Yıl: 2020 Cilt: 26 Sayı: 5 Sayfa Aralığı: 754 - 759 Metin Dili: İngilizce DOI: 10.14744/tjtes.2020.62378 İndeks Tarihi: 04-11-2020

Sedoanalgesia modality during laser photocoagulation for retinopathy of prematurity: Intraoperative complications and early postoperative follow-up

Öz:
BACKGROUND: Laser photocoagulation (LPC) is a surgical procedure used in the treatment of premature retinopathy that maycause retinal detachment and blindness if not diagnosed and treated early. The anesthesia method used in LPC varies from sedoanalgesiato general anesthesia and airway management varies from spontaneous ventilation to endotracheal intubation. In this study, weaimed to evaluate the effectiveness of sedoanalgesia applications and this anesthesia procedure concerning intraoperative and postoperativecomplications by avoiding intubation and mechanical ventilation in premature infants with a fragile population.METHODS: This retrospective study included 89 patients who underwent laser photocoagulation under anesthesia for prematureretinopathy. Patients’ demographic characteristics, preoperative risk factors, anesthesia technique, especially airway management,changes in ventilation status during surgery, intraoperative complications, postoperative complications, and intensive care follow-up,were recorded and analyzed statistically.RESULTS: Two of the 89 patients who underwent laser photocoagulation were excluded from this study because they were followedup intubated. The number of patients who received mask ventilation due to intraoperative complications was 12 (13.8%). The meanoperation time was 36.2±10.1 minutes. In 86.2% (n=75) of the patients, the surgical procedure was completed with sedoanalgesiawhile maintaining spontaneous ventilation.CONCLUSION: Sedoanalgesia application during the surgical intervention of patients with Retinopathy of Prematurity (ROP) requiringearly diagnosis and emergency treatment will minimize intraoperative and postoperative complications. We believe that sedoanalgesiaas an anesthetic method can be applied as an effective alternative method while preserving spontaneous ventilation.
Anahtar Kelime:

Prematüre retinopatisinde lazer fotokoagülasyon sırasında sedoanaljezi yöntemi: İntraoperatif komplikasyonlar ve erken postoperatif takip

Öz:
AMAÇ: Erken teşhis ve tedavi edilmezse retinal dekolmana ve körlüğe neden olabilen prematüre retinopatisinin (PR) tedavisinde uygulanan laser fotokoagülasyon tedavisi (LFT) cerrahi bir prosedürdür. LFT’de uygulanan anestezi yöntemi sedo-analjeziden genel anesteziye, havayolu yönetimi spontan ventilasyondan endotrakeal entübasyona kadar değişkenlik göstermektedir. Bu çalışma ile kırılgan popülasyon olan prematüre bebeklerde entübasyon ve mekanik ventilasyondan kaçınarak sedoanaljezi uygulamalarımızın etkinliğini, bu anestezi yöntemini intraoperatif ve postoperatif komplikasyonlar açısından değerlendirmeyi amaçladık. GEREÇ VE YÖNTEM: Bu geriye dönük çalışma, PR nedeniyle anestezi altında lazer fotokoagülasyon uygulanmış 89 olguyu içermektedir. Hastaların demografik özellikleri, preoperatif risk faktörleri, anestezi tekniği, özellikle havayolu yönetimi, cerrahi süresince ventilasyon durumundaki değişiklikler, intraoperatif komplikasyonlar, postoperatif komplikasyonlar, yoğun bakım takip süreci kayedildi ve istatistiksel olarak analiz edildi. BULGULAR: Lazer fotokoagülasyon uygulanan 89 hastadan ikisi entübe halde takip edildiği için çalışma dışı bırakıldı. İntraoperatif komplikasyon gelişmesi sonucu maske ventilasyon uygulanan hasta sayısı 12 (%13.8) idi. Ortalama operasyon süresi 36.2±10.1 dakika idi. Hastaların %86.2’sinde (n=75) cerrahi işlem spontan ventilasyon korunarak sedoanaljezi ile tamamlanandı. TARTIŞMA: Erken tanı ve acil tedavi gerektiren PR hastalarının cerrahi müdahalesi sırasında sedoanaljezi uygulaması intraoperatif ve postoperatif komplikasyonları azaltabilir. Anestezi yöntemi olarak sedoanaljezi yaklaşımının spontan ventilasyonu koruyarak etkili bir alternatif yöntem olarak uygulanabileceği kanısındayız.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Zin A, Gole GA. Retinopathy of prematurity-incidence today. Clin Perinatol 2013;40:185−200.
  • 2. Gilbert C, Muhit M. Twenty years of childhood blindness: what have we learnt?. Community Eye Health 2008;21:46−7.
  • 3. Owen LA, Morrison MA, Hoffman RO, Yoder BA, DeAngelis MM. Retinopathy of prematurity: A comprehensive risk analysis for prevention and prediction of disease. PLoS One 2017;12:e0171467.
  • 4. Karna P, Muttineni J, Angell L, Karmaus W. Retinopathy of prematurity and risk factors: a prospective cohort study. BMC Pediatr 2005;5:18.
  • 5. Allegaert K, Van de Velde M, Casteels I, Naulaers G, Vanhole C, Devlieger H. Cryotherapy for threshold retinopathy: perioperative management in a single center. Am J Perinatol 2003;20:219−26.
  • 6. Chen SD, Sundaram V, Wilkinson A, Patel CK. Variation in anaesthesia for the laser treatment of retinopathy of prematurity--a survey of ophthalmologists in the UK. Eye (Lond) 2007;21:1033−6.
  • 7. Steward DJ. A simplified scoring system for the post-operative recovery room. Can Anaesth Soc J 1975;22:111−3.
  • 8. Early Treatment For Retinopathy Of Prematurity Cooperative Group. Revised indications for the treatment of retinopathy of prematurity: results of the early treatment for retinopathy of prematurity randomized trial. Arch Ophthalmol 2003;121:1684−94.
  • 9. Anand KJ, Hickey PR. Pain and its effects in the human neonate and fetus. N Engl J Med 1987;317:1321−9.
  • 10. Clarke WN, Hodges E, Noel LP, Roberts D, Coneys M. The oculocardiac reflex during ophthalmoscopy in premature infants. Am J Ophthalmol 1985;99:649−51.
  • 11. Haigh PM, Chiswick ML, O’Donoghue EP. Retinopathy of prematurity: systemic complications associated with different anaesthetic techniques at treatment. Br J Ophthalmol 1997;81:283−7.
  • 12. Piersigilli F, Di Pede A, Catena G, Lozzi S, Auriti C, Bersani I et al. Propofol and fentanyl sedation for laser treatment of retinopathy of prematurity to avoid intubation. J Matern Fetal Neonatal Med 2019;32:517−21.
  • 13. Lyon F, Dabbs T, O’Meara M. Ketamine sedation during the treatment of retinopathy of prematurity. Eye 2007;21:1−3.
  • 14. White PF, Way WL, Trevor AJ. Ketamine--its pharmacology and therapeutic uses. Anesthesiology 1982;56:119−36.
  • 15. Reich DL, Silvay G. Ketamine: an update on the first twenty-five years of clinical experience. Can J Anaesth 1989;36:186−97.
  • 16. Green SM, Roback MG, Krauss B, Brown L, McGlone RG, Agrawal D, et al; Emergency Department Ketamine Meta-Analysis Study Group. Predictors of airway and respiratory adverse events with ketamine sedation in the emergency department: an individual-patient data meta-analysis of 8,282 children. Ann Emerg Med 2009;54:158−68.e1-4.
  • 17. Welborn LG, Greenspun JC. Anesthesia and apnea. Perioperative considerations in the former preterm infant. Pediatr Clin North Am 1994;41:181−98.
  • 18. Demirel N, Bas AY, Kavurt S, Celik IH, Yucel H, Turkbay D, et al. Remifentanil analgesia during laser treatment for retinopathy of prematurity: a practical approach in neonatal intensive care unit. Am J Perinatol 2014;31:983–6.
  • 19. Ulgey A, Güneş I, Bayram A, Aksu R, Biçer C, Uğur F, et al. Decreasing the need for mechanical ventilation after surgery for retinopathy of prematurity: sedoanalgesia vs. general anesthesia. Turk J Med Sci 2015;45:1292−9.
  • 20. Shah VA, Yeo CL, Ling YL, Ho LY. Incidence, risk factors of retinopathy of prematurity among very low birth weight infants in Singapore. Ann Acad Med Singapore 2005;34:169−78.
  • 21. Walther-Larsen S, Rasmussen LS. The former preterm infant and risk of post-operative apnoea: recommendations for management. Acta Anaesthesiol Scand 2006;50:888−93.
  • 22. Yavaşcaoğlu B, Kaya FN, Özcan B, Yılmaz C, Töre G, Ata F, et al. The Practice of General Anesthesia for the Laser Therapy of Neonates with Retinopahty of Prematurity: A Retrospective Analysis. Uludağ Üniversitesi Tıp Fakültesi Derg 2007;33:65−9.
APA SAYLAN S, Akdogan A, KADER S, Tugcugil E, Besir A, kola m, aslan y (2020). Sedoanalgesia modality during laser photocoagulation for retinopathy of prematurity: Intraoperative complications and early postoperative follow-up. , 754 - 759. 10.14744/tjtes.2020.62378
Chicago SAYLAN Sedat,Akdogan Ali,KADER SEBNEM,Tugcugil Ersagun,Besir Ahmet,kola mehmet,aslan yakup Sedoanalgesia modality during laser photocoagulation for retinopathy of prematurity: Intraoperative complications and early postoperative follow-up. (2020): 754 - 759. 10.14744/tjtes.2020.62378
MLA SAYLAN Sedat,Akdogan Ali,KADER SEBNEM,Tugcugil Ersagun,Besir Ahmet,kola mehmet,aslan yakup Sedoanalgesia modality during laser photocoagulation for retinopathy of prematurity: Intraoperative complications and early postoperative follow-up. , 2020, ss.754 - 759. 10.14744/tjtes.2020.62378
AMA SAYLAN S,Akdogan A,KADER S,Tugcugil E,Besir A,kola m,aslan y Sedoanalgesia modality during laser photocoagulation for retinopathy of prematurity: Intraoperative complications and early postoperative follow-up. . 2020; 754 - 759. 10.14744/tjtes.2020.62378
Vancouver SAYLAN S,Akdogan A,KADER S,Tugcugil E,Besir A,kola m,aslan y Sedoanalgesia modality during laser photocoagulation for retinopathy of prematurity: Intraoperative complications and early postoperative follow-up. . 2020; 754 - 759. 10.14744/tjtes.2020.62378
IEEE SAYLAN S,Akdogan A,KADER S,Tugcugil E,Besir A,kola m,aslan y "Sedoanalgesia modality during laser photocoagulation for retinopathy of prematurity: Intraoperative complications and early postoperative follow-up." , ss.754 - 759, 2020. 10.14744/tjtes.2020.62378
ISNAD SAYLAN, Sedat vd. "Sedoanalgesia modality during laser photocoagulation for retinopathy of prematurity: Intraoperative complications and early postoperative follow-up". (2020), 754-759. https://doi.org/10.14744/tjtes.2020.62378
APA SAYLAN S, Akdogan A, KADER S, Tugcugil E, Besir A, kola m, aslan y (2020). Sedoanalgesia modality during laser photocoagulation for retinopathy of prematurity: Intraoperative complications and early postoperative follow-up. Ulusal Travma ve Acil Cerrahi Dergisi, 26(5), 754 - 759. 10.14744/tjtes.2020.62378
Chicago SAYLAN Sedat,Akdogan Ali,KADER SEBNEM,Tugcugil Ersagun,Besir Ahmet,kola mehmet,aslan yakup Sedoanalgesia modality during laser photocoagulation for retinopathy of prematurity: Intraoperative complications and early postoperative follow-up. Ulusal Travma ve Acil Cerrahi Dergisi 26, no.5 (2020): 754 - 759. 10.14744/tjtes.2020.62378
MLA SAYLAN Sedat,Akdogan Ali,KADER SEBNEM,Tugcugil Ersagun,Besir Ahmet,kola mehmet,aslan yakup Sedoanalgesia modality during laser photocoagulation for retinopathy of prematurity: Intraoperative complications and early postoperative follow-up. Ulusal Travma ve Acil Cerrahi Dergisi, vol.26, no.5, 2020, ss.754 - 759. 10.14744/tjtes.2020.62378
AMA SAYLAN S,Akdogan A,KADER S,Tugcugil E,Besir A,kola m,aslan y Sedoanalgesia modality during laser photocoagulation for retinopathy of prematurity: Intraoperative complications and early postoperative follow-up. Ulusal Travma ve Acil Cerrahi Dergisi. 2020; 26(5): 754 - 759. 10.14744/tjtes.2020.62378
Vancouver SAYLAN S,Akdogan A,KADER S,Tugcugil E,Besir A,kola m,aslan y Sedoanalgesia modality during laser photocoagulation for retinopathy of prematurity: Intraoperative complications and early postoperative follow-up. Ulusal Travma ve Acil Cerrahi Dergisi. 2020; 26(5): 754 - 759. 10.14744/tjtes.2020.62378
IEEE SAYLAN S,Akdogan A,KADER S,Tugcugil E,Besir A,kola m,aslan y "Sedoanalgesia modality during laser photocoagulation for retinopathy of prematurity: Intraoperative complications and early postoperative follow-up." Ulusal Travma ve Acil Cerrahi Dergisi, 26, ss.754 - 759, 2020. 10.14744/tjtes.2020.62378
ISNAD SAYLAN, Sedat vd. "Sedoanalgesia modality during laser photocoagulation for retinopathy of prematurity: Intraoperative complications and early postoperative follow-up". Ulusal Travma ve Acil Cerrahi Dergisi 26/5 (2020), 754-759. https://doi.org/10.14744/tjtes.2020.62378