirdiğimiz kanısındayız. Anahtar Kelimeler: Entübasyon, maksillofasiyal cerrahi.OUR EXPERINCE WITH NASOTRACHEAL INTUBATION ABSTRACT Aim: In this article, we aimed to present our experience on nasotracheal intubation in cases with maxillofacial surgery in the light of literature. Materials and Methods: Anesthesia records of cases, undergoing surgery under general anesthesia and with nasotracheal intubation applied by a single anesthesiologist, dated between 01.09.2015 and 01.11.2016 were retrospectively reviewed. Gender, height, body weight, size of the intubation tube used, operation type and duration, difficulties encountered during intubation, maneuvers or interventions applied to overcome these difficulties and data of adverse side effects were evaluated. Results: It was found that the nasotracheal intubation procedure was successful at all 227 cases evaluated. It was also found that the size of intubation tubes varied between 5.0 and 8.0, post-intubation bleeding occurred at 8 cases and McCoy laryngoscope was used at 46 cases. It was also determined that in 14 cases, intubation tube could not be guided, therefore it was rotated to ¼, being successful in 8 of these cases, whereas Magill forceps was required in 6 of these cases. Conclusion: We believe that thanks to careful preoperative evaluation, right technique, and utilization of appropriate size nasotracheal intubation tubes designed for this purpose, the nasotracheal intubation procedure in all of the cases were successful, and complications were minimized. Keywords: Intubation, maxillofacial surgery

Anahtar Kelimeler:

Entübasyon

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