Does Nitrous Oxide Affect the Corneal Endothelium? A Prospective Randomized Study in Pediatric Patients

Yıl 2018, Cilt: 23 Sayı: 1, 20 - 25, 29.01.2018

Ahmet Selim Özkan Sedat Akbaş Nihat Polat Mehmet Rıdvan Yalın

https://doi.org/10.21673/anadoluklin.358521

Öz

Aim: To evaluate
the mean changes for endothelial cell and corneal pachymetry in eyes which
underwent general anesthesia with N₂O and O₂ with
sevoflurane.

Material and
methods: 40 eyes of 40
patients who had extraocular surgery under general anesthesia included in this
prospective study. The cases divided to two groups as O₂ and N₂O.
%50 O₂ (total flow rate; 2 L/min in O₂-air mixture) and %50
O₂ (total flow rate; 2 L/min in O₂-N₂O
mixture) were used in each group respectively. The duration of surgery was
recorded. CD (Cell Density), CV (Cell Variation), Hex (Hexagonality Rate) and
pachymetric specular microscopy results were evaluated before surgery, 1. week
and 4. week after surgery.

Results: The
duration of surgery and demographic data of groups were similar and
statistically there was no significant difference between the groups. The value
of CV for O₂ group was 26
± 2 cell/mm² and for N₂O group was 30 cell/mm²
at the 1. week. Statistically there was significant
increase in N₂O group compared with preoperative values (p=0,008). The value of Hex for O₂ group was 52 ± 10% and for N₂O was 62 ± 11% at the 1.week and statistically there was significant increase in N₂O group compared with
preoperative values (p=0,007). There was no significant difference between groups in terms of
CD, CV, Hex, pachymetry at other times.

Conclusion: There is
only significant change at the 1.week after surgery in corneal variation and
hexagonality rate in pediatric cases who had general anesthesia with nitrous
oxide and further work is needed in this regard.

Anahtar Kelimeler

nitrous oxide, corneal endothelium, child, general anesthesia

Nitröz Oksit Korneal Endoteli Etkiler mi? Pediyatrik Hastalarda Prospektif Randomize Bir Çalışma

Öz

Amaç: Sevofluran
ve N₂O veya O₂ karışımıyla genel anestezi uygulanan
gözlerde endotel hücre ve korneal pakimetri değerleri için ortalama
değişikliklerin değerlendirilmesi.

Gereç ve
yöntemler: Bu prospektif çalışmaya genel anestezi altında
ekstraoküler cerrahi uygulanan 40 hastanın 40 gözü dahil edildi. Olgular N₂O
veya O₂ grubu olarak iki gruba ayrıldı. Her bir grupta% 50 O₂
(toplam debi; O₂ -hava karışımı içinde 2 L / dk) ve% 50 O₂
(toplam debi; O₂-N₂O karışımı içinde 2 L / dk)
kullanıldı. Ameliyat süresi kaydedildi. Cerrahi öncesi, ameliyattan 1 hafta ve
4 hafta sonrasında CD (Hücre Yoğunluğu), CV (Hücre Değişimi), Hex (Heksagonality
Oranı) ve pakimetrik speküler mikroskopi sonuçları değerlendirildi.

Bulgular: Ameliyat
süresi ve grupların demografik verileri benzerdi ve istatistiksel olarak
gruplar arasında anlamlı fark yoktu. Birinci haftada, CV değeri O₂
grubunda 26 ± 2 hücre / mm² ve N₂O grubunda 30 hücre / mm²
bulundu. Bu verilen değerlendirildiğinde, istatistiksel olarak preoperatif
değerlere kıyasla N₂O grubunda anlamlı bir artış vardı (p = 0,008).
Birinci haftada, Hex değeri O₂ grubunda % 52 ± 10 ve N₂O
grubunda % 62 ± 11 idi ve istatistiksel olarak preoperatif değerlere kıyasla N₂O
grubunda anlamlı artış vardı (p = 0,007). Diğer zamanlarda CD, CV, Hex,
pakimetri verileri açısından gruplar arasında anlamlı fark yoktu.

Sonuç: Nitröz oksit
karışımı ile genel anestezi uygulanan pediatrik olgularda korneal varyasyon ve
hexagonalite oranında ameliyat sonrası 1. haftada anlamlı değişiklik
saptanmıştır ve bu konuda daha ileri çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

azot oksit, kornea endoteli, çocuk, genel anestezi

Kaynakça

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