Anesteziyoloji anabilim dalında uygulanan spinal anestezi sonrası baş ağrısı ve diğer komplikasyonların değerlendirilmesi
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Date
2008
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Abstract
Çalışmamızda Trakya Üniversitesi Tıp Fakültesi Anesteziyoloji Anabilim Dalında 01/05/2006-15/11/2006 tarihleri arasında spinal anestezi yöntemi ile opere edilmiş olan 256 olgu postspinal baş ağrısı ve diğer komplikasyonlar açısından retrospektif olarak incelendi. Bilgiler olgu dosyalarından, anestezi belgelerinden ve hastalar ile bizzat ya da telefon ile görüşülerek elde edildi. Dosyalardan ve belgelerden yaş, cinsiyet, boy, kilo, opere eden klinik, operasyon nedeni, enjeksiyonun yapıldığı spinal aralık, kullanılan lokal anestezik madde, operasyon sırasında verilen kristaloid ve kolloid miktarları kayıt edildi. Hastalar ile bizzat ya da telefon ile görüşülerek spinal anestezi ile yapılan operasyon sonrasında baş ağrısı olup olmadığı, operasyondan ne kadar sonra başladığı, yeri (frontal, oksipital, yaygın) ayağa kalktığında artıp artmadığı, yatar pozisyonda azalıp azalmadığı ve operasyondan sonra kaçıncı saatte ayağa kalktığı sorgulandı. Görme bozukluğu, çift görme, bulanık görme, kulak çınlaması, işitme kaybı, sırt ve bel ağrısı, idrar yapamama şikayetleri, bağırsak şikayetleri, cinsel aktivitede azalma olup olmadığı sorgulandı. Uygulamada L3-4, L4-5 aralığı ve 22-gauge iğne kullanılan 256 olgunun postspinal baş ağrısı ve diğer komplikasyonlar açısından retrospektif olarak incelenmesi ile 16 (%6,9) olguda post spinal baş ağrısı, 5 (%1,95) olguda sırt-bel ağrısı, 3 (%1,17) olguda idrar yapamama, 2 (%0,78) olguda bağırsak şikayetleri ve 1 (%0,59) olguda cinsel aktivitede azalma olmak üzere toplam 27 komplikasyon geliştiği belirlendi. Diplopi, görme bozukluğu, çift görme, kulak çınlaması, duyma kaybı hiçbir olguda görülmedi. Genç olgularda (yaş ortalaması:34,81 yıl) PSBA'nın anlamlı olarak fazla görüldüğü tespit edildi (p<0,05). Cinsiyet, girişim yapılan aralık, ilk ayağa kalkma zamanları ile PSBA arasında istatistiksel olarak anlamlı bir fark tespit edilmedi. Sonuç olarak, %6,9 oranında belirlediğimiz PSBA'nın genç olgularda daha fazla ortaya çıktığı saptandı ve kolloid kullanımı ile yatak istirahatinin baş ağrısının önlenmesinde etkili olabileceği düşünüldü. Anahtar kelimeler: Spinal anestezi, komplikasyon, baş ağrısı.
In our study, 256 cases -who were operated with spinal anesthesia method between May 1, 2006 and November 15, 2006 in Anesthesiology deportment in the School of Medicine, Trakya University, Edirne, Turkey- were retrospectively investigated for post-spinal headache and for other complications. Data were collected from case files, anesthesia documents, and via interviews or phone calls with the patients. From the files and the documents; age, gender, height, weight, operation clinic, operation reason, the spinal gap injection applied, the local anesthetic substance used, and the dose of crystalloid and colloid given during the operation were recorded. In the interviews and the phone calls; whether headache occurred or not after the operation done with spinal anesthesia, -if occurred- when it occurred, where it occurred (frontal, occipital, widespread), whether it increased when standing, whether it decreased while lying, and when the patient stood up after operation were investigated. Poor eyesight, diplopia (double vision), blurred vision, tinnitus, hearing loss, backache or and lumbago, difficulty in urination, intestinal sufferings, and decrease in sexual activity were also questioned. In the retrospective investigation of 256 cases for post-spinal headache and for the other complications, who were applied with 22-gauge needle from the L3-4, L4-5 gap; a total of 27 complications were observed: post-spinal headache in 16 (6,9%), backache and lumbago in 5 (1,95%), difficulty in urination in 3 (1,17%), intestinal sufferings in 2 (0,78%), and decrease in sexual activity in 1 (0,59%) case. Diplopia, poor eyesight, tinnitus, or hearing loss was not abserved in the cases. It was determined that PSBA was significantly more often at younger ages (age average: 34,81 years) (p<0,05). No significant difference was observed between gender, operation gap, first standing up time and PSBA. In conclusion, PSBA ?determined as observed in a rate of 6,9%? was found out to occur more often in younger cases; and colloid use and bedrest were thought to be effective in preventing headache. Key words: Spinal anesthesia, complication, headache.
In our study, 256 cases -who were operated with spinal anesthesia method between May 1, 2006 and November 15, 2006 in Anesthesiology deportment in the School of Medicine, Trakya University, Edirne, Turkey- were retrospectively investigated for post-spinal headache and for other complications. Data were collected from case files, anesthesia documents, and via interviews or phone calls with the patients. From the files and the documents; age, gender, height, weight, operation clinic, operation reason, the spinal gap injection applied, the local anesthetic substance used, and the dose of crystalloid and colloid given during the operation were recorded. In the interviews and the phone calls; whether headache occurred or not after the operation done with spinal anesthesia, -if occurred- when it occurred, where it occurred (frontal, occipital, widespread), whether it increased when standing, whether it decreased while lying, and when the patient stood up after operation were investigated. Poor eyesight, diplopia (double vision), blurred vision, tinnitus, hearing loss, backache or and lumbago, difficulty in urination, intestinal sufferings, and decrease in sexual activity were also questioned. In the retrospective investigation of 256 cases for post-spinal headache and for the other complications, who were applied with 22-gauge needle from the L3-4, L4-5 gap; a total of 27 complications were observed: post-spinal headache in 16 (6,9%), backache and lumbago in 5 (1,95%), difficulty in urination in 3 (1,17%), intestinal sufferings in 2 (0,78%), and decrease in sexual activity in 1 (0,59%) case. Diplopia, poor eyesight, tinnitus, or hearing loss was not abserved in the cases. It was determined that PSBA was significantly more often at younger ages (age average: 34,81 years) (p<0,05). No significant difference was observed between gender, operation gap, first standing up time and PSBA. In conclusion, PSBA ?determined as observed in a rate of 6,9%? was found out to occur more often in younger cases; and colloid use and bedrest were thought to be effective in preventing headache. Key words: Spinal anesthesia, complication, headache.
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Keywords
Anestezi ve Reanimasyon, Anesthesiology and Reanimation
