Murat BAKIŞ, Sinem SARI, Ayhan Öznur CİLLİMOĞLU, Özgür ÖZBEY, Bakiye UĞUR, Mustafa OĞURLU

The effect of anesthesia type on the postoperative complications of major lower extremity surgery

Amaç: Major alt ekstremite cerrahisinde rejyonel anestezi genel anesteziye göre daha fazla tercih edilmektedir. Çalışmamızda rejyonel anestezinin major cerrahilerde genel anesteziye göre komplikasyon insidansı ile ilişkisini araştırmayı amaçladık. Yöntemler: Bu çalışmada 1 Ocak 2009-31 Aralık 2012 tarihleri arasında total diz protezi ve total kalça protezi geçiren 372 olgunun dosyaları retrospektif incelendi. Genel anestezi uygulanan hasta sayısı 118, rejyonel anestezi uygulanan hasta sayısı 254 idi. Hasta birden fazla kalça veya diz replasmanı geçirdiyse sadece ilk operasyon çalışmaya dahil edildi. Hastaların operasyon sonrası 30 gün süresince olan komplikasyonları araştırıldı. Hastaların yaşı, cinsiyeti, operasyon türü (unilateral, bilateral), ek hastalığı olup olmadığı, postoperatif komplikasyonlar bakıldı. Bulgular: Hastaların yaşı, cinsiyeti, sahip oldukları ek hastalıkları bakımından farklılık yoktu. total kalça protezi hastalarının 92 sine genel anestezi 135 hastaya rejyonel anestezi uygulanırken, total diz protezi yapılmış olan hastaların 26 sına genel anestezi, 119 una rejyonel anestezi uygulandığı görüldü (p=0,001). Postoperatif komplikasyonlar incelendiğinde; kardiyak atak hiçbir hasta grubunda yoktu. Pulmoner emboli ve eksitus genel anestezi uygulanan 7, rejyonel anestezi uygulanan 2 hastada tespit edildi. Cerrahi yeri enfeksiyonu genel anestezi uygulanan 9 hastada, rejyonel anestezi uygulanan 7 hastada saptandı ve bu farklar istatistiksel olarak anlamlı bulundu. Sonuç: Kliniğimizde major alt ekstremite cerrahisi geçiren hastalarda rejyonel ve genel anestezi uygulamalarında postop 1 aylık dönem süresince komplikasyonlar bakımından rejyonel anestezi lehine anlamlı fark bulundu.

Anahtar Kelimeler:

Cerrahi alan enfeksiyonu, anestezi çeşidi, alt ekstremite cerrahisi

The effect of anesthesia type on the postoperative complications of major lower extremity surgery

Objective: Regional anesthesia is preferred more than general anesthesia in major lower extremity surgery. In our study, we aimed to investigate the relationship incidence of complications between regional anesthesia and general anesthesia in major surgery. Method: A total of 372 patients who underwent total hip or knee replacement from 1 January 2009 to 31 December 2012 were evaluated retrospectively in the study. The number of patients undergoing general anesthesia and regional anesthesia was respectively 118 and 254. If the patient has a history of more than one hip or knee replacements we were included only the first operation in the study. Postoperative complications were investigated over the course of 30 days. Patients' age, sex, type of operation (unilateral, bilateral), whether additional disease, postoperative complications were evaluated. Results: There were no difference for patients' age, sex and in terms of additional diseases. 92 patients general anesthesia and 135 patients regional anesthesia were performed to the patients who underwent total hip replacement, and 26 general anesthesia and 119 regional anesthesia is applied to patients who underwent total knee replacement (p=0.001). Postoperative complications are examined none of patients had no cardiac attack. Pulmonary embolism and death were found 7 in general anesthesia and 2 in regional anesthesia. Surgical site infection was found in 9 patients undergoing general anesthesia and 7 patients undergoing regional anesthesia and difference was statistically significant. Conclusion: In our clinic, regional and general anesthesia in patients undergoing major lower limb surgery applications observe significant difference in terms of complications during the postoperative period of 1 month.

Keywords:

Surgical site infection, type of anesthesia, lower extremity surgery,

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