Turkiye Klinikleri Journal of Medical Sciences

.: ORIGINAL RESEARCH
Tek Akciğer Ventilasyonun Kognitif Fonksiyonlar Üzerine Etkisi: Kesitsel Araştırma
The Effect of One-Lung Ventilation on Cognitive Functions: Cross-Sectional Research
Mesut AYDOĞANa , Enes ÇELİKb, Zeynep BAYSAL YILDIRIMc , Mahir KUYUMCUc
aMardin Eğitim ve Araştırma Hastanesi, Anestezi Kliniği, Mardin, Türkiye
bMardin Artuklu Üniversitesi Tıp Fakültesi, Anesteziyoloji ve Reanimasyon ABD, Mardin,Türkiye
cDicle Üniversitesi Tıp Fakültesi, Anesteziyoloji ve Reanimasyon ABD, Diyarbakır, Türkiye
Turkiye Klinikleri J Med Sci. 2023;43(3):225-32
doi: 10.5336/medsci.2023-97412
Article Language: TR
Full Text
ÖZET
 Amaç: Postoperatif kognitif disfonksiyon (POKD), majör cerrahi sonrası özellikle ileri yaş olmak üzere tüm yaş grubu hastalarda sıkça görülür ve aylarca sebat edebilir. Etiyolojisi multifaktöriyel olmakla birlikte, serebral oksijen sunum ve tüketim dengesini etkileyen faktörler suçlanmaktadır. Bu nedenle hipoksi gibi ciddi komplikasyonlarla seyredebilen tek akciğer ventilasyonu (TAV) uygulanan torasik cerrahi hastalarında POKD'yi mini-mental durum testi ile değerlendirerek hastalarda POKD'nin değerlendirilmesi amaçlandı. Gereç ve Yöntemler: Bu çalışmaya 20 yaş ve 72 yaş arası, torasik cerrahide TAV adayı hastalar dâhil edildi. Anestezi protokolü tüm hastalarda aynı şekilde uygulandı. Kognitif değerlendirme operasyondan 1 gün önce, operasyondan 1 ve 3 gün sonra yapıldı. Bu amaçla MiniMental Durum Değerlendirme Testi kullanıldı. Bulgular: Çalışmaya 30 hasta dâhil edildi. TAV uygulanan hastaların %26,6'sında POKD tespit edildi. Hastaların yapılan mini-mental durum değerlendirme testi, ameliyat öncesi ile ameliyat sonrası 1. gün ile 3. gün arasında kognitif disfonksiyon açısından fark tespit edildi. Ameliyat sonrası 1. gün ile ameliyat sonrası 3. gün arasında fark tespit edilmemiştir. Sonuç: Toraks cerrahisinde TAV uygulanan hastalarda erken dönem kognitif disfonksiyon görülmektedir. Bunda cerrahi süre, anestetik ilaçlar, hastayla ilgili parametreler etkili olmakta olup, hastalar intaroperatif yakın takip edilmeli ve ameliyat sonrasında da hastalar kognitif fonksiyonları açısından yakından izlenmelidir.

Anahtar Kelimeler: Kognitif disfonksiyon; mental durum ve demans testi; tek-akciğer ventilasyonu
ABSTRACT
 Objective: Postoperative cognitive dysfunction (POCD) is frequently seen in patients of all age groups, especially advanced age, after major surgery and may persist for months. Although its etiology is multifactorial, factors affecting the balance of cerebral oxygen delivery and consumption are blamed. For this reason, it was aimed to evaluate whether patients developed POCD by evaluating POCD with mini-mental state test in thoracic surgery patients who underwent one lung ventilation (OLV), which can progress with serious complications such as hypoxia. Material and Methods: Patients between 20 years and 72 years of age candidates for OLV in thoracic surgery were included in the study. The anesthesia protocol was applied the same way in all patients. Cognitive assessment was conducted 1 day before the operation, 1 day after the operation and 3 days after. For this purpose, Mini-Mental Status Examination test was used. Results: Thirty patients were included in the study. POCD was detected in 26% of patients who underwent OLV. The mini-mental state test of the patients showed a difference in terms of cognitive dysfunction between preoperative and postoperative day 1 and day 3. However, no difference was detected between day 1 and day 3 after surgery. Conclusion: Early cognitive dysfunction is observed in patients undergoing OLV in thoracic surgery. Surgical time, anesthetic drugs, and patient-related parameters are effective, and patients should be closely monitored in terms of cognitive functions of the patients, in close follow-up and after surgery.

Keywords: Cognitive dysfunction; mental status and dementia tests; one-lung ventilation
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