Taner Şerif KÜÇÜKCERİT, Tülay ÖRKİ, Atakan ERKILINÇ, Rezan YALTIRIK, Halide OĞUŞ, Füsun GÜZELMERİÇ, Tuncer KOÇAK

Desfluranın sigara içen koroner arter bypass hastalarında solunum mekaniklerine etkisi

Amaç: Bu çalışmada koroner arter bypass cerrahisi planlanan sigara içen hastalarda desfluranın solunum mekaniklerine etkisi araştırıldı. Metod: Randomize, kontrollü, prospektif olarak elektif koroner arter bypass cerrahisi planlanan ASA II-III grubu, 3080 yaş arası hastalar sigara içen ve kontrol grubu olarak iki gruba ayrıldı. İntravenöz anestezi indüksiyonundan sonra FiO2 % 60 80 oksijen ve kuru hava karışımı içine 1 MAC % 6 desfluran başlandı. Kardiyopulmoner bypass dönemi hariç operasyon süresince desflurana devam edildi. İki grubun kalp atım hızı KAH , ortalama arter basıncı OAB , periferik oksijen satürasyonu SpO2 , endtidal CO2 Et CO2 değerleri ve solunum mekaniği parametreleri havayolu direnci Paw , dinamik kompliyans Cdyn , tepe hava yolu basıncı PIP entübasyon sonrası başlangıç desfluran solumaya başlandıktan sonra 5. ve 20. dakika, sternum açılma, sternum kapama 0., 5. ve 20. dakikalarda kaydedildi. Bulgular: Her iki grup arasında tüm dönemlerde KAH, OAB, SpO2, EtCO2, Paw, Cdyn, PIP değerleri benzer bulundu p>0.05 . Sonuç: İki grup arasında anlamlı bir fark bulunmaması; sigara içen hastaların preoperatif solunum fonksiyon testlerinin normal sınırlarda olmasına bağlı olabilir.

Anahtar Kelimeler:

desfluran, koroner arter bypass, sigara

The effect of desflurane to the respiratory mechanics in smokers patients with coronary artery bypass grafting

This study was planned coronary artery bypass graft surgery in patients who smoke to investigate the effect of desflurane respiratory mechanics Method: ASA II-III group, undergoing coronary artery bypass surgery were classified as smokers and non-smokers. After induction of intravenous anesthesia, FiO2 60 - 80% of dry air into a mixture of oxygen and 1 MAC 6% desflurane was started. Desflurana except for the period of cardiopulmonary bypass was continued during the operation.Two groups, heart rate HR , mean arterial pressure MAP , peripheral oxygen saturation SpO2 , end-tidal CO2 Et CO2 and respiratory mechanics parameters airway resistance Paw , dynamic compliance Cdyn , peak airway pressure PIP after intubation baseline after the initiation of breathing desflurane 5th and 20th minutes, opening the sternum, sternal closure at 0, 5th and 20th minutes were compared. Results: All measurement periods HR, MAP, EtCO2, SpO2, PIP, Paw, Cdyn values were not significantly different between the two groups. Conclusions: Similar effects are seen in both groups. It may be due to smokers in the study having normal preoperative pulmonary function tests.

Keywords:

desflurane, coronary artery bypass grafting, smoking,

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