COVID-19 Hastalarında Rejyonel Anestezi ve Genel Anestezinin Yoğun Bakım Başvurusu, Mortalite Oranları ve Pulmoner Komplikasyonlar Üzerine Etkisi

Yıl 2023, Cilt: 13 Sayı: 1, 27 - 34, 16.03.2023

Fatih Şahin , Havva Kocayigit , Bedirhan Günel , Onur Balaban

https://doi.org/10.31832/smj.1123832

Öz

Amaç
Yeni tip koronavirüs hastalığı (COVID-19) olan ve cerrahi tedavi gerektiren hastalarda hangi anestezi yönteminin uygulanacağı belirsizliğini korumaktadır. Bu çalışmada COVID-19 enfeksiyonu olan hastalarda rejyonel anestezi (RA) ve genel anestezi (GA)’nın yoğun bakım ünitesine (YBÜ) kabul, pulmoner komplikasyon oranı ve mortalite açısından karşılaştırması amaçladı.
Gereç ve Yöntem
Mart 2020 ile Aralık 2021 arasında tıbbi kayıtlar incelendi ve çalışmaya RA veya GA altında ameliyat edilen COVID-19 hastaları dahil edildi. Hastalar iki gruba ayrıldı: 1. Grup RA ile ameliyat edilen hastalar ve 2. grup GA ile ameliyat edilen hastalar. Birincil sonuçlarımız yoğun bakım ünitesine kabul oranları, akut pulmoner, renal ve hepatik komplikasyonlar ve perioperatif mortalite oranlarıydı.
Bulgular
123 hastayı çalışmaya dahil ettik. Rejyonel anestezi uygulanan hasta sayısı anlamlı olarak daha yüksekti. 97 (%78.9) hasta RA, 26 (%21.1) hasta GA altında opere edildi. YBÜ'ye kabul oranı RA grubunda %8.2 ve GA grubunda %11,5 idi. Fark anlamlı değildi (p=0.422). RA grubunda 6 (%6.2) hastada ve GA grubunda 2 (%7.7) hastada pulmoner komplikasyonlar görüldü ve anlamlı bir fark yoktu (p=0.535). Perioperatif mortalite oranları gruplar arasında anlamlı fark yoktu (RA grubunda %5,2, GA grubunda %7,7) (p=0,535).
Sonuç
Rejyonel anestezi ile ameliyat edilen COVID-19 hastalarında pulmoner komplikasyonlar, yoğun bakıma yatışı ve perioperatif mortalite oranları daha düşüktü fakat anlamlı bir fark yoktu.

Anahtar Kelimeler

Rejyonel anestezi, Genel anestezi, COVİD-19, YBÜ kabulü, Pulmoner komplikasyonlar

Regional Anesthesia Vs General Anesthesia In Patients With Covid-19: The Effect On Critical Care Admission, Mortality Rates And Pulmonary Complications

Öz

Objectives
The appropriate anesthesia method in patients requiring surgical treatment with confirmed or suspected new coronavirus disease (COVID-19) is unclear. This study aimed to compare regional anesthesia (RA) with general anesthesia (GA) in patients with COVID-19 infection in terms of admission to intensive care unit (ICU), rate of pulmonary complications, and mortality.
Materials and Methods
We reviewed medical records between March 2020 and December 2021 added patients with COVID-19 that operated under RA or GA in the study. The patients were assigned into two groups: 1. patients operated under RA and 2. patients operated under GA. Primary outcomes were admission rates to the ICU, acute pulmonary, renal, and hepatic complications, and perioperative mortality rates.
Results
We included 123 patients in the study. Regional anesthesia was significantly higher in the cohort. 97 (78.9 %) patients were operated under RA and 26 (21.1 %) patients under GA. The admission rate to ICU was 8.2 %in the RA group and 11.5 %in the GA group. The difference was not significant (p=0.422). Pulmonary complications were seen in 6 (6.2 %) patients in the RA group and 2 (7.7 %) patients in the GA group without a significant difference (p=0.535). Perioperative mortality rates were comparable between groups (5.2 %in the RA group vs. 7.7 %in the GA group) (p=0.535).
Conclusion
Pulmonary complications, ICU admission, and perioperative mortality rates were lower in COVID-19 patients operated under regional anesthesia; however, the differences were not significant.

Anahtar Kelimeler

Regional anesthesia, General anesthesia, COVID-19, ICU admission, Pulmonary complications

Kaynakça

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