Turkiye Klinikleri Journal of Anesthesiology Reanimation

.: ORIGINAL RESEARCH
Anesthetic Management for Hip Arthroscopy: A Retrospective Study
Kalça Artroskopisinde Anestezi Yönetimi: Bir Retrospektif Çalışma
Mehmet Anıl SÜZERa, Mehmet Özgür ÖZHANa, İlkay Baran AKKUŞb, Ceyda ÇAPARLARb, Bülent ATİKc Mehmet Burak EŞKİNd, Metin POLATe
aClinical of Anesthesiology and Reanimation, Private Çankaya Hospital, Ankara, Turkey
bDepartment of Anesthesiology and Reanimation, University of Health Sciences, Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
cDepartment of Anesthesiology and Reanimation, Balıkesir University Medical Faculty, Balıkesir, Turkey
dDepartment of Anesthesiology and Reanimation, University of Health Sciences, Gülhane Training and Research Hospital, Ankara, Turkey
eClinical of Orthopaedics and Traumatology, Private Çankaya Hospital, Ankara, Turkey
Turkiye Klinikleri J Anest Reanim. 2020;18(2):54-61
doi: 10.5336/anesthe.2020-78686
Article Language: EN
Full Text
ABSTRACT
 Objective: Hip arthroscopy is a minimally invasive procedure which is most recently introduced in the field of arthroscopic orthopedic surgery. The aim of this retrospective study was to share our five years' experience in the anesthetic management of these patients and discuss within the literature. Material and Methods: After obtaining hospital's ethic committee approval, retrospective data were collected from the electronic database, anesthesia records and medical files of patients who underwent unilateral hip arthroscopy between 2015 and 2020. Results: Two hundred six patients were included in the study. Mean age was 39.9±7.2 (16-70) years. Ninety four patients were female and one hundred twelve were male. All patients received general anesthesia. Mean operative time was 141.6±14.8 (65-240) minutes. Mean hospital discharge time was 27.1±9.3 (16-68) hours. One hundred twenty seven patients (61.6%) were discharged in an outpatient manner (<24 hours). Thirty six patients (17.4%) suffered from intractable pain that required opioids. Main anesthetic complications were postoperative shivering, nausea and vomiting. Nerve palsy was recorded in 12 patients (5.8%) due to the positioning, traction and compression injuries which resolved spontaneously in postoperative 8 weeks. Conclusion: Anesthetic considerations of hip arthroscopy include special attention to positioning in order to prevent traction and compression injuries, hypotensive anesthesia, fluid extravasation, hypothermia, shivering, and postoperative pain management.

Keywords: Anesthesia; arthroscopy; intraoperative complications; pain, postoperative.
ÖZET
 Amaç: Kalça artroskopisi, artroskopik ortopedik cerrahiler arasında en son uygulamaya giren minimal invaziv bir işlemdir. Bu retrospektif çalışmanın amacı anestezi yönetimindeki 5 yıllık deneyimimizi paylaşmak ve literatür eşliğinde tartışmaktır. Gereç ve Yöntemler: Hastane etik kurul onamının alınmasını takiben, elektronik veri bankası, anestezi kayıtları ve hasta dosyaları taranarak 2015-2020 yılları arasında uygulanan planlı unilateral kalça artroskopilerine ait veri toplandı. Bulgular: Çalışmaya 206 hasta alındı. Ortalama yaş 39.9±7.2 (16-70) yıl idi. 94 hasta kadın ve 112 hasta erkekti. Tüm hastalara genel anestezi uygulanmıştı. Ortalama cerrahi süresi 141.6±14.8 (65-240) dakika ve ortalama hastane taburculuk süresi 27.1±9.3 (16- 68) saatti. 127 hasta (%61.6) günübirlik cerrahi uygulamalarına uygun biçimde 24 saatten kısa sürede taburcu edillmişti. 36 hastada (%17.4) şiddetli ağrı nedeniyle opioid analjezik uygulanması gerekti. Anestezi komplikasyonları olarak en sık postoperatif titreme, bulantı ve kusma gözlendi. 12 hastada (%5,8) pozisyon, traksiyon ve bası hasarları nedeniyle sinir felci gözlendi. Bunlar 8 hafta içerisinde kendiliğinden düzeldi. Sonuç: Kalça artroskopilerindeki anestezi yönetimi traksiyon ve kompresyon hasarlarını önlemek için pozisyon verilmesine özellikle dikkat edilmesi, hipotansif anestezi gereksinimi, sıvı ekstravazasyonu, hipotermi, titreme ve postoperatif ağrı yönetimini içermektedir.

Anahtar Kelimeler: Anestezi; artroskopi; intraoperatif komplikasyonlar; ağrii postoperatif.
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