Amaç:
Sugammadeks; genel anestezi uygulamalarında steroid yapıda kas gevşeticilerin
etkisini farmakolojik olarak ortadan kaldıran ve yan etkileri az görülen bir
ajandır. Ancak maliyeti yüksek olduğu, iki yaş altında kullanımı konusunda
yeterli veri bulunmadığı, diğer ilaç ve besinlerle etkileşimi tam olarak
bilinmediği için kullanımı kısıtlıdır. Bu çalışma ile sugammadeks kullanılan
hastaların çeşitli parametreleri incelenmiş olup, sonuçlarımızı paylaşmayı ve
yeni çalışmalara ışık tutmayı amaçladık. Yöntem:
Retrospektif olan bu çalışmada, dosya taraması yapılarak genel anestezi altında
ameliyata alınan ve sugammadeks kullanılan hastaların cinsiyetleri, branşlara
göre sayıları, yaş aralıkları, sugammadeks kullanım endikasyonları elektronik
ortama aktarılmış, sayılar % dağılım olarak ifade edilmiştir. Kullanılan
sugammadeks dozları miligram/kilogram, anestezi risk değerlerinin ortalaması
rakamsal olarak ifade edilmiştir. Bulgular:
Farklı branşlarda sugammadeks kullanılan 1381 hasta çalışmaya dahil edildi.
Hastaların 506’sı kadın, 875’i erkekti.
22 hasta 2 yaş ve altı, 65 hasta 3-7 yaş arası, 135 hasta 8-18 yaş
arası, 874 hasta 19-65 yaş arası, 253 hasta 66 yaş ve üzerindeydi. 317 hasta
ASA (American Society of Anesthesiologists, anestezi risk sınıflaması)-I, 636
hasta ASA-II, 300 hasta ASA-III, 128 hasta ASA-IV risk grubunda idi. Ortalama
ASA değeri 2.20 idi. Sugammadeks zor entübasyon (n=55), obesite cerrahisi
(n=110), vertebral cerrahi (n=274), atropin ve neostigmin ile yetersiz
dekürarizasyon (n=30), ameliyat iptali veya hızlı uyandırma gerektiren durum
(n=100), 80 yaş üzeri (n=26), konjental malformasyon (mukopolisakkaridoz tip 3,
vajinal agenezi=Rokitansky Mayer Hauser
Küstner sendromu, doudenal atrezili
down sendromu) (n=3), neostigmin kullanımının
kontrendike olması (n=783) nedeniyle kullanılmıştı. Ameliyat süreleri en kısa
15 dakika, en uzun 420 dakika idi. Sugammadeks kullanım dozu 2.0-4.0
miligram/kilogram arasındaydı. Hastalarda anaflaksi veya benzeri herhangi bir
yan etkiye rastlanmadı. Sonuç: Bu
çalışmanın sonuçları sugammadeksin; cinsiyet ayırdetmeden, yaş farkı
gözetmeden, ASA risk faktörü düşük veya yüksek, tüm branşların kısa veya uzun
süreli ameliyatlarında 2.0-4.0 mg/kg doz aralığında güvenle kullanılabilecek
bir ilaç olduğunu göstermektedir.
Objective: Sugammadex;
pharmacological elimination of the effects of steroidal muscle relaxants in
general anesthesia applications and side effects is a rare agent. However, the
cost is high, there is not enough data about the use under the age of two
years, and the interaction with other drugs and nutrients is not known, so its
use is limited. In this study, various parameters of sugammadex patients were
examined and we aimed to share our results and to shed light on new studies. Methods: In this retrospective study,
the gender of the patients who underwent surgery under general anesthesia and
sugammadex were used, their numbers, age ranges, sugammadex usage indications
were transferred to the electronic environment and the numbers were expressed
as % distribution. The mean sugammadex doses were expressed in
milligram/kilogram and the mean anesthesia risk values were quantified. Results: A total of 1381 patients with
sugammadex were included in the study. Of the patients, 506 were female and 875
were male. 22 patients under 2 years and under, 65 patients between 3 and 7
years of age, 135 patients aged 8-18 years, 874 patients between 19-65 years of
age, 253 patients over 65 years and older. There were 317 patients with ASA-I,
636 patients with ASA-II, 300 patients with ASA-III and 128 patients with
ASA-IV. The mean ASA value was 2.20. Sugammadex difficult intubation (n = 55),
obesity surgery (n = 110), vertebral surgery (n = 274), inadequate
decurarization with atropine and neostigmine (n = 30), operation cancellation
or rapid awakening (n = 100), Over 80 years old (n = 26), congenital
malformation (mucopolysaccharidosis type 3, vaginal agenesis = Rokitansky Mayer
Hauser Küstner syndrome, down syndrome of doudenal atresia) (n = 3),
contraindication of neostigmine use (n = 783) was used. The operation time was
15 minutes at the shortest and 420 minutes at the longest. Sugammadex
administration dose was between 2.0-4.0 miligram/kilogram. No anaphylaxis or
similar side effects were observed in the patients. Conclusion: The results of this study included sugammadex; without
gender discrimination, age difference, low or high ASA risk, short or long-term
surgery of all branches at a dose of 2-4 mg/kg dose can be used safely shows a
drug.
Primary Language | Turkish |
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Subjects | Health Care Administration |
Journal Section | Articles |
Authors | |
Publication Date | August 30, 2019 |
Submission Date | September 22, 2018 |
Acceptance Date | November 5, 2018 |
Published in Issue | Year 2019 Volume: 12 Issue: 2 |
MEU Journal of Health Sciences Assoc was began to the publishing process in 2008 under the supervision of Assoc. Prof. Gönül Aslan, Editor-in-Chief, and affiliated to Mersin University Institute of Health Sciences. In March 2015, Prof. Dr. Caferi Tayyar Şaşmaz undertook the Editor-in Chief position and since then he has been in charge.
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