ALT ÇENE GÖMÜLÜ 20 YAŞ CERRAHİSİNDE MÜZİK DiNLETİSİNİN ANKSİYETE ÜZERİNE ETKİSİ

Yıl 2019, Cilt: 46 Sayı: 2, 77 - 90, 01.08.2019

Tansu Erakman Burak Bayram

Öz

Gömülü mandibular 20 yaş dişi ameliyatı toplum tarafından korkutucu olarak nitelendirilen diş hekimliğinde sık uygulanan bir işlemdir. Hekimler tarafından düşük riskli bir tedavi olmasına rağmen ciddi komplikasyon riskleri de bulunmaktadır. Hastaların anksiyete durumu psikolojisini de etkiler. İntraoperatif anestezik maddeye olan ihtiyaçta artış, daha yüksek perioperatif ağrı algısı ve cerrahi sonrasında analjezik madde ihtiyacında artış, istenmeyen kardiyovasküler etkilerle sonuçlanabilecek şekilde hemodinamik değişiklikler de anksiyete ile ilişkilidir. Perioperatif anksiyetenin kontrol edilmesi için ilaç tedavisi ve psikolojik girişimlerde bulunulur. Bu tür girişimlerden en kolay ve non-invaziv olanı intraoperatif müzik dinletisi uygulamasıdır. Bu çalışmada 20 yaş diş çekimi ameliyatı sırasında müzik dinletmenin anksiyolitik etkisi ve vital bulgulardaki değişimin araştırılması amaçlanmıştır. Alt çenede kemik retansiyonlu gömülü yirmi yaş dişi operasyonu geçirecek olan 80 hasta kontrol grubu, 80 hasta deney grubu olarak değerlendirildi. Deney grubundaki hastalara ameliyat esnasında kulaklıktan müzik dinletildi.Tüm hastalara ameliyat öncesi Modified Dental Anxiety Scale (MDAS) kullanılarak anksiyete seviyesi belirlendi. Vital bulgular ise kan basıncı ve nabız ölçümleri ile değerlendirildi. Ölçümler bekleme salonunda, hasta diş ünitine oturduğunda, lokal anestezi yapıldığında, cerrahi örtüler örtüldüğünde, insizyon yapıldığı sırada, kemik kaldırma ya da dişin bölünmesi sırasında, dişin çekildiği sırada, yara bölgesine dikiş atıldığında ve ameliyat sonunda hasta üzerinden ameliyat örtüleri kaldırıldığında kaydedildi. İstatistiksel analiz için Student’s t-testi ve. eşleştirilmiş t-testi kullanıldı (p≤0.05).Ameliyat sırasında alınan kan basıncı ve nabız ölçümleri bakımından müzik dinletilen ve dinletilmeyen gruplar arasında istatistiksel olarak anlamlı bir fark bulunamamıştır. Yalnızca sutur atıldığı sırada alınan nabız ölçümleri bakımından müzik dinletilen ve dinletilmeyen gruplar arasında istatistiksel olarak anlamlı bir fark vardır (p=0,036). MDAS skorlarına göre operasyon sırasında müzik dinletilen grup ile müzik dinletilmeden operasyona alınan grup arasında istatistiksel olarak anlamlı (p=0,953) bir fark bulunamamıştır.

Anahtar Kelimeler

anksiyete, gömülü 20 yaş dişi, müzik

Evaluation of the Effect of Intra-Operative Music on Patient Anxiety in Impacted 3rd Molar Surgery

Öz

Mandibular impacted third molar surgery is considered scary among the society. Yet it’s a low risk application according to dentists. Although it has serious complication risks cited in dental literature. Patients’ anxiexty status had direct effect on their psychology. Excess need for the intra-operative anesthetic solution, post operative pain killer, higher perioperative pain sensation, undesired cardiovascular situations are related to anxiety. Medication and psychological interventions are used in order to deal with the anxiety. Music is the easiest and non-invasive method for relaxation of the patients. In the present study anxiolytic effects of music and changes in vital signs are examined. 80 patients who are going to take an impacted lower third molar surgery are assigned for the experiment group, and 80 patients for the control group. Experiment group patients listened music using headphones during the surgery. All patients took Modified Dental Anxiety Scale (MDAS) tests prior to the surgery. Vital signs are tracked with blood pressure and pulse measurements which are taken during waiting room, after sitting on the dental chair, during local anestesia administration, incision, bone reduction, suturing and at the end of the surgery. Student’s t-test and paired t-test were used for statistical analysis (p≤0.05). No statisticaly significant differences were recorded for control and experiment groups except for time time of suturing. According to MDAS scores no statistically significant differences were recorded as well.

Anahtar Kelimeler

anxiety, impacted lower third molar tooth, music

Kaynakça

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