ESWL’de hasta kontrollü veya anestezist kontrollü sedasyon/analjezi yöntemlerinin karşılaştırılması
Küçük Resim Yok
Tarih
2021
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Maltepe Üniversitesi
Erişim Hakkı
CC0 1.0 Universal
info:eu-repo/semantics/openAccess
info:eu-repo/semantics/openAccess
Özet
Amaç: Bu çalışmada üriner sistem taşlarının, beden dışı şok dalgalarıyla taş kırma (ESWL) ile tedavisinde propofol ve remifentanil ile sağlanan anestezist kontrollü sedasyon/analjezi (AKSA) ile hasta kontrollü sedasyon/analjezi (HKSA) yöntemlerinin hasta konforu, derlenme hızı, psikomotor ve bilişsel fonksiyonlar üzerine etkilerini karşılaştırmayı amaçladık. Materyal ve Metodlar: ASA fiziksel durum sınıflaması I-II olan 40 erişkin hasta çalışmaya alındı, rastlantısal olarak iki gruba ayrıldı ve temel kognitif fonksiyonları değerlendirmek üzere Standardize Mini Mental Test (SMMT) yapıldı. Propofol/remifentanil ile Grup H’de hasta kontrollü (HKSA), Grup A’da anestezist kontrollü (AKSA) sedasyon/ analjezi yöntemi uygulandı. Hastaların yaşı, ASA puanı, vücut ağırlığı, vital bulguları, ağrı skorları, ilaç dozları, derleme kalitesi ve zamanları işlem öncesi ve işlem sırasında kaydedildi. Çalışmadan elde edilen verilerin istatistiksel analizi için SPSS (Statistical Package for Social Sciences) for Windows 10.0 programı kullanıldı. İstatistiksel olarak anlamlılık p<0.05 düzeyinde değerlendirildi. Bulgular: Yaş ortalaması 44.27±12.85 yıl idi. Yaş, vücut ağırlığı ve ASA fiziksel durumlarına göre gruplar arasında istatistiksel olarak anlamlı bir farklılık bulunmamıştır (p>0.05). AKSA yöntemi uygulanan hastaların büyük çoğunluğunda geçici desatürasyon gözlendi. HKSA yöntemi uygulanan hasta grubunda ise yeterli analjezi sağlanırken, hastalar hemodinamik ve solunumsal yönden stabildi. HKSA yöntemi uygulanan grupta derlenme zamanı daha kısa, kullanılan ilaç miktarları da daha azdı. Hastaların hiçbirinde ek ilaç gereksinimi olmadı. Yine söz konusu gruptaki hastaların AKSA yöntemi uygulanan hastalara göre kognitif fonksiyonlarının geri dönüşü daha kısa zamanda gerçekleşti. Sonuç: Çalışmamızda hasta kontrollü sedasyon/analjezi yöntemi ile yeterli analjezi sağlanırken, anestezist kontrollü yönteme göre daha güvenli bir işlem süreci ve kısa zamanda derlenme sağlandı.
Aim: The purpose of this study is to compare anesthesiologist-controlled sedation/analgesia (ACSA) and patient-controlled sedation/analgesia (PCSA) in patients undergoing extracorporeal shock wave lithotripsy (ESWL) for urinary calculi. Material and Methods: 40 patients scheduled for ESWL treatment (ASA I or II) were investigated. They were randomly allocated to two groups and Standardized Mini Mental Test (SMMT) was applied to evaluate basic cognitive functions. Patient controlled (PCSA) in Group H and anesthetistcontrolled (ACSA) sedation/analgesia method was used in Group A with propofol/remifentanil. The patients’ age, ASA score, body weight, vital signs, pain scores, drug doses, review quality and time were recorded before and during the procedure. SPSS (Statistical Package for Social Sciences) for Windows 10.0 program was used for the statistical analysis of the data obtained from the study. Statistical significance was evaluated at the p <0.05 level. Results: The mean age was 44.27 ± 12.85 years. There was no statistically significant difference between the groups in terms of age, body weight and ASA physical status (p> 0.05). Transient desaturation was observed in the majority of patients who underwent the ACSA method. While adequate analgesia was provided in the patient group in whom the PCSA method was applied, the patients were hemodynamically and respiratoryly stable. Recovery time was shorter and the amount of drugs used was less in the group in which the PCSA method was applied. None of the patients required additional medication. Again, the recovery of cognitive functions of the patients in the mentioned group occurred in a shorter time compared to the patients who received the ACSA method. Conclusion: This study demonstrated that PCSA is associated with safe and early psycomotor recovery, and sufficient pain control and no major complications are related to this method.
Aim: The purpose of this study is to compare anesthesiologist-controlled sedation/analgesia (ACSA) and patient-controlled sedation/analgesia (PCSA) in patients undergoing extracorporeal shock wave lithotripsy (ESWL) for urinary calculi. Material and Methods: 40 patients scheduled for ESWL treatment (ASA I or II) were investigated. They were randomly allocated to two groups and Standardized Mini Mental Test (SMMT) was applied to evaluate basic cognitive functions. Patient controlled (PCSA) in Group H and anesthetistcontrolled (ACSA) sedation/analgesia method was used in Group A with propofol/remifentanil. The patients’ age, ASA score, body weight, vital signs, pain scores, drug doses, review quality and time were recorded before and during the procedure. SPSS (Statistical Package for Social Sciences) for Windows 10.0 program was used for the statistical analysis of the data obtained from the study. Statistical significance was evaluated at the p <0.05 level. Results: The mean age was 44.27 ± 12.85 years. There was no statistically significant difference between the groups in terms of age, body weight and ASA physical status (p> 0.05). Transient desaturation was observed in the majority of patients who underwent the ACSA method. While adequate analgesia was provided in the patient group in whom the PCSA method was applied, the patients were hemodynamically and respiratoryly stable. Recovery time was shorter and the amount of drugs used was less in the group in which the PCSA method was applied. None of the patients required additional medication. Again, the recovery of cognitive functions of the patients in the mentioned group occurred in a shorter time compared to the patients who received the ACSA method. Conclusion: This study demonstrated that PCSA is associated with safe and early psycomotor recovery, and sufficient pain control and no major complications are related to this method.
Açıklama
Anahtar Kelimeler
Beden dışı şok dalgalarıyla taş kırma (ESWL), hasta kontrollü sedasyon ve analjezi (HKSA), propofol, remifentanil, Extracorporeal shock wave lithotripsy (ESWL), patient-controlled sedation/analgesia (PCSA), propofol, remifentanil
Kaynak
Maltepe Tıp Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
13
Sayı
1
Künye
Kızıltunç, B. ve Altıntaş, F. (2021) ESWL’de hasta kontrollü veya anestezist kontrollü sedasyon/analjezi yöntemlerinin karşılaştırılması / Comparison of patient controlled or anesthetic controlled sedation/analgesia methods in ESWL. Maltepe Tıp Dergisi, Maltepe Üniversitesi. 13(1), s. 22-27.
