Anesthesia management of open tracheostomy patients: A single center experience

The purpose of the present study of ours was to evaluate anesthesia management and complications in open technique tracheostomy cases. This study was conducted in 105 patients who underwent tracheostomy. The patients were retrospectively screened. The demographic data, anesthesia management, length of hospital stay, Intensive Care Unit stay, mortality, perioperative, postoperative, and early complications of the patients were evaluated. The average age of the patients was 20-91 (60±14.92) years. ASA scores were as follows: 54 cases (51.4%) were ASA II; 45 cases (42.8%) were ASA III; and 6 cases (5.7%) were ASA IV. The most common complaints of the patients were as follows: Head-neck tumor in 75 cases (71.4%). The anesthesia methods were as follows: General anesthesia in 92 cases (87.6%), and sedoanalgesia in 13 cases (12.4%). The most common complications were as follows: Bleeding in 5 patients (4.7%) in the perioperative period; and respiratory failure in 19 patients (18.1%) in the postoperative period. Postoperative mortality was seen in 6 cases (5.7%). There was a statistically significant difference between the mortality rates, hospital stay, and age (P: 0.008) (P

PDF

___

1. De LP, Bedert L, Delcroix M, et al. Tracheotomy: clinical review and guidelines. Eur J Cardiothorac Surg. 2007;32:412–21.

2. Shirawi N, Arabi Y. Bench-to-bedside review: early tracheostomy in critically ill trauma patients. Crit Care. 2006;10:201.

3. Young D. Early tracheostomy reduces sedative use but does not affect mortality: Presented at ISICEM. 29th International Symposium on Intensive Care and Emergency Medicine 2009.

4. Spataro E, Durakovic N, Kallogjeri D. Complications and 30-day hospital readmission rates of patients undergoing tracheostomy: A prospective analysis. Laryngoscope. 2017;127:2746-53.

5. Dierks EJ: Tracheotomy: Elective and emergent. Oral Maxillofac Surg Clin North Am. 2008;20:513-20.

6. DurbinCGJr.:Tracheostomy:Why,when,andhow?RespirCare. 2010;55:1056-68.

7. Straetmans J, Schlöndorff G, Herzhoff G, et al. Complications of midline-open tracheotomy in adults. Laryngoscope. 2010;120:84-92.

8. Schulz KF, Altman DG, Moher D; CONSORT Group. CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. Int J Surg. 2011;9:672-7.

9. Aldrete JA, Kroulik D. A postanesthetic recovery score. Anesth Analg. 1970;49:924-34.

10. Pogue MD, Pecaro BC. Safety and efficiency of elective tracheostomy performed in the intensive care unit. J Oral Maxillofac Surg. 1995;53:895-7.

11. Yuan I, Bruins BB, Kiell EP, et al. Anesthetic Management for Pediatric Awake Tracheostomy. A A Case Rep. 2016 1;7:236-38.

12. Goff MJ, Arain SR, Ficke DJ, et al. Absence of bronchodilation during desflurane anesthesia: A comparison to sevoflurane and thiopental. Anesthesiology. 2000;93:404-8.

13. Erkalp K, Kalekoglu N, Erden V, et al. Inhalation Induction in Tracheostomized Patients: Comparison of Desflurane and Sevoflurane. Int J Anesthetic Anesthesiol. 2019;6:089.

14. Delaney A, Bagshaw SM, Nalos M. Percutaneous dilatational tracheostomy versus surgical tracheostomy in critically ill patients: a systematic review and meta-analysis. Crit Care. 2006;10:R55.

15. Halum SL, Ting JY, Plowman EK, et al. A multi-institutional analysis of tracheotomy complications. Laryngoscope. 2012;122:38–45.

16. Arabi YM, Alhashemi JA, Tamim HM, et al. The impact of time to tracheostomy on mechanical ventilation duration, length of stay, and mortality in intensive care unit patients. J Crit Care. 2009;24:435-40.