Research Information System
Thesis Type: Expertise In Medicine
Institution Of The Thesis: Recep Tayyip Erdogan University, Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü, Turkey
Approval Date: 2021
Thesis Language: Turkish
Student: GÜL KESİMAL
Supervisor: Leyla Kazancıoğlu
Abstract:
Objective: Inadvertent perioperative hypothermia (IPH) is frequently
observed in patients undergoing general anesthesia. Intraoperative high fresh
gas flow (FGF), dry and cold air can contribute to IPH. Therefore, low and
minimal flow anesthesia methods are used in today's practice. There are
implementation reservations due to the risk of hypoxia. In our study, we aimed
to investigate the effect of minimal, low and high flow anesthesia on body temperature
and tissue oxygenation in patients undergoing elective nasal surgery.
Material and Methods: With the permission of Recep Tayyip Erdoğan
University Non- Invasive Clinical Trials Ethics Committee dated 23.12.2016 and
2016/39, in this prospective randomized controlled study, under hypotensive
anesthesia, elective nasal surgery planned, aged 18-60, BMI 19-27, ASA 1-2 risk
group, the operation time between 1 and 4 hours patients were included. The
patients were divided into groups as minimal (0.5L / min), low (1L / min) and
high (2L / min) flow anesthesia. Demographic data of the patients such as age,
gender, BMI and operative data (duration of anesthesia, operation time, iv
total fluid) were recorded. Preoperative waiting room temperature,
intraoperative operating room room temperature and intraoperative body
temperature, anesthesia respiratory circuit humidity and temperature, tissue
oxygen saturation and tissue hemoglobin index were recorded at 0, 15, 30, 60,
90, 120 and 150 minutes. In the postoperative period, shivering and body temperatures
of the patients, Alderete score, room temperature of the recovery unit were recorded.
Results: Data of 92 patients were analyzed. IPH was observed in
patients (p = 0.001; p <0.01). There was no significant difference in
demographic data, perioperative hemodynamic parameters and body temperature of
the patients (p> 0.05). Tissue oxygen saturation (p = 0.033, p = 0.028, p =
0.011, p = 0.02; p <0.05) and postoperative Aldrete score (p = 0.002; p
<0.01) were found to be significantly higher in the minimal flow group at
15th, 60th, 90th and 120th minutes. A correlation was found between body
temperature and postoperative recovery temperatures and operating room
temperature (r = .446, r = .531; p <0.05).
Conclusion: IPH was detected in patients who underwent elective nasal
surgery. It was observed that 0.5, 1 and 2 L / min FGF rates had no effect on
body temperature and at the same time, the humidity and temperature of the
anesthesia circuit were maintained. However, it was found tissue oxygen
saturation at 0.5 L / min FGF and Aldrete score in the postoperative recovery
unit were higher. Body temperature was correlated with preoperative waiting
room, operating room and postoperative recovery room temperature.
Keywords: Minimal Flow Anesthesia, Low Flow Anesthesia, İnadvertent
Perioperative Hypothermia, Tissue Oxygen Saturation (StO2)