Research Article
OBSTRÜKTİF UYKU APNESİ HASTALARINDA UYKU ENDOSKOPİSİNDE POZİSYON VE UYKU DERİNLİĞİNE GÖRE OBSTRÜKSİYON DERECESİNİN DEĞERLENDİRİLMESİ
Abstract
Amaç: Obstrüktif uyku apnesi (OSA) hastalarında
anestezi yönetimi peroperatif dönemde özellikle havayolu yönetimi açısından
özellik göstermektedir. Çalışmamızda OSA hastalarının uyku derinliğine ve
pozisyona göre obstrüksiyon bölgeleri endoskopik olarak tespit edilerek üst
havayolu ile ilgili değerlendirmeler yapılması amaçlanmıştır.
Yöntem: Çalışmaya polisomnografi yapılmış ve OSA tanısı
almış 47 hasta dahil edildi. Hastalar preoperatif dönemde uyku endoskopisi (UE)
ile değerlendirildi. Fleksibl nazofaringoskop ile yüzeyel sedasyonda supin ve
lateral pozisyonda, derin sedasyonda supin ve lateral pozisyonda hastaların
obstrüksiyon bölgeleri VOTE sınıflamasına göre değerlendirildi.
Bulgular: Vellum düzeyinde, lateral pozisyonda derin
sedasyon sırasındaki obstrüksiyon derecesi yüzeyel sedasyon ile
karşılaştırıldığında aradaki farklılık istatistiksel olarak anlamlı tespit
edilmiştir (p=0,006).
Sonuç: Çalışmamızda supin pozisyonda derin sedasyon
altındaki obstrüksiyon yüzeyel sedasyona göre ve lateral pozisyona göre daha
fazla tespit edilmiştir.
References
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- 13- Dhonneur G, Combes X, Leroux B, Duvaldestin P. Postoperative obstructive apne. Anesthesia&Analgesia, 1999; 89(3): 762-767.
- 14- Mahmoud HE, Rashwan DOE. Efficacy of Dexmedetomidine versus Ketofol for Sedation of Postoperative Mechanically Ventilated Patients with Obstructive Sleep Apnea. Hindawi Critical Care Research and Practice 2018
- 15- Lee CH, Kim DK, Kim SY, Rhee CS, Won TB. Changes in Site of Obstruction in Obstructive Sleep Apnea Patients According to Sleep Position: A DISE Study. Laryngoscope 2015;125:248-254. 16- Tami TA, Chu F, Wildes TO, Kaplan M. Pulmonary edema and acute upper airway obstruction. Laryngoscope 1986;96(5):506-9.
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Year 2019,
Volume: 26 Issue: 3, 240 - 246, 01.09.2019
Abstract
References
- 1- Lo YL, Ni YL, Wang TY, Lin TY, Li HY, White DP,Lin JR, Kuo HP.Bispectral Index in Evaluating Effects of Sedation Depth on Drug-Induced Sleep Endoscopy. J Clin Sleep Med 2015;11(9): 1011-20.
- 2- Croft CB, Pringle M. Sleep nasendoscopy: a technique of assessment in snoring and obstructive sleep apnoea. Clin Otolaryngol Allied Sci 1991;16:504–9.
- 3- Sigl JC, Chamoun NG. An introduction to bispectral analysis for the electroencephalogram. J ClinMonit 1994;10:392–404.
- 4- Rampil IJ. A primerfor EEG signal processing in anesthesia. Anesthesiology. 1998;89:980–1002.
- 5- Benissa MR, Khirani S, Hartley S, Adala A, Ramirez A, Fernandez-Bolanos M, Quera-Salva MA, Fauroux B. Utility of the bispectral index for assessing natural physiological sleep stages in children and young adults. J Clin Monit Comput.2016;30(6):957-963.
- 6- Cartwright RD. Effect of sleep position on sleep apnea severity. Sleep 1984;7:110–114.
- 7- Pevernagie DA, Shepard JW Jr. Effects of body position on upperairway size and shape in patients with obstructive sleep apnea. Acta Psychiatr Belg 1994;94:101–103.
- 8- Stanski DR. Monitoring depth anesthesia. In:Miller RD (eds). Anesthesia: 3rd edition. New York: Churchill LivingstoneInc: 2000, 1087-116.)
- 9- Maddison KJ, Shepherd KL, Baker VA, et al. Effects on upper airway collapsibility of presence of a pharyngeal catheter. J Sleep Res. 2015; 24(1): 92–99
- 10- Berry RB, Brooks R, Gamaldo CE, Harding SM, Marcus CL, Vaughn BV for the American Academy of Sleep Medicine. The AASM Manual fort he Scoring of Sleep and Associated Events: Rules, Terminology and Technical Specifications, Version 2.0 www.aasmnet.org, Darien, Illınois: American Academy of SleepMedicine, 2012.
- 11- American Academy of Sleep Medicine (2014) ICSD-3:the international classification of sleep disorders. Diagnostic and coding manual. AASM, Westchester, Illinois
- 12- Hong SD, Dhong HJ, Kim HY, Sohn JH, Jung YG, Chung SK, Park JY, Kim JK. Change of obstruction level during drug-induced sleep endoscopy according to sedation depth in obstructive sleep apnea. Laryngoscope. 2013;123(11):2896-9
- 13- Dhonneur G, Combes X, Leroux B, Duvaldestin P. Postoperative obstructive apne. Anesthesia&Analgesia, 1999; 89(3): 762-767.
- 14- Mahmoud HE, Rashwan DOE. Efficacy of Dexmedetomidine versus Ketofol for Sedation of Postoperative Mechanically Ventilated Patients with Obstructive Sleep Apnea. Hindawi Critical Care Research and Practice 2018
- 15- Lee CH, Kim DK, Kim SY, Rhee CS, Won TB. Changes in Site of Obstruction in Obstructive Sleep Apnea Patients According to Sleep Position: A DISE Study. Laryngoscope 2015;125:248-254. 16- Tami TA, Chu F, Wildes TO, Kaplan M. Pulmonary edema and acute upper airway obstruction. Laryngoscope 1986;96(5):506-9.
- 17- Goldenberg JD, Portugal LG, Wenig BL, Weingarten RT. Negative-pressure pulmonary edema in the otolaryngology patient. Otolaryngol Head Neck Surg 1997;117(1):62-6.
There are 16 citations in total.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Research Articles |
| Authors | |
| Publication Date | September 1, 2019 |
| Submission Date | May 24, 2019 |
| Acceptance Date | May 30, 2019 |
| Published in Issue | Year 2019 Volume: 26 Issue: 3 |
Cited By
Difficult Airway Anthropometric Measurements in Patients with Obstructive Sleep Apnea According to Sleep Endoscopy Scores
Cukurova Anestezi ve Cerrahi Bilimler Dergisi
https://doi.org/10.36516/jocass.1130112
Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi/Medical Journal of Süleyman Demirel University is licensed under Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International.