Sigara içen hastalarda ameliyat sonrası üç top solunum egzersiz uygulamasının solunum fonksiyon testleri üzerine etkisi

Öz

Amaç: Anestezi altında cerrahi girişimler sonrasında ortaya çıkan pulmoner komplikasyonları azaltmak için insentif spirometri kullanılmaktadır. Bu çalışmada, sigara içen ve genel anestezi altında ekstremite cerrahisi uygulanan hastalarda post operatif insentif spirometri uygulamasının solunum fonksiyon testleri üzerine etkisini araştırmayı amaçladık. Çalışma Planı: 3. Basamak bir hastanede extremite operasyonu uygulanan, 18-61 yaş arası, ASA I-II fizyolojik skoru olan80 hasta çalışmaya dahil edildi. Hastalar her grupta 40 hasta olarak en az 5 yıl/günde 10-20 adet sigara içen ve sigara içmeyen olarak 2 gruba ayrıldıktan sonra her grup insentifspirometri (üç top solunum eksersizi) kullanıp kullanmayacağına göre randomize edildi. Grup K (n=20): Sigara içmeyen ve insentifspirometri kullanmayan, Grup T (n=20): Sigara içmeyen ve insentifspirometri kullanan, Grup S (n=20): En az 5 yıl/günde 10-20 adet sigara içen ve insentifspirometri kullanmayan, Grup ST (n=20): En az 5 yıl/günde 10-20 adet sigara içen ve insentifspirometri kullanan. Bulgular: Çalışmaya katılan hastaların demografik verileri gruplar arasında benzerdi. Preoperatif ve postoperatif FVC ve FEV1 değerleri bakımından gruplar karşılaştırıldıklarında Grup K ve Grup S’deki postoperatif FVC değerleri preoperatif değerlere göre anlamlı derecede düşük bulundu (sırasıyla p=0,001, p=0,002).Gruplar içi karşılaştırmalarda Grup K, Grup S ve Grup ST’dekipostoperatif PEF değerleri preoperatif değerlere göre anlamlı derecede düşük bulundu (sırasıyla p=0,024, p=0,024, p=0,001). Gruplar içi karşılaştırıldıklarında Grup K ve Grup S’deki postoperatif VC değerleri preoperatif değerlerine göre anlamlı derecede düşük bulundu (sırasıyla p=0,037, p=0,012). Gruplar kendi içlerinde preoperatif ve postoperatif FEV1/FVC değerleri bakımından istatistiksel olarak karşılaştırıldıklarında anlamlı bir fark bulunmadı (p>0,05). Sonuç: Genelanestezi alan sigara içen hastalarda postoperatifkötüleşen solunum fonsiyon testi değerlerinininsentifspirometre kullanımı ile düzeldiği saptandı. Bu nedenle genel anestezi altında uygulananekstremite operasyonlarında postoperatif dönemde insentifspirometri kullanımının, postoperatif solunum komplikasyonlarını önlemede faydalı olacağı düşünülmektedir.

Anahtar Kelimeler

• Genel anestezi
• sigara
• solunum fonksiyon testleri
• insentifspirometri

Effects of postoperative three-balls respiratory exercise on respiratory function tests in smoking patients who underwent extremity surgery under generel anesthesia.

Öz

Aim:Incentive spirometry is used to reduce pulmonary complications after surgical interventions under general anesthesia. In this study, we aimed to investigate the effect of postoperative incentive spirometry on pulmonary function tests in patients who smoke and undergo extremity surgery under general anesthesia. Study design: Eighty patients with ASA I-II physiological score, aged 18-61 years, who underwent extremity operation in a 3rd level hospital were included in the study. After the patients were divided into two groups as 40 patients in each group, smokers of 10-20 cigarettes per day for at least 5 years and non-smokers and the groups were once more randomized according to whether they would use incentive spirometry (three balls of breathing exercise) or not. Group K (n=20):Non-smoker and not using incentivespirometry, Group T (n=20): Non-smoker and using incentivespirometry, Group S (n=20): Smoker of 10-20 cigarettes per day for at least 5 years andnot using incentive spirometry, Group ST (n=20): Smokers of 10-20 cigarettes per day for at least 5 years and using incentive spirometry. Results:The demographic data similar between the groups. When the groups were compared in terms of preoperative and postoperative FVC and FEV1 values, the postoperative FVC values in Group K and Group S were found to be significantly lower than the preoperative values (p=0.001, p=0.002, respectively). Postoperative PEF values were significantly lower than preoperative values (p=0.024, p=0.024, p=0.001, respectively). When compared within groups, postoperative VC values in Group K and Group S were found to be significantly lower than preoperative values (p=0.037, p=0.012, respectively). When the groups were compared statistically in terms of preoperative and postoperative FEV1/FVC values, no significant difference was found (p>0.05). Conclusion:It was found that postoperative worsening of respiratory function test values in smokers who received general anesthesia has improved with the use of incentive spirometry. For this reason, it is assumed that the use of incentivespirometry in the postoperative period in extremity operations performed under general anesthesia will be helpful in preventing postoperative respiratory complications.

Anahtar Kelimeler

• General anesthesia
• cigarette
• incentivespirometry
• respiratory function test
• Genel anestezi
• sigara
• solunum fonksiyon testleri
• insentifspirometri.
• insentifspirometri

Kaynakça

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