Selim TURHANOĞLU, Ertap AKOĞLU, Şemsettin OKUYUCU, Menekşe OKŞAR, Sait ÇOLAK

OBSTRÜKTİF UYKU APNESI CERRAHİSİNİ TAKİBEN EKSTÜBASYON SONRASI SONUÇLARIN BELİRLEYİCİLERİ: RETROSPEKTİF KOHORT ÇALIŞMA

Amaç Obstrüktif uyku apnesi (OSA) hastaları ekstübasyon sırasında sık sık çeşitli komplikasyonlarla karşılaşırlar. Bu retrospektif çalışmada, OSA cerrahi olgularında ekstübasyonda görülen çeşitli komplikasyonların sıklıkları ve postoperatif ekstübasyon sonrası komplikasyonlar ile ilişkisi araştırıldı.Yöntem Bu çalışma, Mustafa Kemal Üniversitesi Hastanesi Kulak Burun Boğaz Kliniğine başvuran ve tek başına veya diğer OSA ile ilgili prosedürlere ek olarak uvulofaringoplasti yapılması planlanan ve Ekim 2011 ile Aralık 2013 arasında 22 OSA hastasını kapsamaktadır. Veri toplamak için OSA cerrahisi vakalarının, OSA ve OSA’lı hastaların özellikleri, ve ayrıca OSA ile ilişkili komplikasyonların tipi ve sıklığı konularında literatüre dayanan bir araştırma protokolü kullanıldı. Veriler hasta ve hasta yakınları ile temas kurularak doğrulandı. OSA cerrahisi olgularında ekstübasyonda ve post operatif ekstübasyon sonrası dönemde görülen başlıca komplikasyonlar ve bu komplikasyonlar arasındaki ilişki araştırıldı.Bulgular En sık görülen ekstübasyon komplikasyonu hipertansiyondu (% 31.8), en sık görülen postoperatif komplikasyonlar ise hemoglobin oksijen desatürasyonu (% 18.2) idi ve bunu yutma zorluğu (% 13.6) izledi. Aşağıdaki komplikasyonlar arasında anlamlı ilişkiler vardı (p

PREDICTORS OF POSTEXTUBATIONAL OUTCOMES FOLLOWING OBSTRUCTIVE SLEEP APNEA SURGERY: A RETROSPECTIVE COHORT STUDY

ObjectiveObstructive sleep apnea (OSA) patients often present with various complications during extubation. This retrospective study investigated the frequenciesof various complications during extubation and theirassociations with postextubation/postoperative complications in OSA surgery cases.Material and MethodsThis study comprised 22 OSA patients admitted to the otolaryngology clinic of Mustafa Kemal University Hospital, Turkey. The patients underwent uvulopharyngoplasty alone or with other OSA-related procedures between October 2011 and December 2013. We reviewed the literature on the management of OSAsurgery cases, the related characteristics of OSA and patients with OSA, and the type and frequency of the complications associated with OSA surgery. The collected data were verified by contacting the patients and their relatives. The chief complications seen during and after extubation in the OSA surgery cases, as well as the relationship between these complications, were investigated.ResultsHypertension was the most frequent extubation complication (31.8%). The most frequent postoperative complications were hemoglobin oxygen desaturation (18.2%) and difficulty swallowing (13.6%). Significant associations (P < 0.05) were noted between the following complications during extubation and postoperatively: upper airway obstruction and delirium/difficulty swallowing, respectively; cough and delirium/ desaturation, respectively; laryngomalacia–pulmonary aspiration and reintubation, respectively; hypertension and desaturation, respectively; tachycardiaand desaturation, respectively; and dysrhythmia and delirium/unexpected need for intensive care unit admission/desaturation, respectively.ConclusionExtubation complications can be used to predict postoperative complications. Furthermore, patients exhibiting dysrhythmia at extubation should be monitoredclosely.

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