Neurosurgery in the sitting position: retrospective analysis of 692 adult and pediatric cases

TUNALI, Yusuf; AYDIN, Sabri; TANRIVERDİ, Taner; KORKMAZ DİLMEN, Özlem; AKÇIL, Eren Fatma; Tureci, Ercan; YENTÜR, ERCÜMENT; BAHAR, Mois

Neurosurgery in the sitting position: retrospective analysis of 692 adult and pediatric cases

Özlem KORKMAZ DİLMEN, (İstanbul Üniversitesi, Cerrahpaşa Tıp Fakültesi, Anestezi Yoğun Bakım Ünitesi, İstanbul, Türkiye)

Eren Fatma AKÇIL, (İstanbul Üniversitesi, Cerrahpaşa Tıp Fakültesi, Anestezi Yoğun Bakım Ünitesi, İstanbul, Türkiye)

Ercan TÜRECİ, (İstanbul Üniversitesi, Cerrahpaşa Tıp Fakültesi, Anestezi Yoğun Bakım Ünitesi, İstanbul, Türkiye)

Yusuf TUNALI, (İstanbul Üniversitesi, Cerrahpaşa Tıp Fakültesi, Anestezi Yoğun Bakım Ünitesi, İstanbul, Türkiye)

Mois BAHAR, (İstanbul Üniversitesi, Cerrahpaşa Tıp Fakültesi, Anestezi Yoğun Bakım Ünitesi, İstanbul, Türkiye)

Taner TANRIVERDİ, (İstanbul Üniversitesi, Cerrahpaşa Tıp Fakültesi, Nöroşirürji Anabilim Dalı, İstanbul, Türkiye)

Sabri AYDIN, (İstanbul Üniversitesi, Cerrahpaşa Tıp Fakültesi, Nöroşirürji Anabilim Dalı, İstanbul, Türkiye)

ERCÜMENT YENTÜR (İstanbul Üniversitesi, Cerrahpaşa Tıp Fakültesi, Anestezi Yoğun Bakım Ünitesi, İstanbul, Türkiye)

Turkish Neurosurgery

4 2

Yıl: 2011 Cilt: 21 Sayı: 4 Sayfa Aralığı: 634 - 640 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Neurosurgery in the sitting position: retrospective analysis of 692 adult and pediatric cases

Öz:

AMAÇ: Oturur pozisyon, venöz hava embolisi (VHE) riski nedeniyle gitgide daha az kullanılıp tartışmalı bir konu olmayı sürdürse de, pek çok merkezde rutin olarak kullanılmaktadır. YÖNTEM ve GEREÇler: Bu yazı, Ocak 1995 ile Aralık 2010 tarihleri arasında oturur pozisyonda ameliyat edilen 601 erişkin ve 91 çocuk olgunun retrospektif analizidir. Bu çalışmada VHE ve oturur pozisyonla ilişkili diğer komplikasyonlar tespit edilmiştir. VHE’si tanısı, end tidal karbondioksit (ETCO2) düzeyinde ani ve sürekli bir şekilde 0,7 kPa’dan fazla düşüşle konmuştur. BULGULAR: VHE insidansı çocuklarda %26,3 (n=24) ve erişkinlerde %20,4 (n=123) bulunmuştur, fakat bu fark anlamlı değildir. Oturur pozisyonun oluşturduğu hipotansiyon insidansı erişkinlerde (%37,6) çocuklardan fazladır (%18,6, p=0,00001). KOAH hastası olma (p= 0,04) ve yüksek ASA skoru (p=0,03) pozisyonun oluşturduğu hipotansiyon ile ilişkili bulunmuştur. Ameliyat sırasında ölen hasta yoktur. SONUÇ: Bu çalışma, oturur pozisyonda nöroanestezi uygulaması açısından oldukça fazla sayıda veri içermektedir. Eğer oturur pozisyon cerrahi bir gereklilikse ve daha gelişmiş bir monitörizasyon olanağınız yoksa sadece ETCO2 monitörizasyonu ile VHE oluşumu ihtiyatli bir şekilde takip edilerek uygulanabilir.

Anahtar Kelime:

Konular: Cerrahi

Oturur pozisyonda nöroşirürji: 692 erişkin ve çocuk olgunun retrospektif analizi

Öz:

AIm: The sitting position is routinely used in many centers, although its use remains controversial and appears to be diminishing because of the risk of venous air embolism (VAE). Ma terIal and Methods: This is a retrospective analysis of 601 adult and 91 pediatric cases underwent neurosurgery from January 1995 through December 2010 in the sitting position. The incidence of VAE and other complications related to the sitting position has been determined. VAE was defined as a sudden and sustained decrease of end-tidal carbon dioxide (ETCO2) ≥0.7kPa. Results: The incidence of VAE in children and adults were found to be 26.3% (n=24) and 20.4% (n=123) consecutively but the difference was not significant. The incidence of positioning induced hypotension was more in adults (37.6%) compared to children (18.6%, p=0.00001). The presence of COPD (p=0.04) and ASA status (p=0.03) showed a correlation with ‘hypotension with positioning’. There was no peroperative mortality. ConclusIon: The study provides a significant body of data on neuroanesthesia for the sitting position and our results suggest that if the sitting position is a neurosurgical necessity it can be used with vigilant follow up throughout the procedure to detect any occurrence of VAE by ETCO2 monitoring if you do not have the chance to use more sensitive tools.

Anahtar Kelime:

Konular: Cerrahi

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	KORKMAZ DİLMEN Ö, AKÇIL E, Tureci E, TUNALI Y, BAHAR M, TANRIVERDİ T, AYDIN S, YENTÜR E (2011). Neurosurgery in the sitting position: retrospective analysis of 692 adult and pediatric cases. , 634 - 640.
Chicago	KORKMAZ DİLMEN Özlem,AKÇIL Eren Fatma,Tureci Ercan,TUNALI Yusuf,BAHAR Mois,TANRIVERDİ Taner,AYDIN Sabri,YENTÜR ERCÜMENT Neurosurgery in the sitting position: retrospective analysis of 692 adult and pediatric cases. (2011): 634 - 640.
MLA	KORKMAZ DİLMEN Özlem,AKÇIL Eren Fatma,Tureci Ercan,TUNALI Yusuf,BAHAR Mois,TANRIVERDİ Taner,AYDIN Sabri,YENTÜR ERCÜMENT Neurosurgery in the sitting position: retrospective analysis of 692 adult and pediatric cases. , 2011, ss.634 - 640.
AMA	KORKMAZ DİLMEN Ö,AKÇIL E,Tureci E,TUNALI Y,BAHAR M,TANRIVERDİ T,AYDIN S,YENTÜR E Neurosurgery in the sitting position: retrospective analysis of 692 adult and pediatric cases. . 2011; 634 - 640.
Vancouver	KORKMAZ DİLMEN Ö,AKÇIL E,Tureci E,TUNALI Y,BAHAR M,TANRIVERDİ T,AYDIN S,YENTÜR E Neurosurgery in the sitting position: retrospective analysis of 692 adult and pediatric cases. . 2011; 634 - 640.
IEEE	KORKMAZ DİLMEN Ö,AKÇIL E,Tureci E,TUNALI Y,BAHAR M,TANRIVERDİ T,AYDIN S,YENTÜR E "Neurosurgery in the sitting position: retrospective analysis of 692 adult and pediatric cases." , ss.634 - 640, 2011.
ISNAD	KORKMAZ DİLMEN, Özlem vd. "Neurosurgery in the sitting position: retrospective analysis of 692 adult and pediatric cases". (2011), 634-640.

APA	KORKMAZ DİLMEN Ö, AKÇIL E, Tureci E, TUNALI Y, BAHAR M, TANRIVERDİ T, AYDIN S, YENTÜR E (2011). Neurosurgery in the sitting position: retrospective analysis of 692 adult and pediatric cases. Turkish Neurosurgery, 21(4), 634 - 640.
Chicago	KORKMAZ DİLMEN Özlem,AKÇIL Eren Fatma,Tureci Ercan,TUNALI Yusuf,BAHAR Mois,TANRIVERDİ Taner,AYDIN Sabri,YENTÜR ERCÜMENT Neurosurgery in the sitting position: retrospective analysis of 692 adult and pediatric cases. Turkish Neurosurgery 21, no.4 (2011): 634 - 640.
MLA	KORKMAZ DİLMEN Özlem,AKÇIL Eren Fatma,Tureci Ercan,TUNALI Yusuf,BAHAR Mois,TANRIVERDİ Taner,AYDIN Sabri,YENTÜR ERCÜMENT Neurosurgery in the sitting position: retrospective analysis of 692 adult and pediatric cases. Turkish Neurosurgery, vol.21, no.4, 2011, ss.634 - 640.
AMA	KORKMAZ DİLMEN Ö,AKÇIL E,Tureci E,TUNALI Y,BAHAR M,TANRIVERDİ T,AYDIN S,YENTÜR E Neurosurgery in the sitting position: retrospective analysis of 692 adult and pediatric cases. Turkish Neurosurgery. 2011; 21(4): 634 - 640.
Vancouver	KORKMAZ DİLMEN Ö,AKÇIL E,Tureci E,TUNALI Y,BAHAR M,TANRIVERDİ T,AYDIN S,YENTÜR E Neurosurgery in the sitting position: retrospective analysis of 692 adult and pediatric cases. Turkish Neurosurgery. 2011; 21(4): 634 - 640.
IEEE	KORKMAZ DİLMEN Ö,AKÇIL E,Tureci E,TUNALI Y,BAHAR M,TANRIVERDİ T,AYDIN S,YENTÜR E "Neurosurgery in the sitting position: retrospective analysis of 692 adult and pediatric cases." Turkish Neurosurgery, 21, ss.634 - 640, 2011.
ISNAD	KORKMAZ DİLMEN, Özlem vd. "Neurosurgery in the sitting position: retrospective analysis of 692 adult and pediatric cases". Turkish Neurosurgery 21/4 (2011), 634-640.