Genel Anestezi Sırasında Farkındalık

Year 2024, , 1 - 5, 01.03.2024

Gülseren Yılmaz , Ziya Salihoğlu

https://doi.org/10.38175/phnx.1322627

Abstract

Genel anestezinin uygulanma amacı ameliyat sırasında bilinç kaybı ve amnezi oluşturmak, yeterli analjezi ve kas gevşemesi sağlamaktır. Anestezi sırasında farkındalık, genel anestezi altında hastanın bilinçli olması veya cerrahi işlemi hatırlayabilmesi durumunu ifade eder. Bu durum, anestezinin yetersiz olduğunun bir göstergesi olabilir ve potansiyel psikolojik komplikasyonlara yol açabilir. Ayrıca, anestezistlere yönelik iddiaların yaklaşık %2’si anestezi sırasında farkındalık komplikasyonlarıyla ilgilidir. Farkındalığın insidansı nadirdir, ancak risk faktörleri hastaya ve teknik faktörlere bağlıdır. Entübasyon zorluğu, obezite, daha önce anestezi sırasında farkındalık yaşama öyküsü, ilaç toleransı gibi faktörler riski artırabilir. Ayrıca, teknik hatalar, anestezi makinelerinin yanlış kullanımı ve anestezik uygulama hataları da farkındalığa neden olabilir. Bazı cerrahi prosedürler ve total intravenöz anestezi tekniği de risk faktörleri arasındadır. Bu risk faktörlerinin farkında olmak, farkındalığı önlemek, tanımak ve yönetmek için önemlidir. Anestezi uygulamasında farkındalık halini önlemek için optimal bir strateji, hastaların bireysel hazırlığı ve dikkatli anestezi yönetiminin kombinasyonudur. Risk altındaki hastaların belirlenmesi, ilaçların dikkatli bir şekilde hazırlanması ve uygulanmasıyla birlikte, anestezi yönetimi için uygun stratejilerin kullanılmasıyla bu komplikasyon azaltılabilir. İlaçların kullanım miktarını, nöromuskuler blok düzeyini ve uyku derinliğini ölçen cihazların rutin kullanımı ameliyat sırasındaki farkındalığı azaltmaya yardımcı olacaktır. Bu yazıda anestezi sırasında farkındalık durumunun risk faktörleri, önlenmesi, tanınması ve yönetimi tartışılacaktır.

Keywords

İntraoperatif farkındalık, Anestezi komplikasyonları, Genel anestezi, Monitorizasyon

Awareness During General Anesthesia

Abstract

The aim of general anesthesia is to induce unconsciousness and amnesia during the surgery, and to provide adequate analgesia and muscle relaxation. Awareness during anesthesia refers to the state of the patient being conscious or able to remember the surgical procedure under general anesthesia. This may be an indication of insufficient anesthesia and may lead to potential psychological complications. Also, about 2% of claims against anesthesiologists have been related to the awareness complications during anesthesia. The incidence of awareness is rare, but the risk factors depend on the patient and technical factors. Factors such as difficulty in intubation, obesity, previous awareness during anesthesia, drug tolerance may increase the risk. In addition, technical errors, misuse of anesthesia machines and anesthetic administration errors may also cause awareness. Some surgical procedures and total intravenous anesthesia technique are also among the risk factors. Being aware of these risk factors is crucial for preventing, recognizing and managing awareness. An optimal strategy for avoiding awareness in anesthesia practice is a combination of individual patient preparation and careful anesthesia management. This complication can be reduced by identifying patients at risk, careful preparation and administration of drugs, and the use of appropriate strategies for anesthesia management. Routine use of devices that measure the amount of medication, neuromuscular block level and depth of sleep will help reduce awareness during surgery. In this article, the risk factors, prevention, recognition and management of awareness during anesthesia will be discussed.

Keywords

intraoperative awareness, anesthesia complications, general anesthesia, monitoring

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