Laparoskopik kolesistektomide timpanometrik ölçümlerin postoperatif bulantı-kusma ile ilişkisi
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Dosyalar
Tarih
2006
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Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Laparoskopik kolesistektomi vakalarında postoperatif bulantı kusma (POBK) sık karşılaşılan bir bulgudur. Çalışmamızda laparoskopik kolesistektomi olgularında timpanometri değerlerinin POBK ile ilişkisini araştırmayı amaçladık. Gereç ve Yöntem: Laparoskopik kolesistektomi operasyonu planlanan 30-65 yaş arası, ASA I-II risk grubunda 30 olgu çalışmaya alındı. Impedance Audiometer AZ26 (Denmark) timpanometri cihazı ile olguların, operasyon öncesi (T0), entübasyon sonrası (T1), CO2 insüflasyonu sonrası (T2), ekstübasyon öncesi (T3) ve operasyondan hemen sonra ayılma ünitesinde (T4) timpanometrik değerleri kaydedildi. POBK postoperatif 24 saatte üç ayrı periyotta (0-2 st, 2-6 st, 6-24 st) değerlendirildi ve Numerik Rank Skoruna göre (0: bulantı kusma yok, 1: bulantı var, kusma yok, 2: Bir kez kusma var, 3: İki veya daha fazla kusma atağı var) kaydedildi. Bulgular: Ekstübasyon öncesi Vsağ'ın Vsol’a göre daha düşük olması (p<0.05) dışında aynı zaman periyodunda sağ ve sol kulağa ait timpanometri parametreleri arasında anlamlı fark yoktu (p>0.05). Her iki kulakta entübasyondan sonra orta kulak basınçları (T1,2,3) anlamlı olarak yüksekken, bazal değere göre tüm ölçümlerde volüm ve kompliyansta düşme, gradiyentte artma olduğu saptandı. Postoperatif dönemde on sekiz (% 60) olguda POBK gözlendi. Entübasyon sonrası yapılan ölçümlerdeki Vsağ, Vsol operasyon öncesi ve ekstübasyon öncesi Vsol değerleri ile POBK arasında anlamlı negatif korelasyon bulunurken, entübasyon sonrası ölçümlerdeki Psağ, Gsağ ve Gsol ile POBK arasında ise anlamlı düzeyde pozitif korelasyon saptandı (p<0.05). Sonuç: Orta kulak timpanometrik değişiklikler ile POBK arasında ilişki bulunduğu kanısına varıldı.
Objective: The aim of this study was to investigate the possible correlation between tympanometric changes and postoperative nausea and vomiting (PONV) in laparascopic cholecystectomy operations. Patients and Methods: Thirty ASA I-II patients, aging between 30-65 years, undergoing laparascopic cholecystectomy were included in the study. Tympanometric measures were performed and recorded using Impedence Audiometer AZ26 (Denmark) before operation (T0), after intubation (T1), after CO2 insuflation (T2), before extubation (T3) and immediately after operation in the recovery room (T4). PONV was evalutaed in three periods postoperatively (0-2 hr, 2-6 hr, 6-24 hr) and scored by using Numeric Rank Score (0; no nausea, 1; nausea without vomiting, 2; vomiting one time, 3; two or more vomiting attacks). Results: There was no significant difference between the measures of two ears in any measurement except that Vright was lower than Vleft at T3. In both ears, middle ear pressures were significantly higher at the measurements of T 1,2,3 than that of T0. Volume and compliance values were decreased, whereas gradient values were increased at T 1,2,3 measurements in both ears, compared to T0 values. Eigtheen cases (60 %) experienced PONV postoperatively. Negative correlation was found between PONV and the values of Vright and Vleft in the measurements of T0 and T4 and Vleft at T3. A positive correlation was observed between Pright, Gright, Gleft at the measurement of T4 and PONV. Conclusion: We conclude that the tympanometric changes may affect the incidence of PONV in laparoscopic surgery patients.
Objective: The aim of this study was to investigate the possible correlation between tympanometric changes and postoperative nausea and vomiting (PONV) in laparascopic cholecystectomy operations. Patients and Methods: Thirty ASA I-II patients, aging between 30-65 years, undergoing laparascopic cholecystectomy were included in the study. Tympanometric measures were performed and recorded using Impedence Audiometer AZ26 (Denmark) before operation (T0), after intubation (T1), after CO2 insuflation (T2), before extubation (T3) and immediately after operation in the recovery room (T4). PONV was evalutaed in three periods postoperatively (0-2 hr, 2-6 hr, 6-24 hr) and scored by using Numeric Rank Score (0; no nausea, 1; nausea without vomiting, 2; vomiting one time, 3; two or more vomiting attacks). Results: There was no significant difference between the measures of two ears in any measurement except that Vright was lower than Vleft at T3. In both ears, middle ear pressures were significantly higher at the measurements of T 1,2,3 than that of T0. Volume and compliance values were decreased, whereas gradient values were increased at T 1,2,3 measurements in both ears, compared to T0 values. Eigtheen cases (60 %) experienced PONV postoperatively. Negative correlation was found between PONV and the values of Vright and Vleft in the measurements of T0 and T4 and Vleft at T3. A positive correlation was observed between Pright, Gright, Gleft at the measurement of T4 and PONV. Conclusion: We conclude that the tympanometric changes may affect the incidence of PONV in laparoscopic surgery patients.
Açıklama
Anahtar Kelimeler
Postoperatif Bulantı Kusma, Timpanometri, Postoperative Nausea and Vomiting, Tympanometry
Kaynak
Türk Anestezi ve Reanimasyon Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
34
Sayı
4
