j cukurova anesth surg

Journal of Cukurova Anesthesia and Surgical Sciences

2667-498X

Merthan TUNAY

Anaesthesiology

Anesteziyoloji

Endoskopik Transsfenoidal Cerrahi Uygulanan Akromegalik Hastalarda Anestezi Yönetiminin Retrospektif Analizi

A Retrospective Analysis of Anesthesia Management of Acromegalic Patients Undergoing Endoscopic Transsphenoidal Surgery

https://orcid.org/0000-0001-9183-9124

Ilgınel

Murat Türkeün

ÇUKUROVA ÜNİVERSİTESİ, TIP FAKÜLTESİ

https://orcid.org/0000-0002-7984-1800

Laflı Tunay

Demet

ÇUKUROVA ÜNİVERSİTESİ, TIP FAKÜLTESİ

08 31 2019

2 2 169 179 08 25 2019 08 31 2019

2018

Journal of Cukurova Anesthesia and Surgical Sciences

Amaç: Endoskopik transsfenoidal cerrahi ile tümör rezeksiyonuuygulanan akromegalik hastaların anestezi yönetimi eşlik eden endokrinolojik veanatomik anamoliler sebebiyle özel dikkat ve yaklaşım gerektirmektedir. Buretrospektif çalışma ile akromegali tanısı alarak transsfenoidal hipofizcerrahisi geçiren hastalardaki anestezi yönetimine ve perioperatif bakıma değinilmekistenmiştir.Materyal ve Metot: Üniversitemiz Tıp Fakültesi Klinik AraştırmalarEtik Kurulu’ndan etik kurul onayı alındıktan sonra Ocak 2017 ile Aralık 2018tarihleri arasında endoskopik transsfenoidal cerrahi ile hipofizer tümöreksizyonu uygulanan 25 akromegalik hastanın yazılı ve dijital dosyaları ileanestezi kayıt formları incelenerek retrospektif analizi yapılmıştır.Bulgular: Hastaların çoğunluğunun geliş şikayeti tümörün aşırı hormonsalgılamasının etkileriyle ilişkiliydi. Yaygın semptomlar somatik dismorfiklik,baş ağrısı ve görme alanı defektleri idi. Hastalardan 3’ünde zor maskeventilasyonu 2’sinde zor entübasyon gelişmişti. Zor entübasyon olgularınınbirinde uyanık fiberoptik bronkoskop ile entübasyon sağlanırken diğer olgudavideolaringoskop kullanılmıştı.Sonuç: Akromegalik hastalarıncerrahisi birçok hava yolu sorunu, kalp ve metabolik risk faktörleridolayısıyla pek çok anestezik zorluğu barındırabilir. Anestezistler, hipofizhastalığının çeşitli sunumlarını ve hastanın perioperatif durumu üzerineetkilerini iyi bilmelidir.

Aim: Anesthesia management of acromegalic patients undergoing tumorresection with endoscopic transsphenoidal surgery requires special attentionand approach due to the accompanying endocrinological and anatomical anamolies.In this retrospective study, we aimed to address anesthesia management andperioperative care in patients undergoing transsphenoidal pituitary surgerywith the diagnosis of acromegaly.Material and Methods: After obtaining approval from the Institutional Investigation and EthicsCommittee of our university, between January 2017 and December 2018, 25acromegalic patients with endoscopic transsphenoidal surgery underwentpituitary tumor excision were retrospectively analyzed by using written andonline files and anesthesia records.Results: The majority of patients presented with complaints ofexcessive hormone secretion. Common symptoms were somatic dysmorphicity,headache and visual field defects. Difficult mask ventilation was developed in3 patients and difficult intubation in 2 patients. One of the difficultintubation case was intubated with awake fiberoptic bronchoscope and the otherpatient was with videolaryngoscope.Conclusion: Surgery of acromegalic patients may involve several anestheticdifficulties due to many airway problems, heart and metabolic risk factors.Anesthesiologists should be familiar with the various presentations ofpituitary disease and its effects on the perioperative status of the patient.

Akromegali anestezi yönetimi

Acromegaly anesthesia management

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