HASTANEMİZDE ÇOCUKLUK ÇAĞI YABANCI CİSİM ASPİRASYONLARINDA ANESTEZİK YAKLAŞIM

Year 2022, , 378 - 384, 17.10.2022

Elif Büyükerkmen , Ahmet Yuksek , Elif Doğan Bakı , Ali Kaynak Evrim Özkaraca Boyacı , Tuba Berra Sarıtaş , Remziye Sıvacı

https://doi.org/10.18229/kocatepetip.942159

Abstract

AMAÇ: Yabancı cisim aspirasyonları her yaşta görülebilmekle beraber pediatrik hastalarda önemli bir mortalite ve morbidite sebebidir. Anestezi tercihi hafif sedasyondan genel anesteziye kadar değişebilmektedir. Bu çalışmamızda yabancı cisim aspriasyonu nedeniyle anestezi uyguladığımız pediatrik vakalar incelenerek, yaş, cinsiyet, aspire edilen cisimlerin hastaneye yatış ve mortalite açısından farklılıkları analiz edildi.
GEREÇ VE YÖNTEM: Ocak 2018 - Aralık 2020 tarihleri arasında 3 yıllık bir dönemde Çocuk Cerrahisi Kliniği tarafından yabancı cisim aspirasyonu opere edilen pediatrik vakalar retrospektif olarak analiz edildi. Toplam 46 hasta çalışmaya dahil edildi. Hastalarda yaş, cinsiyet, hastaneye başvuru şikayetleri, preoperatif geçen süre, aspire edilen cisimlerin niteliği ve yerleşimi, uygulanan tedavi yöntemleri, anestezi süresi, perioperatif komplikasyonlar, yatış süresi ve mortalite parametreleri incelendi.
BULGULAR: Hastaların % 39,1’i kız, % 60,9’u erkek, yaş ortalamaları 33,47 ± 39,72 ay idi. Aspire edilen materyallerin çeşitlilik göstermekle birlikte en çok aspire edilen materyal % 43,5 oranında kuruyemişti. Tüm hastalarda intravenöz anestezikler ve kontrollü ventilasyon uygulanıldı. Hastaların % 76,1’inde komplikasyon gözlenmezken, % 10,9’unda bronkospazm, % 13’ünde geç uyanma gözlendi. Hastaların ameliyat sonrası % 89,1 servise çıkarken, bronkospazm gelişen % 10,9 hasta yoğun bakımda izlendi.
SONUÇ: Bir yaşın altındaki ve üstündeki aspirasyon vakalarında komplikasyonlar ve hastenede kalış süreleri değişmemektedir. Hastalarda anestezi tercihi hasta bazlı düşünülmesi gereken bir durumdur. Çalışmamızın sonuçlarına göre intravenöz – inhalasyon anestezisi ve kontrollü ventilasyonda anestezi tercihin de dikkate alınması gereken bir seçenektir.

Keywords

Yabancı cisim, Aspirasyon, Anestezi

ANESTHETIC APPROACH IN CHILDHOOD FOREIGN BODY ASPIRATIONS IN OUR HOSPITAL

Abstract

OBJECTIVE: Although foreign body aspirations can be seen at any age, they are an important cause of mortality and morbidity in pediatric patients. Anesthesia preference can range from mild sedation to general anesthesia. In this study, pediatric cases that we underwent anesthesia for foreign body aspiration were examined, and differences in terms of age, gender, hospitalization of aspirated objects and mortality were analyzed.
MATERIAL AND METHODS: Pediatric cases who underwent foreign body aspiration operation by the Pediatric Surgery Clinic over a 3-year period between January 2018 and December 2020 were analyzed retrospectively. A total of 46 patients were included in the study. Age, gender, hospital admission complaints, duration of preoperative, quality and location of the aspirated objects, treatment methods, anesthesia duration, perioperative complications, length of stay, and mortality parameters were analyzed.
RESULTS: 39.1 % of the patients were girls, and 60.9 % were boys. Their mean age was 33.47 ± 39.72 months. Although the materials aspirated varied, the most aspirated material was dried nuts at a rate of 43.5%. Intravenous anesthetics and controlled ventilation were used in all patients. While 76.1% of the patients had no complications, 10.9% had bronchospasm and 13% had a late awakening. While 89.1% of the patients went to the service after surgery, 10.9 % of the patients who developed bronchospasm were followed up in the intensive care unit.
CONCLUSIONS: Complications and length of stay in the hospital do not change in cases of aspiration below and above the age of one. Anesthesia preference in patients should be considered on a patient basis. According to the results of our study, intravenous-inhalation anesthesia and controlled ventilation are also an option that should be taken into consideration.

Keywords

Foreign body, Aspiration, Anesthesia

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