Genel Anestezi Altında Prone Pozisyonda Farklı Taze Gaz Akımının; Maliyet, Havayolu ve Endotrakeal Kaf Basınçlarına Etkisinin Karşılaştırılması

Year 2021, Volume: 5 Issue: 5, 467 - 471, 01.05.2021

Ahmet Gültekin Ayhan Sahin İlker Yıldırım Cavidan Arar

https://doi.org/10.28982/josam.790635

Abstract

Amaç: Prone pozisyonda genel anestezi alan hastaların, farklı taze akımlarının (düşük, orta, yüksek) maliyet, havayolu ve endotrakeal kaf basınçlarını karşılaştırmayı amaçladık.
Yöntemler: Çalışmaya ASA I-II, prone pozisyonda lomber vertebra cerrahisi geçiren, 18 yaş üzeri 150 hasta dahil edildi. Hastalar düşük akım (n=50, taze gaz akımı:1 l/dk), orta akım (n=50, taze gaz akımı: 2 l/dk) ve yüksek akım (n=50, taze gaz akımı: 4 l/dk) olarak üç gruba ayrıldı. Bu gruplardaki hastaların ilk 60 dakika (0, 15, 30, 45, 60.dakika olarak) içinde perop kalp atım hızı, periferik oksijen saturasyonu, ortalama arter basınçları, endotrakeal kaf basınçları, havayolu tepe ve plato basınçları ve maliyet açısından ise vaka sonunda kullanılan cihaz verileri aracılığı ile kullanlan inhale gazların (sevoflurane, oksijen, azot protoksit) miktarları kayıt edildi.
Bulgular: Gruplar arasında hemodinami, havayolu basınçları ve endotrakeal kaf basınçları açısından fark yoktu. Maliyet açısından ise inhale anestezik ajan, oksijen ve azot protoksit açısından düşük akım anestezi grubunda anlamlı fark vardır.
Sonuç: Modern anestezi cihazları ile düşük akım ile anestezi uygulamasından kaçınmaya gerek yoktur ancak deneyim eksikliği veya düşük akım anestezi tercih etmek istemeyen anestezistler için taze gaz akımının 2 l/dk fazla olmamasını önermekteyiz.

Keywords

Düşük akım anestezi, Prone pozisyon, Genel anestezi, Sevofluran

Different fresh gas flows in prone position under general anesthesia: comparison of costs and effects on airway and endotracheal cuff pressures

Abstract

Background/Aim: Many studies have been performed on different fresh gas flows for general anesthesia. In this study, we aimed to compare the costs, airway, and endotracheal cuff pressures of different fresh flows (low, medium, high) of patients receiving general anesthesia in the prone position.
Methods: A total of 150 ASA I-II patients over the age of 18 years who underwent lumbar vertebral surgery in prone position were included in this retrospective cohort study. Patients were divided into three groups: Low-flow (n=50, fresh gas flow: 1 l/min), medium-flow (n=50, fresh gas flow: 2 l/min) and high-flow (n=50, fresh gas flow: 4 l/min). In addition to the preoperative heart rates, peripheral oxygen saturation, mean arterial pressures, endotracheal cuff pressures, airway peak and plateau pressures in the first 60 minutes (as 0th, 15th, 30th, 45th, 60th minutes) were noted, and the amount of inhaled gases (sevoflurane, oxygen, nitrogen protoxide) based on the data of the device were recorded to evaluate cost.
Results: The two groups were similar in terms of hemodynamics, airway, and endotracheal cuff pressures. Regarding cost, there was a significant difference in the low-flow anesthesia group in terms of inhaled anesthetic agents, oxygen, and nitrogen protoxide.
Conclusion: With modern anesthesia machines, it is unnecessary to avoid low-flow anesthesia applications. However, we recommend that the fresh gas flow be more than 2 l/min for anesthetists lacking experience or those who do not prefer low-flow anesthesia.

Keywords

Low-flow anesthesia, Prone position, General anesthesia, Sevoflurane

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