Septoplasti Cerrahi Vakalarında Hacim Kontrollü ve Basınç Kontrollü Venti-lasyonun Serebral Oksijen Satürasyonu, Perfüzyon İndeksi ve Pleth Değişken-lik İndeksi Üzerindeki Etkilerinin Değerlendirilmesi: Gözlemsel Prospektif Çalışma

Abstract

Amaç: Bu çalışma, genel anestezi altında septorinoplasti geçiren hastalarda iki ventilasyon stratejisi boyunca plet variabilite indeksi (PVI), perfüzyon indeksi (PI) ve rejyonel serebral oksijen satürasyonu (rSO₂) güvenilirliğini değerlendirmek amacıyla yapılmıştır. Materyal ve Metod: İndüksiyondan sonra, hastalara 20 dakika boyunca hacim kontrollü modda venti-lasyon uygulandı ve bu süre boyunca kalp atım hızı (HR), PI, PVI, periferik oksijen satürasyonu (SpO₂), non-invaziv kan basıncı (NIBP) ve rSO₂ 5 dakikalık aralıklarla kaydedildi. Ardından, ventilasyon 20 daki-ka boyunca basınç kontrollü moda geçirildi ve aynı aralıklarla ölçümler tekrarlandı. Bulgular: Amerikan Anesteziyologlar Derneği (ASA) I-III sınıflandırmasına sahip ve vücut kitle indeksi (BMI) 30'un altında olan 50 hasta çalışmaya dahil edildi. Ameliyat öncesi PI değerleri, her iki ventilas-yon stratejisinde de ameliyat sırasındaki kayıtlara kıyasla anlamlı olarak daha düşüktü (p<0,05). Ameli-yat öncesi PVI, sonraki ölçümlere göre daha yüksekti ve hacim kontrollü ventilasyon (VCV) sırasında 10. dakikada anlamlı olarak yükseldi (p<0,05). Sol taraf rSO₂ değerleri bazal değere göre kademeli bir düşüş gösterirken, sağ taraf rSO₂ değerleri kademeli bir artış gösterdi; ancak dalgalanmalar %10 içinde kaldı. Sonuç: HR, PI, PVI, SpO₂, NIBP ve rSO₂ gibi parametreler iki ventilasyon modu arasında birbirinin yerine kullanılamadı. Genel olarak, VCV'den basınç kontrollü ventilasyona (PCV) geçiş bu değişkenler-de önemli değişikliklere yol açmadı.

Keywords

• ventilasyon
• plet variabilite indeksi
• perfüzyon indeksi
• rejyonel serebral oksijen satürasyonu

Ethical Statement

Çalışma, Helsinki Bildirgesi’ne uygun olarak yürütülmüş ve 29.06.2020 tarihli, HRU/20.12.17 sayılı karar ile Harran Üniversitesi Etik Kurulu tarafından onaylanmıştır.

Evaluation of the Effects of Volume-Controlled and Pressure-Controlled Ventilation on Cerebral Oxygen Saturation, Perfusion Index, and Pleth Variability Index in Septoplasty Surgical Cases: An Observational Prospective Study

Abstract

Background: This study aimed to assess the reliability of pleth variability index (PVI), perfusion index (PI), and regional cerebral oxygen saturation (rSO₂) across two ventilation strategies in patients un-dergoing septorhinoplasty under general anaesthesia. Materials and Methods: After induction, patients were ventilated with a volume-controlled mode for 20 minutes, during which heart rate (HR), PI, PVI, peripheral oxygen saturation (SpO₂), non-invasive blood pressure (NIBP), and rSO₂ were recorded at 5-minute intervals. Subsequently, ventilation was switched to a pressure-controlled mode for another 20 minutes with repeated measurements at the same intervals. Results: Fifty patients with American Society of Anesthesiologists (ASA) I–III classification and a body mass index (BMI) under 30 were included. Preoperative PI values were significantly lower compared with intraoperative recordings under both ventilation strategies (p<0.05). Preoperative PVI was higher than subsequent measurements, with significantly elevated values during volume-controlled ventilation (VCV) at the 10-minute mark (p<0.05). Left-sided rSO₂ values showed a gradual decrease relative to baseline, whereas right-sided rSO₂ demonstrated progressive increases; however, fluctua-tions remained within 10%. Conclusions: Parameters including HR, PI, PVI, SpO₂, NIBP, and rSO₂ were not interchangeable between the two ventilatory modes. Overall, the transition from VCV to pressure-controlled ventila-tion (PCV) did not yield significant alterations in these variables.

Keywords

• ventilation mode
• pleth variability index
• perfusion index
• regional cerebral oxygen saturation

Ethical Statement

The study was conducted in accordance with the Declaration of Helsinki, and approved by the Ethics Committee of Harran University dated 29.06.2020 and document number HRU/20.12.17.

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