Zor entübasyon olgularında frova kateteri ile video laringoskop kullanımının entübasyon başarısı açısından karşılaştırılması
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Tarih
2015
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Yayıncı
Selçuk Üniversitesi Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Genel anestezi alması planlanan, zor entübasyon kriterlerine sahip ve entübasyon endikasyonu bulunan zor entübasyon hastalarında Frova kateteri ve Mc Grath MAC videolaringoskopun entübasyon başarısı açısından karşılaştırılması. Yöntem: Yapılan preoperatif değerlendirmede zor entübasyon kriterlerine sahip olan 49 hastaçalışmaya alındı. Zor entübasyon değerlendirmesinde kullanılan parametreler kaydedildi.Her hasta için standart anestezi protokolü uygulandı. En az üç yıllık deneyimi olan bir anestezist tarafından uygulanan entübasyon denemesi bir kez başarısız olması ile hasta zor entübasyon olarak kabul edildi. Çalışmaya dahil edilen hastalar rastgele iki gruba ay¬rıldı. Grup V deki hastaların video larengoskop (Mac-Grath MAC) kullanarak Grup F'dekilerin ise Frova kateteri kullanılarak entübe edilmesi planlandı. Seçilen cihazla en az 3 yıllık deneyimi bulunan anestezist tarafından 3 denemede entübasyon yapılamaması durumunda cihaz başarısız olarak kabul edildi ve diğer cihaza geçildi. Üçüncü yöntem olarak iki cihazın birlikte kullanımı ile entübasyon tercih edildi.Hastaların entübasyon sürecindeki başarı ile ilgili verileri, peroperatif ve ekstübasyon sürecindeki parametreleri kaydedildi. Cerrahi bitiminin ardından planlanmış olan ekstübasyon stratejisine uygun olarak ekstübasyon işlemi gerçekleştirildi. Bulgular: Çalışmaya alınan 24 VL ve 25 F grubu hastalarda entübasyon başarı oranı Grup F'de; % 88 grup VL de; %66 olarak bulundu. Fakat istatiksel analizde bu fark anlamlı değildi. İstatistiksel karşılaştırmada 1., 2. ve 3. denemede başarı oranları açısından anlamlı fark . VL grubunda ortalama başarılı entübasyon süresi 42,5 ve F grubunda 38,68 olarak kaydedildi. İstatiksel olarak anlamlı fark bulunmadı. Frova ile elde edilen CL skoru ve VL ile elde edilen CL skoru karşılaştırmasında anlamlı fark vardı VL grubunda CL skoru anlamlı derecede az bulundu Çalışmamızda; Komplikasyon hemodinami, demografik veri, ve hastanın fiziksel özellikleri açısından iki grup arasında anlamlı fark görülmedi. Sonuç: Klinik deneyimlerimize göre Frova kateterinin video laringoskopa göre daha başarılı olduğunu düşünmekteyiz. Fakat çalışmamızda başarılı entübasyon oranında iki grup arasında anlamlı fark görülmemiştir. Bu sonucun vaka sayısının artırılması ile değişebileceğini düşünmekteyiz. Fakat iki cihazın başarı oranında anlamlı fark çıkmaması da klinik önem taşımaktadır. Cihazların maliyetleri göz önüne alınırsa her ikisi de aynı başarıya sahip olduğundan Frova kateteri çok daha avantajlıdır.. Çalışmamızda VL grubunun CL skorunu düşürdüğü sonucuna vardık. Fakat düşük CL skoru tek başına entübasyon başarısını artırmaya yetmeyebilir. Pek çok klinisyen elde edilen elverişli görüntüye rağmen tüpü vokal kordlara yönlendirme konusunda problem yaşamaktadır. İki cihazın beraber kullanımı ile ilgili çalışmalar yapılabilir.
Comparison of frova catheter versus Mc Grath MAC video-laryngoscope in patients with positive difficult intubation criteria and intubation indicated known difficult intubation patients Methods:49 patients who has difficult intubation criteria in preoperative anesthetical evaluation was included to study. Parameters which are used to define difficult intubation were recorded/(noted). Whole patients had a Standard anesthesia protocol. Patient is admitted as difficult intubation in circumstance of one unsuccesful intubation attempt which is been applied by an anesthesist who has 3 years or more proffesional experiment. Patients were divided into two groups randomly. Patients in Group V were planned to intubate via Video Laryngoscope (Mac-Grath MAC) and patients in Group F were planned to intubate via Frova catheter. In circumstance of failed intubation for 3 times which is performed by 3 years or more experienced anesthesist, device considered unsuccessful and other device was used. Combination of both devices for intubation is considered as third method. All data about intubation, perioperative and extubation processes were recorded./(noted). At the end of procedure extubation performed as according to planned strategy. Results: The susscess rate of intubation was found ; 66% İn the VL group which has 24 patients and 88 % in the group F which has 25 patients. The result was not statistically significant. The intubation success at the first, second and thirth attempt ratio between the two groups was not statistically significant. The mean successful intubation time was found in VL group 42,5 and 38,68 seconds in the F group. This was not also statistically significant. There was a statistically significant difference in CL score which achieved with group F and VL. VL decreased the CL score significantly. There was no significiant difference between the two groups about patient's physical, demographic, hemodynamic values and complications Conlusion: According to our clinical experience we think that Frova catheter is more successful than video laryngoscopes. But in our study the susscess rate of intubation was not seen statistically significant between the two groups. We believe in that the results could change with increasing number of cases in the study. But still no significant difference in the rate of success of the two devices is clinically important. If the device's costs is taken into account Frova catheter has much more advantage because of their same clinical success . İn our study we have found that the VL decreased the CL score significantly. However low CL score may not be enough to increase intubation success alone. Many clinicians experiencing problems in diverting the tube to the vocal cords despite the favorable image obtained. However combined use of the two devices seems to be more succesfull so further more studies can be done about this combination.
Comparison of frova catheter versus Mc Grath MAC video-laryngoscope in patients with positive difficult intubation criteria and intubation indicated known difficult intubation patients Methods:49 patients who has difficult intubation criteria in preoperative anesthetical evaluation was included to study. Parameters which are used to define difficult intubation were recorded/(noted). Whole patients had a Standard anesthesia protocol. Patient is admitted as difficult intubation in circumstance of one unsuccesful intubation attempt which is been applied by an anesthesist who has 3 years or more proffesional experiment. Patients were divided into two groups randomly. Patients in Group V were planned to intubate via Video Laryngoscope (Mac-Grath MAC) and patients in Group F were planned to intubate via Frova catheter. In circumstance of failed intubation for 3 times which is performed by 3 years or more experienced anesthesist, device considered unsuccessful and other device was used. Combination of both devices for intubation is considered as third method. All data about intubation, perioperative and extubation processes were recorded./(noted). At the end of procedure extubation performed as according to planned strategy. Results: The susscess rate of intubation was found ; 66% İn the VL group which has 24 patients and 88 % in the group F which has 25 patients. The result was not statistically significant. The intubation success at the first, second and thirth attempt ratio between the two groups was not statistically significant. The mean successful intubation time was found in VL group 42,5 and 38,68 seconds in the F group. This was not also statistically significant. There was a statistically significant difference in CL score which achieved with group F and VL. VL decreased the CL score significantly. There was no significiant difference between the two groups about patient's physical, demographic, hemodynamic values and complications Conlusion: According to our clinical experience we think that Frova catheter is more successful than video laryngoscopes. But in our study the susscess rate of intubation was not seen statistically significant between the two groups. We believe in that the results could change with increasing number of cases in the study. But still no significant difference in the rate of success of the two devices is clinically important. If the device's costs is taken into account Frova catheter has much more advantage because of their same clinical success . İn our study we have found that the VL decreased the CL score significantly. However low CL score may not be enough to increase intubation success alone. Many clinicians experiencing problems in diverting the tube to the vocal cords despite the favorable image obtained. However combined use of the two devices seems to be more succesfull so further more studies can be done about this combination.
Açıklama
Anahtar Kelimeler
Difficult intubation, Frova catheter, Success rate, Mc Grath MAC videolaryngoscope, Zor entübasyon, Frova kateteri, Mc Grath MAC videolaringoskop, Başarı oranı
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Özdemirkan, A. (2015). Zor entübasyon olgularında frova kateteri ile video laringoskop kullanımının entübasyon başarısı açısından karşılaştırılması. Selçuk Üniversitesi, Yayımlanmış uzmanlık tezi, Konya.
