The Effect of Different Anesthetic Agents on Emergence Agitation in Patients Undergoing Vitreoretinal Surgery - Retrospective Study

Öz

Objective: Emergence agitation is a condition occurring in the early recovery phase of general anesthesia, negatively impacting patient comfort. It is particularly relevant in vitreoretinal surgery due to prolonged duration and changes in intraocular pressure. This study retrospectively compares the effects of different inhalation anesthetics on emergence agitation in such cases. Material and Method: A total of 254 ASA I–III patients who underwent vitreoretinal surgery were included. Based on anesthesia maintenance, patients were divided into two groups: sevoflurane (Group S) and desflurane (Group D). Hemodynamic data, extubation quality score, Richmond Agitation-Sedation Scale (RASS) scores at 0, 15, and 30 minutes, nausea-vomiting, and additional analgesic needs were evaluated from anesthesia records. Results: No significant differences were found between groups regarding demographics, surgery/anesthesia durations, extubation times, RASS scores, or extubation quality. However, Group D showed significantly higher heart rate at 30 and 60 minutes, and mean arterial pressure at 45 minutes. Conclusion: The choice of inhalation agent does not significantly impact emergence agitation in vitreoretinal surgery. However, desflurane may lead to increased intraoperative hemodynamic responses compared to sevoflurane.

Anahtar Kelimeler

• Anesthesia
• Desflurane
• Emergence Agitation
• Sevoflurane
• Vitreoretinal Surgery

Etik Beyan

This study was approved by the Ethics Committee of Karadeniz Technical University, School of Medicine (Decision No: 147, dated 13.07.2023).

Farklı Anestezik Ajanların Vitreoretinal Cerrahi Geçiren Hastalarda Uyanma Agitasyonuna Etkisi - Retrospektif Çalışma

Öz

Amaç: Uyanma ajitasyonu, genel anesteziden erken iyileşme döneminde ortaya çıkan ve hasta konforunu olumsuz etkileyen bir durumdur. Özellikle süresi uzun olan ve göz içi basıncında değişikliklere yol açan vitreoretinal cerrahilerde önemli bir klinik sorun teşkil etmektedir. Bu retrospektif çalışmada, farklı inhalasyon anesteziklerinin bu hasta grubunda uyanma ajitasyonu üzerine etkileri karşılaştırılmıştır. Gereç ve Yöntem: ASA I–III grubu toplam 254 hasta çalışmaya dahil edilmiştir. Anestezi idame yöntemine göre hastalar iki gruba ayrılmıştır: sevofluran (Grup S) ve desfluran (Grup D). Hemodinamik veriler, ekstübasyon kalitesi skoru, 0, 15 ve 30 dakikalarda Richmond Agitasyon-Sedasyon Ölçeği (RASS) skorları, bulantı-kusma ve ek analjezik ihtiyaçlar anestezi kayıtlarından değerlendirildi. Bulgular: Gruplar arasında demografik özellikler, cerrahi/anestezi süresi, ekstübasyon süresi, RASS skorları ve ekstübasyon kalitesi açısından anlamlı bir fark bulunmamıştır. Ancak, Grup D’de 30. ve 60. dakikalarda kalp hızı ve 45. dakikada ortalama arter basıncı anlamlı derecede yüksek bulunmuştur. Sonuç: Vitreoretinal cerrahilerde kullanılan inhalasyon ajanlarının uyanma ajitasyonu üzerine belirgin bir etkisi bulunmamaktadır. Bununla birlikte, desfluran kullanımının sevoflurana kıyasla intraoperatif dönemde artmış hemodinamik yanıtlarla ilişkili olabileceği göz önünde bulundurulmalıdır.

Anahtar Kelimeler

• Anestezi
• Desfluran
• Sevofluran
• Uyanma Agitasyonu
• Vitreoretinal Cerrahi

Etik Beyan

Bu çalışma, Karadeniz Teknik Üniversitesi Tıp Fakültesi Etik Kurulu’nun 13.07.2023 tarihli ve 147 sayılı kararı ile etik açıdan onaylanmıştır.

Kaynakça

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