SİGARA İÇEN VE İÇMEYENLERDE GENEL ANESTEZİ SIRASINDA KULLANILAN TAZE GAZ AKIMININ KARBOKSİHEMOGLOBİN DÜZEYLERİNE ETKİSİ

Year 2023, Volume: 4 Issue: 1, 29 - 33, 29.03.2023

Ebru Özen Alkin Colak Sevtap Hekimoglu Sahin Cavidan Arar

https://doi.org/10.48176/esmj.2023.100

Abstract

Giriş: Sigara ve değişik şekillerde kullanılan tütün, sağlığa olan zararının bilinmesine karşın tüm dünyada oldukça yaygın bir şekilde kullanılmaktadır. Günümüzde birçok hastalık ile sigara kullanımı
arasındaki ilişki gösterilmiştir. Postoperatif dönemde en önemli mortalite ve morbidite nedeni pulmoner komplikasyonlardır ve sigara kullanımı postoperatif pulmoner komplikasyonların gelişimi için en önemli risk faktörlerinden birisidir. Bu çalışmada elektif olarak operasyona alınan sigara içen ve içmeyen hastalardaki farklı taze gaz akımlarının (4 ve 6 lt/dk) karboksihemoglobin düzeylerine olan etkisinin araştırılması amaçlandı.
Yöntemler: Genel anestezi altında elektif cerrahi planlanan Amerikan Anesteziyoloji Derneği risk skoru I-II risk grubunda, yaşları 18-80 arasında değişen 100 hasta çalışmaya dahil edildi. Operasyon öncesi olgular öncelikle, sigara içenler (Grup A, n=50) ve sigara içmeyenler (Grup B, n=50) şeklinde iki gruba ayrıldı. Tüm olguların indüksiyon öncesi, indüksiyon sonrası, entübasyon sonrası, intraoperatif her 30 dakikada bir, operasyon sonu, ekstübasyon sonrası, postoperatif 30. ve 60. dakikalarda kalp tepe atımı, sistolik arter basıncı (mmHg), diyastolik arter basıncı (mmHg), SpO2, end-tidal karbondioksit ve karboksihemoglobin değerleri ölçülerek kayıt edildi.
Bulgular: Çalışmaya dahil edilen olgular arasında cinsiyet, yaş, kullanılan sigara miktarı, operasyon süresi ve ekstübasyon zamanı açısından fark yoktu. Farklı taze gaz akım hızlarına göre (n=25)
karşılaştırıldıklarında operasyon öncesinde, sırasında ve sonrasında farklı zamanlarda ölçülen karboksihemoglobin değerleri açısından gruplar arasında istatistiksel anlamlı farklılık saptanmadı.
Sonuç: Bu durum, elektif operasyon planlanan hastalarda preoperatif değerlendirme sonrasında operasyona kadar geçen sürede sigaraya ara verilmesi nedeniyle bu süre içerisinde karboksihemoglobinin kandan elimine edilmesine bağlanmaktadır.

Keywords

Sigara, taze gaz akımı, karboksihemoglobin., General anesthesia, smoking, carboxyhemoglobin

Supporting Institution

Trakya Üniversitesi Bilimsel Araştırma Projeleri Birimi

Project Number

TÜBAP- 2009/53

Thanks

Projeye vermiş oldukları destek nedeni ile Trakya Üniversitesi Bilimsel Araştırma Projeleri Birimi'ne teşekkür ederiz.

THE EFFECTS OF FRESH GAS FLOW ON CARBOXYHEMOGLOBIN LEVELS IN SMOKERS AND NON-SMOKERS DURING GENERAL ANESTHESIA

Abstract

Introduction: Cigarettes and tobacco, which are used in different ways, are widely used all over the world, despite the known harm to health. Today, the relationship between many diseases and smoking has been shown. Pulmonary complications are the most important cause of mortality and morbidity in the postoperative period, and smoking is one of the most important risk factors for the development of postoperative pulmonary complications. In this study, we aimed to investigate the effect of different fresh gas flows (4 and 6 lt/min) on carboxyhemoglobin levels in smokers and non-smokers who were operated on electively.
Methods: A total of 100 patients, aged between 18-80, in the American Society of Anesthesiology risk score I-II risk group, who were scheduled for elective surgery under general anesthesia, were included in the study. Preoperatively, cases were divided into two groups smokers (n = 50) and non-smokers (n = 50). Pre-induction, post-induction, postintubation, intraoperatively every 30 minutes, post-operative, postextubation, postoperative 30th and 60th minutes, peak heart rate, systolic arterial pressure (mmHg), diastolic arterial pressure (mmHg), SpO2, End-tidal carbon dioxide, and carboxyhemoglobin values were measured and recorded.
Results: There was no difference between the cases included in the study in terms of gender, age, amount of cigarette smoked, operation time, and extubation time. When compared according to different fresh gas flow rates (n = 25), no statistically significant difference was found between the groups in terms of carboxyhemoglobin values measured at different times before, during, and after the operation.
Conclusion: This situation is attributed to the elimination of carboxyhemoglobin from the blood during this period, due to the cessation of smoking in patients scheduled for elective surgery after
the preoperative evaluation until the operation.

Keywords

General anesthesia, smoking, carboxyhemoglobin

Project Number

TÜBAP- 2009/53

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