Necmiye AY, Ayça Sultan ŞAHİN, Asuman SARGIN, Ziya SALİHOĞLU, Abdurrahim DERBENT

Jinekolojik laparoskopi uygulanan hastaların serebral oksijenasyon takiplerinin retrospektif olarak incelenmesi

Amaç: Laparaskopik cerrahide uygulanan Trendelenburg pozisyonu ve karbondioksit insüflasyonuyla oluşturulan pnömoperiton, serebral oksijen satürasyonu (rSO2) ile pek çok sistemi etkilemektedir. Laparaskopik cerrahi sırasında serebral oksijen satürasyonunda oluşan değişiklikler, serebral oksimetre (NIRS) ile ölçülmektedir. NIRS kullanılarak, rSO2 düşüklüğü ve doku hipoksisi erkenden tespit edilebilmektedir. Bu çalışmada, jinekolojik laparoskopi olgularında uyguladığımız farklı pozitif end ekspiryum basıncı (PEEP) düzeylerinin serebral oksijenasyon ve hastaların hemodinamik verileri üzerine olan etkilerini retrospektif olarak araştırmayı planladık. Gereç ve Yöntem: Jinekolojik laparoskopi uygulanmış, 69 hastanın dosyaları incelendi. 22 hastaya 8 PEEP, 23 hastaya 6 PEEP ve 24 hastaya 4 PEEP uygulanmış olduğu belirlendi. Bu hastaların oluşturduğu gruplara sırasıyla Grup 8, Grup 6 ve Grup 4 isimleri verildi. Non-invaziv ortalama kan basıncı (OKB), kalp hızı (KAH), oksijen satürasyonu (SpO2), end-tidal karbondioksit (ETCO2) ve rSO2 verilerini kaydedildi. Bulgular: Hasta Trendelenburg pozisyonuna alındıktan ve intraperitoneal insuflasyon uygulandıktan sonraki KAH ve OKB’nin tüm gruplarda belirgin olarak azaldığı görüldü. Üç grupta da entübasyon sonrası ETCO2 değerine göre, sonrasında meydana gelen tüm ölçümler istatistiksel olarak anlamlı artmış (p

The retrospective evaluation of cerebral oxygenation monitorization in patients undergoing gynecologic laparoscopy

Aim: Several systems and cerebral oxygen saturation are affected by Trendelenburg position and pneumoperitoneum created by carbon dioxide insufflation. Alterations in cerebral oxygen saturation (rSO2) during laparoscopic surgery and PEEP administration are measured by cerebral oximetry (NIRS). By using NIRS, depression in rSO2 tissue hypoxia and can be detected earlier, as soon as is affected. In this study, we aimed to investigate retrospectively the effects of different PEEP levels on cerebral oxygenation and hemodynamic effects of patients undergoing gynecologic laparoscopy. Materials and Methods: The files of 69 patients undergoing gynecologic laparoscopy were analyzed. Eight 8 PEEPs in 22 patients, 6 PEEPs in 23 patients and 4 PEEPs in 24 patients had been administrated. The groups were named as Group 8, Group 6 and Group 4. Non-invasive arterial blood pressure (ABP), heart rate (HR), oxygen saturation, end-tidal carbon dioxide (ETCO2) and rSO2 were recorded in all patients. Results: After the patient was put into Trendelenburg position and after intraperitoneal insufflations were given, ABP and HR were significantly reduced in all groups. After intubation, in all groups ETCO2 was increased significantly, but the changes in SpO2 and rSO2 were not statistically significant. There was a significant positive correlation between ETCO2 and rSO2 in all groups (p

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