Effects of Inhalation Anesthetics on Respiratory Mechanics

Öz

This study aimed to compare the effects of sevoflurane and desflurane on respiratory mechanics during general anesthesia in pediatric patients with respiratory problems. This prospective, randomized study included 40 pediatric patients (6 girls and 34 boys), aged 1-6 years, who underwent elective lower urinary tract surgery (e.g., orchiopexy and hypospadias repair) under general anesthesia at our university hospital between February 1, 2015, and May 1, 2015. Patients were assigned to two groups based on the administered inhalation agent: sevoflurane or desflurane. Airway resistance (RAW), dynamic compliance (Cdyn), peak inspiratory pressure (PIP), and plateau pressure (Pplato) were measured at multiple time points during general anesthesia at 1, 3, 6, 10, 15, 20, 30, 40, 60, 90, 120 min and after intubation. The values were then compared between the groups There were no statistically significant differences between the sevoflurane and desflurane groups regarding RAW, Cdyn, PIP, and Pplato values (p> 0.05). Sevoflurane and desflurane are both viable options for maintaining general anesthesia in children with RADS. However, additional studies are required to identify the safest anesthetic agents, especially in pediatric patients with underlying respiratory issues.

Anahtar Kelimeler

• reactive airway dysfunction syndrome
• respiratory mechanics
• inhalation anesthetics
• sevoflurane
• desflurane

İnhalasyon Anesteziklerinin Solunum Mekaniklerine Etkileri

Öz

Reaktif hava yolu disfonksiyon sendromu gibi solunum problemleri olan pediatrik hastalarda, genel anestezi sırasında kullanılan inhalasyon anesteziklerinin (sevofluran ve desfluran) hastalarda introperatif dönemde solunum mekanikleri üzerindeki etkilerinin karşılaştırılması hedeflenmiştir. Prospektif, randomize olarak dizayn edilen bu çalışmada, elektif alt üriner sistem cerrahisi (örneğin, orşiopeksi ve hipospadias onarımı) nedeniyle genel anestezi verilen, RADS tanılı, 1-6 yaş arası 40 pediatrik hasta (6 kız ve 34 erkek) bulunmaktadır. Hastalar, anestezi idamesi için uygulanan inhalasyon ajanına göre , sevfluran ve desfluran olacak şekilde, iki gruba ayrılmıştır. Hava yolu direnci (RAW), dinamik kompliyans (Cdyn), pik inspiratuar basınç (PIP) ve plato basıncı (Pplato) değerleri, genel anestezi süresince entübasyondan sonra, 1, 3, 6, 10, 15, 20, 30, 40, 60, 90 ve 120. dakikalarda kaydedilmiş ve karşılaştırılmıştır. Gruplar arasında RAW, Cdyn, PIP ve Pplato değerleri açısından istatistiksel olarak anlamlı fark saptanmamıştır. (p > 0,05). RADS’lı çocuklarda genel anestezinin idamesinde sevofluran ve desfluran kullanımı ile hastalarda intraoperatif havayolu basınçları üzerinde gruplar arasında istatistiksel anlamlı fark saptanmamış olup, daha çok hasta sayıları ile yapılacak çalışmalara da ihtiyaç olduğu vurgusu ile, RADS tanılı hastalarda anestezi idamesi için sevofluran ve desfluranın güvenle kullanılabileceğini düşünmekteyiz.

Anahtar Kelimeler

• reaktif hava yolu disfonksiyon sendromu
• solunum mekanikleri
• inhalasyon anestezikleri
• sevofluran
• desfluran

Kaynakça

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