Prematüre retinopatili yenidoğanların laser tedavisinde genel anestezi uygulamalarımız: retrospektif değerlendirme
Date
2007-11-20
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Publisher
Uludağ Üniversitesi
Abstract
Prematüre ve düşük doğum ağırlıklı bebeklerde retinal damarların immattüritesine bağlı oluşan prematür retinopatisi (PR) acil tedavi gerektirir. Prematür bebeklerde artan yaşam oranlarına bağlı olarak PR görülme sıklığı artmıştır. PR tedavisinde kullanılan indirekt lazer fotokoagülasyon işlemi sırasında bebekler analjezi ve anesteziye gereksinim duyarlar. PR tedavisi sırasında kardiyovasküler arrest, oksijen desatürasyonu, ciddi bradikardi ve apne gibi hayatı tehdit eden komplikasyonlar görülebilir. Bu nedenle prematürelerde uygulanacak anestezi tekniği ve postoperatif bakım özellik gerektirir. Hastanemizde Ekim 2004-Ağustos 2007 dönemleri arasında PR tedavisi için lazer fotokoagülasyon uygulanan bebeklerde sıklıkla endotrakeal entübasyon ile genel anestezi uygulamasının tercih edildiği görüldü. Lazer fotokoagülasyon tedavisinin genel anestezi altında minimal risk ile gerçekleştirildiği saptandı. Bebeklerin postoperatif dönemde gelişebilecek komplikasyonlarını azaltmak için ilk 24 saat yoğun bakım ünitesinde izlenmesinin uygun bakımı sağladığı görüldü. PR’li bebeklerin tanı ve tedavileri sırasında neonatolog, pediatrik anestezist ve pediatrik oftalmolog işbirliği ile değerlendirilmesi ve izlenmesi gerektiği kanısındayız.
Retinopathy of prematurity (ROP) which is due to the immaturity of retinal vascularity in premature and low birth weight infants, needs emergency treatment. Along with the increased survival rates of premature infants, the incidence of ROP has been increased. During the indirect laser photocoagulation procedure for the treatment of ROP, infants require analgesia as well as anesthesia. During ROP treatment, life-threatening complications, such as cardiovascular arrest, desaturation, serious bradycardia or apnea can be seen. Therefore, anesthesia technique and postoperative care require special attention for premature infants. As we rewieved the periods between October 2004-August 2007, we have noticed that the technique chosen was general anesthesia with endotracheal intubation for the babies who was treated with laser photocoagulation for ROP in our hospital. Laser photocoagulation under general anesthesia was observed to be used with minimal risks. In the postoperative period, taking patients into the intensive care unit for the first 24 hours in order to observe possible complications was seen to provide appropriate care. We consider that the cooperation and discussion between the neonatologist, pediatric anesthesiologist and pediatric opthalmologist are necessary for the diagnosis and treatment of ROP.
Retinopathy of prematurity (ROP) which is due to the immaturity of retinal vascularity in premature and low birth weight infants, needs emergency treatment. Along with the increased survival rates of premature infants, the incidence of ROP has been increased. During the indirect laser photocoagulation procedure for the treatment of ROP, infants require analgesia as well as anesthesia. During ROP treatment, life-threatening complications, such as cardiovascular arrest, desaturation, serious bradycardia or apnea can be seen. Therefore, anesthesia technique and postoperative care require special attention for premature infants. As we rewieved the periods between October 2004-August 2007, we have noticed that the technique chosen was general anesthesia with endotracheal intubation for the babies who was treated with laser photocoagulation for ROP in our hospital. Laser photocoagulation under general anesthesia was observed to be used with minimal risks. In the postoperative period, taking patients into the intensive care unit for the first 24 hours in order to observe possible complications was seen to provide appropriate care. We consider that the cooperation and discussion between the neonatologist, pediatric anesthesiologist and pediatric opthalmologist are necessary for the diagnosis and treatment of ROP.
Description
Keywords
Prematüre, Prematüre retinopatisi, Genel anestezi, Prematurity, Retinopathy of prematurity, General anaesthesia
Citation
Yavaşcaoğlu, B. vd. (2007). "Prematüre retinopatili yenidoğanların laser tedavisinde genel anestezi uygulamalarımız: retrospektif değerlendirme". Uludağ Üniversitesi Tıp Fakültesi Dergisi, 33(2), 65-69.