Jülide SAYİN KART, Ummahan DALKİLİNC HOKENEK

Gastrointestinal endoskopiler öncesinde uygulanan sedasyon hastaların gelecekteki işlemler için kaygı düzeyini nasıl etkiler?

Amaç: Gastrointestinal endoskopik işlemler sırasında sedoanaljezi uygulaması, işlem başarısının yanı sıra hasta konforu ve güvenliğini de artırmaktadır. Bu çalışmanın amacı, gastrointestinal endoskopik işlemlerde sedoanaljezi uygulanan hastaların anksiyete düzeylerini ve olası erken komplikasyonları gastrointestinal endoskopik işlemlerden önce ve iki gün sonra araştırmaktır. Gereç ve Yöntem: Çalışma prospektif, randomize, tek merkezli bir klinik araştırma olarak tasarlandı. Nisan 2022-Eylül 2022 tarihleri arasında elektif gastrointestinal endoskopi uygulanan 18 yaş üstü, American Society of Anesthesiology (ASA) fiziksel durum skoru 1-3 olan hastalar çalışmaya dahil edildi. Çalışmaya katılmayı reddeden, ASA 3 üzerinde olan, okuma yazma bilmeyen, Ejeksiyon Fraksiyonu <%30 olan, psikiyatrik hastalık tanı ve tedavisi olan hastalar çalışma dışı bırakıldı. Tüm hastalardan bilgilendirilmiş onam alındı. Hastaların anksiyete düzeyleri Beck anksiyete envanteri (BAÖ) ile değerlendirildi. İşlem öncesi ve sonrası hemodinamik değişiklikler, kan testi sonuçları kaydedildi ve karşılaştırıldı. Sonuç: Anestezi ile anksiyetinin azaltılması hastalara daha etkin bir şekilde endoskopi yapılmasını ve erken tanı konulabilmesini sağlamaktadır. Sedasyon sırasında endoskopi prosedürü geçiren hastaların gelecekle ilgili önemli ölçüde daha az anksiyeteleri azalmaktadır. Bu sayede prosedürün her seferinde başarı şansı artabilir.

Anahtar Kelimeler:

Endoskopi, Anestezi, Anksiyete

How sedation used prior to gastrointestinal endoscopies affects patients' anxiety level for future procedures

Aim: The application of sedoanalgesia during gastrointestinal endoscopic procedures increases the success of the procedure as well as patient comfort and safety. The aims of this study are to investigate the anxiety levels of patients and potential early complications who practised sedoanalgesia in gastrointestinal endoscopic procedures before and two days after. Material and Method: The study was designed as a prospective, randomized, single-centre clinical trial. Patients over the age of 18 and had American Society of Anaesthesiology (ASA) physical status score 1-3 who were practised elective gastrointestinal endoscopy, between April 2022 and September 2022 were included to the study. The patients who refused to participate, were above ASA 3, and were illiterate, had an Ejection Fraction <30%, and had a diagnosis and treatment of psychiatric disease were excluded from the study. Informed consent obtained from all patients. Anxiety levels of the patients were evaluated with Beck Anxiety Inventory (BAI). Hemodynamic changes, blood test results were recorded and compared before and after the procedure. Results: One hundred four patients included to the study with the age of 23 to 79. Preoperative and postoperative BAI scores were found statistically significant (p<0.05). The patients’ satisfactions have seen very high after procedure. The complications have seen on 7 (%6.7) patients. All of the complications were due to nature of the procedure as epistaxis/mucosal trauma (n=3), equipment damage(n=4). There have been no serious or life-threatening complications during procedures.Conclusion: Reducing anxiety by anaesthesia, patients will be more efficiently persuaded to execute endoscopy and by thus early diagnosis can be achieved. Patients who have undergone an endoscopy procedure while sedated have significantly fewer concerns about the future. This may increase the procedure's chances of success every time.

Keywords:

Endoscopy, anesthesia, anxiety,

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