Transüretral prostat rezeksiyonu olan yaşlı hastalarda genel ve rejyonal anestezi uygulamalarının ameliyat sonrası yaşam kalitesine etkilerinin karşılaştırılması

Yıl 2022, Cilt: 13 Sayı: 47, 316 - 322, 15.12.2022

Sedef Gülçin Ural , Fatih Gokalp , Sinan Karazindiyanğlu , İbrahim Hakkı Tör

https://doi.org/10.17944/mkutfd.1025384

Öz

Amaç: Çalışmamızda benign prostat hipertrofisi nedeniyle alt üriner sistem semptomları olan ve transüretral prostat rezeksiyonu uygulanacak hastalara uygulanan anestezi yönteminin postoperatif yaşam kalitesi üzerinde etkisinin olup olmadığı araştırıldı.

Yöntem: Çalışmaya transüretral prostat rezeksiyonu planlanan 60 hasta dahil edildi. 1. gruba spinal anestezi, 2. gruba genel anestezi uygulandı. Demografik veriler, preoperatif ve perioperatif parametreler kaydedildi. Postoperatif yaşam kalitesi ve hasta memnuniyeti Kısa form-36 (SF-36) kullanılarak değerlendirildi.

Bulgular: Demografik veriler ve hemodinamik değişiklikler açısından gruplar arasında fark yoktu. Alkol ve sigara kullananların sigara içmeyenlere göre genel anestezi tercihi daha yüksekti (p<0.05). Hastaların perioperatifhemodinamik bulguları her iki grupta benzerdi (p>0,005). Spinal anestezi grubunda preoperatif ve postoperatif SF-36 alt alan skorları karşılaştırıldığında, tüm parametrelerde istatistiksel olarak anlamlı fark vardı (p<0,001). Ameliyat öncesi ve sonrası SF 36 alt alan skorları genel anestezi grubu içinde karşılaştırıldığında, vitalite, mental sağlık ve sosyal işlevsellik açısından istatistiksel olarak anlamlı farklılıklar gözlendi (p<0.05). Spinal ve genel anestezi grubunun ameliyat öncesi SF-36 alt alan puanları arasında istatistiksel olarak anlamlı fark yoktu (p>0.05). Spinal anestezi grubunda postoperatif birinci ay skorları genel anestezi grubuna göre vitalite skorları dışında alt alanlarda istatistiksel olarak anlamlı derecede yüksekti (p<0.05).

Sonuç: Geriatrik hasta popülasyonunda yapılan TUR-P ameliyatında anestezi sonrası erken yaşama katılmanın önemi yüksektir. Çalışmamız, hasta yaşam kalitesi ve hasta memnuniyeti açısından spinal anestezinin genel anesteziden üstün olduğunu destekledi.

Anahtar Kelimeler

anestezi, prostat, yaşam kalitesi, transüretral rezeksiyon

Comparison of the effects of general and regional anesthesia on postoperative quality of life in elderly patients after transurethral prostate resection

Öz

Objective: In our study, it was investigated whether the anesthesia method applied to patients with lower urinary tract symptoms due to benign prostatic hypertrophy and who will undergo transurethral resection of the prostate has effects on postoperative quality of life.

Method: A total of 60 patients scheduled for TUR-P were included in the study. The patients were divided into two groups as those receiving spinal anesthesia and those receiving general anesthesia. We recorded demographic data and preoperative and perioperative parameters. We evaluated the postoperative quality of life and satisfaction of the patients using the Short Form-36 scale.

Results: There was no statistically significant difference between the two groups in terms of demographic data and hemodynamic changes. There was a higher rate of patients who consumed alcohol and smoked in the general anesthesia group (p<0.05). The perioperative hemodynamic findings of the patients were similar in both groups (p>0.05). The preoperative and postoperative SF-36 subdomain scores were compared within the spinal anesthesia group, there was a statistically significant difference in all parameters (p<0.001). The preoperative and postoperative SF-36 subdomain scores were compared within the general anesthesia group, statistically significant differences were observed in vitality, mental health, and social functioning (p<0.05). There was no statistically significant difference between the preoperative SF-36 subdomain scores of the spinal and general anesthesia group (p>0.05). In the spinal anesthesia group, the postoperative first month scores were statistically significantly higher in the sub-areas, except for the vitality scores, compared to the general anesthesia group (p<0.05).

Conclusion: It is important to ensure that geriatric patients return to their daily life activities in the early period after TUR-P. According to our results, spinal anesthesia was found to be superior to general anesthesia in terms of the quality of life of the patients.

Anahtar Kelimeler

anesthesia, prostate, quality of life, transurethral resection

Kaynakça

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