Ortaç GÜRAN, Ramadan ÖZMANEVRA, Ali İhsan KILIÇ, Onur HOPA

Kalça Artroskopisi Sırasında Karın İçi Basıncı ve Ayak Perfüzyonunu Etkileyen Faktörlerin Değerlendirilmesi

GİRİŞ ve AMAÇ: Bu çalışmanın amacı, kalça artroskopisi operasyonun farklı evrelerinde karın içi basınç ile ayak baş parmağı perfüzyon basıncı ve satürasyon düzeyi parametreleri arasındaki korelasyonu irdelemektir. YÖNTEM ve GEREÇLER: Femoroasetabular sıkışma tanısıyla kalça artroskopisi yapılan 8 hasta çalışmaya dahil edildi. Karın içi basınç, ayak baş parmağı perfüzyon basıncı, satürasyon indeksi, ayak sıcaklığı, vücut sıcaklığı, kan basıncı, kalp hızı, operasyon süresi, traksiyon mesafeleri gibi parametreler sırasıyla ameliyat başlangıcında (AB), traksiyon uygulaması başlangıcında (TB), traksiyon uygulamasının sonlandığı anda (TSON), traksiyon serbestlendiğinde (TS), kalça fleksiyona alındığında (Flex), kalça ekstansiyona alındığında (Ext) ve ameliyat sonunda (AS) değerlendirildi. BULGULAR: Ameliyat süresi AS perfüzyon ile ters korelasyon gösterdi (r: -0.729, p = 0.04). TSON karın içi basınç ile TSON satürasyon negatif korelasyon gösterdi (r: -0.84, p = 0.009). TB karın-içi basınç, TB vücut-sıcaklığı ile pozitif korelasyon gösterdi (r: 0.85, p = 0.007). Traksiyon sonunda intraabdominal basınç, operasyon başlangıcı değerden daha düşük ölçüldü (p = 0.02). Traksiyon sonu ayak perfüzyonu ve satürasyon seviyeleri operasyon başlangıcına kıyasla daha düşük ölçüldü (p = 0.001 ve p = 0.002, sırasıyla). TARTIŞMA ve SONUÇ: Kalça artroskopisi sırasında uygulanan traksiyonun karın içi basıcı, ayak perfüzyon basıncı ve satürasyon değerlerinde düşüşe sebebiyet verdiği sonucuna ulaşılmıştır. Ameliyat süresi ile ayak perfüzyon basıncının negatif korelasyon gösterdiği tespit edilmiştir.

Evaluation of Factors Affecting Intra-Abdominal Pressure and Foot Perfusion During HipArthroscopy

INTRODUCTION: The purpose of the present study was to investigate the correlation between intra-abdominal pressure and great toe perfusion pressure and saturation level at different stages of the hip arthroscopy surgery. METHODS: Eight patients whom were elected to undergo hip arthroscopy for femoroacetabular impingement were included in the study. Intra-abdominal pressure, great toe perfusion pressure, saturation, foot temperature, body temperature, blood pressure, heart rate, operation time, mean traction time were measured at the beginning of surgery (BS), beginning of traction (BT), end of the traction (ET), after releasing of the traction (RT), at hip flexion position(Flex), at hip extension position (Ext) and end of the surgery (End). RESULTS: The operation time was negatively correlated with End perfusion(r: -0.729, p=0.04). ET Intraabdpress was negatively correlated with ETSaturation (r: -0.84,p=0.009). BT Intraabd press was positively correlated with BT body temp (r: 0.85, p=0.007). Intra-abdominal pressure at the end of traction was lower than that at the beginning of operation (p=0.02). Foot perfusion and saturation level at the end of traction was lower than that at the beginning of the operation (p=0.001 and p=0.002, respectively). DISCUSSION AND CONCLUSION: As a conclusion, traction during hip arthroscopy decreases intra-abdominal pressure, foot perfusion pressures and saturation. The operation time negatively correlated with foot perfusion pressure.

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