Lokal Anestezik Toksisitesinde Ortopedi Hekimlerinin Yaklaşımının Değerlendirilmesi

Year 2019, , 111 - 115, 23.08.2019

Bora Bilal , Duran Topak , Fatih Vatansever , Ömer Faruk Boran

https://doi.org/10.30565/medalanya.549378

Abstract

Amaç: Ortopedi hekimlerinin lokal anestezik toksisitesi sendromu (LATS) tanı, tedavi ve önlemleri ile ilgili bilgilerini gözden geçirerek bu konu ile ilgili farkındalığın artırılması amaçlanmıştır. 

Gereç- Yöntem: Türkiye’de farklı hastanelerde ve farklı akademik seviyede olan ortopedi hekimlerine demografik bilgileri, lokal anestezik ilaçlar ile ilgili genel bilgileri, toksisite ile ilgili genel bilgi ve güncel tedavi seçeneklerini sorgulayan 16 soruluk anketi cevaplamaları istendi. 

Bulgular: Toplamda 172 ortopedi hekiminin (%18,6‘sı ortopedi asistanı, %51,7’si ortopedi ve travmatoloji uzmanı, %29,7’si öğretim üyesi) katıldığı çalışmada hekimlerin %45,3’ü 10 yıldan fazla süredir ortopedi alanında çalışmakta olduğu görüldü. Lokal anestezik kullanım yerleri açısından en sık ameliyathane, daha sonra acil servis, poliklinik müdahale odası ve servis olarak sıralandığı tespit edild. LATS tedavisinde lipid kullanımı ile ilgili çalışmaya katılanların %59,6’sı lipid kullanımını daha önce hiç duymadıklarını, %29,8’i daha önce duyduklarını ama anımsamadıklarını, %5,3’ü lipid tedavisinin kullanım alanı ve şeklini bildiklerini belirtmiştir. 

Sonuç: LATS konusunda hekimlerin bilinçli olması ve bu komplikasyon konusunda hazırlıklı olmaları ile lokal anesteziklerin daha güvenli kullanımları sağlanabilir. 

Keywords

Lokal Anestezi Toksisite Sendromu, İntravenöz Lipid Solüsyonu, Ortopedik Cerrahi

An Evaluation of the Approach of Orthopaedic Surgeons to Local Anaesthetic Toxicity

Abstract

Aim: To review the knowledge of orthopaedic surgeons related to the diagnosis, treatment and prevention of local anaesthetic systemic toxicity (LAST) and to raise awareness related to this subject. 

Material and Method: A 16-item questionnaire was applied to orthopaedic surgeons of different academic levels in different hospitals in Turkey. The items 












sought to identify demographic information, general knowledge related to local anaesthetic drugs, general knowledge related to toxicity and current treatment options. 

Results: The study included a
total of 172 orthopaedic surgeons in Turkey, of which 18.6% were orthopaedic
residents, 51.7% orthopaedic and traumatology specialists, and 29.7% faculty
members. Tenure in the orthopaedic area was determined to be >10 years in
45.3% of the participants. Local anaesthetic was seen to be used most in the
operating theatre, followed by the Emergency Department, polyclinic
intervention rooms, and on the wards. Of the total participants, 59.6% stated
that they had never heard of the use of lipids in the treatment of LAST, 29.8%
had heard of it but did not use it and 5.3% knew about the manner and area of
use of lipid treatments.

Conclusion: Awareness of physicians about LAST and preparedness for complications can ensure safer use of these local anaesthetics. 

Keywords

Local Anaesthetic Systemic Toxicity, Intravenous Lipid Solution, Orthopaedic Surgery

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