Erkek sünnetinde kaygı, endişe ve korkuyu azaltmak için anestezi seçimi

Abstract

Amaç: Lokal anestezi(LA) veya genel anestezi (GA) ile yapılan sünnet işleminin neden olduğu stresi yani kaygı, endişe ve korkuyu Venham resim testi (VPT) ve fasyal imaj skalası (FIS) ile değerlendirmek. 

Yöntem ve Gereçler: Ailesinden onam alınan 50 si ga, 40 i la ile sünnet yapılan 90 çocuk çalışmaya dahil edildi. Sünnet öncesi ve sonrasında tüm çocuklar VPT ve FIS testlerini doldurdu. İstatistiki analiz için SSPS 16 kullanıldı. 

Bulgular: Sünnet yapılan çocuklar LA alanlar ve GA alanlar olarak 2 gruba ayrıldılar. LA verilen çocukların yaş ortalaması 7,75±2,04(4- 12 yaş), GA verilen çocukların ise 7,28±1,4(4- 12 yaş) idi. İki grup arasında yaş farkı yoktu (p=0,233). VRT ile FIS korele idi. Lokal anestezi ile sünnet yapılan grupta FIS %57 ve VRT %22 arttı (sırasıyla p=0,0001 ve p=0,001). Genel anestezi ile yapılan sünnet grubunda ise FIS’teki artış %7, VPT deki artış %0,69 idi ve bu artışlar anlamlı değildi( sırasıyla; p=0,520, p=0,385). 

Sonuç: Sünnet işleminde uygulanan anestezi yönteminin çocukta oluşturacağı stres(korku, kaygı ve endişe) VPT ve FIS ile tespit edilebilmektedir. LA ile yapılan sünnetin GA ile yapılan sünnet işlemine göre VPT ve FIS değerlerini anlamlı olarak daha fazla yükselttiği için çocuklarda daha fazla strese neden olabileceği fikrine ulaştık. Bu nedenle anestezi süresinin uzunluğu ve GA’nin olası risklerine rağmen 4-12 yaş grubu çocuklarda daha az strese neden olacağı için GA tercih edilmelidir. 

Keywords

• anestezi türü,sünnet,stres,VPT,FIS

Selection of anesthesia to reduce anxiety, worry and fear in male circumcision

Abstract

Aim: To evaluate the stress created by the concern, anxiety and fear experienced during the circumcision procedure performed under local anesthesia(LA) or general anesthesia(GA) with the Venham picture test(VPT) and facial image scale(FIS). 

Method and Materials: We included in the study a total of 90 children who were circumcised, 50 under general anesthesia and 40 under local anesthesia, after consent was obtained from the family. All children completed the VPT and FIS tests before and after the circumcision. SSPS 16 was used for statistical analysis. 

Results: The children who were circumcised were divided into 2 as the LA and GA groups. The mean age was 7.75±2.04(4-12) years in the LA and 7.28±1.4(4-12) years in the GA group with no statistically significant difference (p=0.233). VPT results were found to be correlated with FIS results. FIS results increased 57% and VPT results 22% after the procedure in the LA group(p=0.0001 and p=0.001, respectively). This increase rate was 7% and 0.69% respectively in the GA group and these increases were not significant(p=0.520, p=0.385, respectively). 

Conclusion: The stress (fear, concern and anxiety) caused by the anesthesia method used during the circumcision procedure in the child can be detected using VPT and FIS. We concluded that circumcision performed with LA may cause more stress in children than with GA as the VPT and FIS values were significantly higher. GA should therefore be preferred in children aged 4-12 years as it will cause less stress, despite the anesthesia duration and the possible risks. 

Keywords

• anesthesia type,circumcision,stress,VPT,FIS

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