Do totally occlusive nasal packs after nasal surgery increase the risk of immediate respiratory distress during recovery from anesthesia?

Yıl 2016, Cilt: 26 Sayı: 3, 159 - 163, 20.07.2016

Melih Çayönü Dursun Fırat Ergül Mehmet Çelik Funda Durmaz Arif Hikmet Çatakoğlu Mustafa Erdoğan

Öz

Objectives: This study aims to compare the risk of immediate respiratory distress IRD during the recovery of anesthesia between the nasal surgery with totally occlusive nasal packing and non-respiratory tract-related surgeries. Patients and Methods: A total of 300 patients 180 males, 120 females; mean age 30.1±8.2 years; range 18 to 52 years were included in the study. The patients were assigned to one of two age- and sex-matched groups according to surgery type: 1 patients undergoing nasal surgery with totally occlusive nasal packs for nasal septum deviation or 2 patients undergoing non-respiratory tract surgeries for various diseases. Immediate respiratory distress was defined as any unanticipated hypoxemia, hypoventilation or upper-airway obstruction stridor or laryngospasm requiring an active and specific intervention. Results: The patients who underwent nasal surgery with totally occlusive nasal packs had a 6.25 times higher risk of IRD than the patients who underwent non-respiratory tract surgery during recovery from general anesthesia. Smokers had a 4.8 times higher risk of having IRD than non-smokers during the post-extubation phase. There were no significant differences in the incidence of IRD between males and females. Conclusion: Based on our study results, totally occlusive nasal packs and smoking were associated with poor extubation status at the end of the surgical procedure.

Anahtar Kelimeler

Nasal packing, nasal surgical procedure, respiratory distress, tracheal extubation

Total tıkayıcı burun tamponu nazal cerrahi sonrası anesteziden derlenme sırasında erken solunum sıkıntısı riskini artırır mı?

Öz

Amaç: Bu çalışmada anesteziden derlenme sırasında total tıkayıcı burun tampon ile birlikte nazal cerrahi ve solunum yolu ile ilişkili olmayan cerrahiler arasında erken solunum sıkıntısı ESS riski karşılaştırıldı.Hastalar ve Yöntemler: Toplam 300 hasta 180 erkek, 120 kadın; ort. yaş: 30.1±8.2 yıl; dağılım 18-52 yıl çalışmaya alındı. Hastalar cerrahi tipine göre yaş ve cinsiyet eşleştirilmiş iki gruptan birine ayrıldı: 1 total tıkayıcı burun tamponu ile birlikte nazal septum deviasyonu için nazal cerrahi yapılan hastalar veya 2 çeşitli hastalıklar nedeniyle solunum yolu dışı cerrahi yapılan hastalar. Erken solunum sıkıntısı beklenmedik hipoksemi, hipoventilasyon veya aktif ve spesifik girişim gerektiren üst solunum yolu tıkanıklığı stridor veya larengospazm olarak tanımlandı.Bulgular: Genel anesteziden derlenme sırasında total tıkayıcı burun tamponu ile nazal cerrahi yapılan hastalarda ESS riski, solunum yolu dışı cerrahi yapılan hastalara kıyasla, 6.25 kat daha yüksekti. Sigara içenlerde ESS riski, ekstübasyon sonrası fazda, sigara içmeyenlere kıyasla 4.8 kat daha yüksekti. Erkekler ve kadınlar arasında ESS insidansı açısından anlamlı bir fark yoktu.Sonuç: Çalışma sonuçlarımıza göre, total tıkayıcı burun tamponu ve sigara kullanımı, cerrahi işlem sonunda kötü ekstübasyon durumu ile ilişkilendirildi

Anahtar Kelimeler

Burun tamponu, nazal cerrahi işlem, solunum stresi, rakeal ekstübasyon

Kaynakça

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