Sengül ÖZMERT, Emine DİBEK MISIRLIOĞLU, Feyza SEVER, Galip ÖZMERT, Fatih MISIRLIOĞLU, Can Naci KOCABAŞ

Astımlı Hastanın Preoperatif ve İntraoperatif Anestezi Yönetimi: Bir Anket Çalışması

Amaç: Astım en yaygın akciğer hastalıklarından biridir. Havayollarındaki hassasiyet ve yapısal değişiklikler nedeniyle perioperatif ve postoperatif solunum komplikasyonlarına neden olabilmektedir. Perioperatif dönemde bu risklerin önlenmesinde iyi bir preoperatif hazırlık, uygun farmakolojik ajan ve anestezi tekniklerinin seçimi önemlidir. Bu çalışma da anestezi hekimlerinin astımlı hastalara yaklaşımlarının değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Çalışmada, anestezi uzmanlarının astımlı hastalarda anestezi yönetimi ile ilgili yaklaşımlarını değerlendiren 13 sorudan oluşan bir anket uygulandı. Ankete katılan hekimler çalıştıkları kuruma göre gruplandırıldı. Üniversite hastanesi grup A, devlet hastanesi grup B, eğitim ve araştırma hastanesi grup C ve özel hastaneler grup D olarak adlandırıldı. Bulgular: Çalışmamıza 261 anestezi doktoru katıldı. Hekimlerin 45’i (%17,2) üniversite hastanesi, 74’ü (%28,4) devlet hastanesi, 128’i (%49) eğitim araştırma hastanesi, 14’ü (%5,4) özel hastanede çalışmaktaydı. Çalışmamızda, farklı kategorilerdeki hastanelerden katılan anestezi uzmanlarının preoperatif ve intraoperatif astımlı hasta yönetiminde önemli bir değişkenlik saptanmadı. Sadece Grup D yanıtlarında astımlı hasta yönetiminde indüksiyonda tercih edilecek ilaç ve idamede kullanılacak ajan seçiminde diğer gruplara göre istatiksel olarak anlamlı fark mevcuttu. Sonuç: Bu çalışmada, ülkemizde anestezi uzmanlarının astımlı hastalarda anestezi yönetimi ile ilgili yaklaşımlarının güncel durumu analiz edilmiştir. Anketimizde ortaya çıkan sonuçlara göre; anestezi hekimlerinin astımlı hastanın yönetimi ile ilgili tutum ve tecrübeleri literatür ile uyumluydu. Ülkemizde çalışan anesteziyoloji ve reanimasyon uzmanlarının astımlı hastalarda anestezi uygulamaları konusundaki tutum, davranış ve uygulamaları ile ilişkili veriler astımlı hastanın anestezi yönetimleri için yol gösterici olabilir.

Preoperative and Intraoperative Anesthesia Management of Asthmatic Patient: A Survey Study

Objective: Asthma is one of the most common diseases. It may cause peri-postoperative respiratory complications due to sensitivity and structural changes in airways. The selection of anesthesia techniques are important in preventing these risks. The aim of this study is to evaluate the approaches of anesthesiologists to asthmatic patients. Material and Method: A questionnaire consisting of 13 questions was used in order to evaluate anesthesists for their approach to anesthesia management by asthmatic patients. The physicians were grouped according to the institution they work at. The physicians who work at university hospitals, state hospitals, education and research hospitals and private hospitals are divided into group A, group B, group C and group D respectively. Results: Two hundred sixty-one anesthesiologists participated in our study. Forty-five (17,2%) of the physicians were working in university hospitals, 74 (28,4%) in state hospitals, 128 (49%) in educational research hospitals and 14 (5,4%) in private hospitals. In Group D responses, there was a statistically significant difference in the choice of the drug used in the management of asthmatic patients’ induction and the choice of agent used in the maintenance treatment. Conclusion: In this study, the current status of anesthesiologists' approach to anesthesia management in asthmatic patients has been analyzed. According to the results of our survey, the attitudes and experiences of the anesthesiologists regarding the management of asthmatic patients have been found to be consistent with the literature. The data related to the attitudes, behaviors and practices of anesthesiologists and reanimation specialists working in our country in the applications of anesthesia in asthmatic patients may be a guide for the anesthesia management of asthmatic patients.

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