Hasan ŞAHİN, Aslı DEMİR, ÇİĞDEM YILDIRIM GÜÇLÜ, Dilan AKYURT, Candan HAYTURAL, Özcan ERDEMLİ

Laparoskopik ürolojik cerrahide abdominal insuflasyon basıncı ve postoperatif bulantı-Kusma ilişkisi

Amaç: Bu çalışmada ürolojik laparoskopik cerrahi geçiren hastalarda insüflasyon basıncının (10-15 mmHg) postoperatif bulantı kusma üzerine etkisinin araştırılması planlandı. Materyal ve Metot: Elektif ürolojik laparoskopik cerrahi geçirecek 50 hasta çalışmaya dâhil edildi. Grup 1’de abdominal basınç 10 mmHg, Grup 2’de ise 15 mmHg değerinde tutularak operasyon tamamlandı. Derlenme ünitesinde hastaların bulantı ve kusma sorgulaması 0, 1/2.,1.,2.,4.,6.,12.,24. saatlerde yapıldı ve parametreler kaydedildi. Bulantı–kusmanın tespiti için Verbal Deskriptif Skala (VDS) kullanıldı. İnsüflasyon öncesi kontrol değeri olarak arteriyel kan gazı alındı. pH, P02, pC02, St02, HCO3 değerleri ile eşzamanlı olarak end tidal karbondioksit (EtCO2) ve havayolu basıncı (Paw) ve antiemetik ihtiyacı kaydedildi. Hastaların APFEL skorları hesaplandı. Bulgular: Gruplar arasında bulantı açısından sadece 12. saatte anlamlı fark saptandı. Postoperatif 12. saatte Grup II’de bulantı anlamlı olarak artmış bulundu (p

Anahtar Kelimeler:

İnsuflasyon, Laparoskopi, Ameliyat sonrası bulantı ve kusma

The relation of abdominal insufflation pressure and postoperative nausea and vomiting in urological laparoscopic surgery

Objective: We planned to evaluate the effect of insufflation pressure on postoperative nausea and vomiting in patients who will undergo urologic laparoscopic surgery. Materials and Methods: 50 patients who will undergo elective urologic laparoscopic surgery were included in the study. The surgery completed with intraabdominal pressure of 10 mmHg in group I and 15 mmHg in group II. At 0, 1/2.,1.,2.,4.,6.,12.,24 hours nausea and vomiting were questioned in the postoperative care unit and parameters were recorded. Verbal Descriptive Scale (VDS) was used for determining nausea and vomiting. Arterial blood gas samples examined before insufflation as the control parameters. pH, P02, PC02, St02, HCO3 values and end-tidal carbon dioxide (ETCO2), airway pressure (Paw) and antiemetic drug necessity were recorded. APFEL scores were calculated for all patients. Results: Statistically siginificant difference was detected only at the 12th hour according to nausea between groups. At postoperative 12 th hour nausea was significantly increased at group II (p<0,05). There was no difference between the numbers of patients who vomitted and had antiemetic medication. Conclusion: Keeping insufflation pressure at minimum levels would be effective in reducing nausea and vomiting, and other complications.

Keywords:

Insufflation, Laparoscopy, Postoperative Nausea and Vomiting,

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