Etkin Sevofluran Tüketiminde Yeni Parametre; Metabolik Yaş; Prospektif Gözlemsel Çalışma

Öz

ÖZET Giriş: Anestezi idamesinde yaygın kullanılan inhaler ajanlardan sevofluran genellikle minimum alveolar konsantrasyona (MAK) göre uygulanmaktadır. MAK için yaş önemli bir değişkendir. Aynı kronolojik yaştaki iki birey farklı metabolik yaşa sahip olabilir. Amaç: Çalışmamızda sevofluran ile yeterli anestezi derinliği sağlanan hastalarda metabolik yaş ve kronolojik yaş ile sevofluran tüketimi arasındaki ilişkiyi değerlendirmeyi ve bu sayede sevofluran tüketimini azaltarak hastane maliyetlerini ve çevre kirliliğini azaltmayı amaçladık. Gereç ve Yöntem: Rinoplasti ve ya septoplasti planlanan 18-65 yaş arası, 79 hasta preoperatif vücut kompozisyon analizi biyoelektrik impedans analiz (BİA) yöntemi ile değerlendirildi. Hastaların kronolojik yaş, metabolik yaş ve diğer metabolik paremetreleri kaydedildi. Standart anestezi indüksiyonu ile BİS 40-60 arasında tutulacak şekilde anestezinin idamesi sağlandı. Hastalara ait Sevofluran tüketim miktarı ile kronolojik yaş ve metabolik yaşlar arasındaki ilişkiyi standardize edebilmek adına yüzde yaş farkı formülü kullanılarak hastalar 3 gruba ayrıldı. Hastalar Grup A: yüzde yaş farkı -%6.6 dan küçük, Grup B: yüzde yaş farkı -%6.6 ile %11.7 arasında, Grup C: yüzde yaş farkı %11.7 den büyük olanlar olarak adlandırıldı. Grupların dakikadaki sevofluran tüketim miktarı karşılaştırıldı. Bulgular: Çalışmaya 79 hasta dahil edildi. %29.1 kadındı. Hastaların kronolojik yaş ortalaması 31.29 ± 11.9, metabolik yaş ortalaması 30,42 ± 12,89 idi. Hastaların dakikadaki sevofluran tüketim miktarı ortalaması 0,19 ± 0,04 ml/dk idi. Kronolojik yaş ve metabolik yaş ile total sevofluran tüketimi arasında istatistiksel olarak anlamlı fark saptandı (p=0,006; p=0,007), ve negatif yönde zayıf korelasyon gözlendi (r= -0,304; r= -0,301). Hastalar gruplara ayrılarak değerlendirildiğinde ağırlıkları, VKİ, yağ kütlesi, obezite derecesi açısından gruplar karşılaştırıldığında bu üç grup arasında istatistiksel olarak anlamlı farklılık izlendi. Grup A da bu parametrelerin daha yüksek olduğu görüldü(p<0,001). Gruplar BMH açısından karşılaştırıldığında bu üç grup arasında istatistiksel olarak anlamlı fark gözlenmedi (p=0,118). Sonuç: Çalışmamızda yeterli anestezi derinliği sağlanan hastalarda metabolik yaş, kronolojik yaşdan büyük olduğunda tüketilen sevofluran miktarının daha düşük olduğu görülmüştür. İnhalasyon anestezisi uygulamalarında metabolik yaşın kullanımının sevofluran tüketimini azaltacağını düşünmekteyiz.

Anahtar Kelimeler

• Sevofluran
• Sevofluran Tüketim Miktarı
• Metabolik Yaş
• Kronolojik Yaş
• Vücut Kompozisyon Analizi
• Tanita
• Bazal Metabolizma Hızı

Relationship Between Effective Sevoflurane Consumption and Metabolic Age- A Prospective Observational Study

Öz

Abstract Background: Sevoflurane is usually administered according to the minimum alveolar concentration. Age is an important variable affecting the minimum alveolar concentration and it should be kept in mind that two individuals of the same chronologic age may have different metabolic ages. The purpose of this study is to evaluate the relationship between metabolic age, chronological age and sevoflurane consumption in patients with sufficient depth of anesthesia. Methods: Bioelectrical impedance analysis of 79 patients aged 18-65 years, chronological age, metabolic age and other metabolic parameters were recorded. To standardize the relationship between sevoflurane consumption and chronological age and metabolic age, patients were divided into three groups using the percentage age difference formula; Group A; age difference <-6.6%, Group B; age difference -6.6%-11.7%, Group C; age difference >11.7%. Results: The study included 79 patients, 29.1% of whom were women. The mean chronologic and metabolic ages of the patients were 31.29 ± 11.9 and 30.42 ± 12.89 years, respectively. A significant difference was seen between chronologic and metabolic age and total sevoflurane consumption (p=0.006; p=0.007) and a weak negative correlation was observed (r= -0.304; r=-0.301). When the sevoflurane consumption amounts of the groups were compared, a notable difference was observed among the three groups (p<0.001). Sevoflurane consumption was higher in patients whose metabolic age was younger than chronologic age compared to other groups. Conclusion: Metabolic age was associated with sevoflurane consumption, and sevoflurane consumption decreased in patients with chronologic age older than metabolic age.

Anahtar Kelimeler

• Sevoflurane
• Sevoflurane Consumption
• Metabolic Age
• Chronological Age
• Body Composition Analysis

Kaynakça

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