Anestezistlerin rejyonal anestezi kararı verirken dikkate aldıkları kriterler: Ulusal bir anket çalışması

Year 2019, Volume: 2 Issue: 2, 61 - 69, 31.08.2019

Mehmet Sargın , İnci Kara

Abstract

Amaç: Son yıllarda anestezi pratiğinde
giderek artış gösteren rejyonal anestezi uygulamalarının anestezistler
tarafından hangi sebeplerden dolayı tercih edildiği net değildir. Bu
çalışmamızda anestezistlerin rejyonal anestezi kararı verirken dikkate
aldıkları kriterleri değerlendirmeyi amaçladık.

Gereç ve Yöntem: Likert tipi anket
katılımcılara elektronik ortamda ulaştırıldı. Anket toplam 27 sorudan
oluşmakta, birinci bölüm katılımcıların demografik özelliklerinin, ikinci
bölümün hasta özelliklerinin, üçüncü bölümünde cerrahın rejyonal anesteziye
bakış açısının, dördüncü bölümünde ise anestezistsin kendi özelliklerinin
rejyonal anestezi kararına etkisi değerlendirilmiştir.

Bulgular: Anketi 295 anestezist
eksiksiz olarak tamamladı. Katılımcıların % 72.2'si genel olarak rejyonal
anesteziyi tercih ettiğini belirtti. Katılımcıların % 37.6’sı hastanın
cinsiyetinin rejyonal anestezi tercihinde kesinlikle önemli olmadığını
belirtmiştir. Katılımcılar yaşın, mental durumun, operasyon bölgesinin, ek
hastalıkların, cerrahın anestezistle uyumunun, anesteziye kendi bakış açısının
ve rejyonal anestezi tecrübesinin rejyonal anestezi tercihinde kesinlikle
önemli olduğunu belirtmiştir. Anestezistlerin yaş ortalaması ve uzmanlık süresi
arttıkça genel anestezi tercih oranında artış görülmektedir (sırasıyla, P=0.006
ve P=0.014).

Sonuç: Sonuç olarak, anestezistlerin
rejyonal anestezi tercihinde hastaların klinik özellikleri, birlikte
çalıştıkları cerrahi ekiplerin ve kendilerinin özellikleri etkili olmaktadır.
Ayrıca anestezistlerin rejyonal anestezi tercihinde kendi yaş, uzmanlık süresi,
çalıştıkları kurum ve görev unvanlarının da etkili olduğu görülmektedir.

Keywords

Anestezist, rejyonal anestezi, anket

The criteria that anesthesiologists consider in the decision of regional anesthesia: A national survey study

Abstract

Aim: In recent years, gradually
increasing the practice of anesthesia by anesthesiologists of regional
anesthesia is preferred for reasons which are not clear.In this study, we aimed
to evaluate the criteria that anesthesiologists consider in the decision of
regional anesthesia.

Materials and Methods: Likert type
questionnaire was delivered to the participants in an electronic
environment.The questionnaire consisted of 27 questions, the demographic
characteristics of the first part, the patient characteristics of the second
part, the perspective of the surgeon to regional anesthesia in the third part,
and the effect of the anesthesiologist on the regional anesthesia decision in
the fourth part.

Results: The questionnaire was
completed by 295 anesthesiologists. 72.2% of the participants stated that they
preferred regional anesthesia in general. 37.6% of the participants stated that
the gender of the patient was not important in the preference of regional
anesthesia. Participants stated that age, mental status, operation area,
comorbidities, compliance of the surgeon with the anesthesiologist, his / her
perspective of anesthesia and the experience of regional anesthesia are
absolutely important in the choice of regional anesthesia. As the age and
duration of anesthesia of the anesthesiologists increased, general anesthesia
preference rate increased (P = 0.006 and P = 0.014, respectively).

Conclusions: As a result, the clinical
characteristics of the anesthesiologists in the choice of regional anesthesia,
the characteristics of the surgical teams they work with and their
characteristics are effective. Furthermore, it is seen that anesthesiologists
have the choice of regional anesthesia in terms of their age, duration of
expertise, the institutions they work and their duty titles.

Keywords

Anesthetist, regional anesthesia

References

• Cardosa M, Rudkin GE, Osborne GA. Outcome from day-case knee arthroscopy in a major teaching hospital. Arthroscopy 1994; 10: 624-9.
• Liu S, Carpenter RL, Neal JM. Epidural anesthesia and analgesia: their role in postoperative outcome. Anesthesiology 1996; 82: 1474-506.
• Panass SM, McCarthy RJ, Bach BR jr ve ark. Beneficial impact of epidural anesthesia on recovery after outpatients artroscopy. Arthroscopy 1993; 9: 91-5.
• Wu CL, Naqibuddin M, Fleisher LA. Measurement of patients satisfaction as an outcome of regional anesthesia and analgesia: a systemic review. Reg Anesth Pain Med 2001; 26: 196-208.
• Lai HY, Tsai PS, Fan YC, Huang CJ. Anesthetic practice for Caesarean section and factors influencing anesthesiologists' choice of anesthesia: a population-based study. Acta Anaesthesiol Scand. 2014 Aug;58(7):843-50.
• Pelinka LE, Pelinka H, Leixnering M, Mauritz W. Why patients choose regional anesthesia for orthopedic and trauma surgery. Arch Orthop Trauma Surg 2003; 123: 164-7.
• Shevde K, Panagopoulos G. A survey of 800 patients’ knowledge, attitudes, and concerns regarding anesthesia. Anesth Analg 1991; 73: 190-8.
• Aktekin A, Demirel Gandur M.A, Gürleyik G, Sağlam A. Cerrah ve Anestezistlerin Kendileri ve Hastaları için Anestezi Tercihleri. Türk Aile Hek Derg 2006; 10(2): 60-63.
• Garg KL, Bala M, Bansal P, Khanduri KC, Anee, Khatri ML. Preference of General Anaesthesia or Regional Anaesthesia for Appendicectomy Among Medical And Paramedical Staff in A Rural Hospital. IOSR Journal of Dental and Medical Sciences 2016İ 15(10): 13-15.
• Coulter A. Implementing shared decision making in the UK.Scoping paper for the Health Foundation in 2009. http://www.health.org.uk/public/cms/75/76/1915/1522/Implementing_shared_decision_making_in_the_UK2-1.pdf?realName=U39ZtQ.pdf (accessed 01/03/2013)
• Sheridan SL, Harris RP, Woolf SH. Shared decision makingabout screening and chemoprevention: a suggestedapproach from the U.S. Preventive Services Task Force.American Journal of Preventive Medicine2004;26:56–66.
• Coulter A, Jenkison C. European patients’ views on the respon-siveness of health systems and healthcare providers.Euro-pean Journal of Public Health2005;15: 355–60.
• Adam JA, Khaw F, Thomson RG, Gregg PJ, Llewellyn-ThomasHA. Patient decision aids in joint replacement surgery: a liter-ature review and an opinion survey of consultant orthopaedicsurgeons.Annals of the Royal College of Surgeons of England2008;90: 198–207.
• Department of Health.The NHS Constitution 2009. London:Department of Health, 2009.