Turkiye Klinikleri Journal of Anesthesiology Reanimation

.: ORIGINAL RESEARCH
Erken COVID-19 Pandemi Dönemi ve Öncesinde Acil Operasyonlar ve Anestezi Tercihlerinin Değerlendirilmesi: Retrospektif Kesitsel Bir Çalışma
Evaluation of Emergency Operations and Anesthesia Preferences in the Early COVID-19 Pandemic and Before the Pandemic: A Retrospective Cross-Sectional Study
Kadir ARSLANa, Hale ÇETİN ARSLANb, Ayça SULTAN ŞAHİNa
aSağlık Bilimleri Üniversitesi İstanbul Kanuni Sultan Süleyman Eğitim ve Araştırma Hastanesi, Anesteziyoloji ve Reanimasyon Kliniği, İstanbul, Türkiye
bSağlık Bilimleri Üniversitesi İstanbul Kanuni Sultan Süleyman Eğitim ve Araştırma Hastanesi, Kadın Hastalıkları ve Doğum Kliniği, İstanbul, Türkiye
Turkiye Klinikleri J Anest Reanim. 2023;21(1):1-7
doi: 10.5336/anesthe.2022-90780
Article Language: TR
Full Text
ÖZET
 Amaç: Koronavirüs hastalığı-2019 [coronavirus disease-2019 (COVID-19)] pandemisi döneminde elektif cerrahi operasyonlar ertelenmiş, bu durum acil operasyonları da etkilemiştir. Bu çalışmanın amacı, erken pandemi dönemindeki acil cerrahi operasyonlar, anestezi tercihleri ile hasta sonuçlarının pandemi öncesi dönem ile karşılaştırılması ve pandeminin acil operasyonlara etkisinin araştırılmasıdır. Gereç ve Yöntemler: 15 Mart-15 Nisan 2020 tarihleri arasında, pandemi döneminde gerçekleşen acil cerrahi operasyonlar, cerrahi teknikler, anestezi tercihleri ve hasta sonuçları, pandemi öncesi dönem olan 2019 yılının aynı dönemindeki acil cerrahilerle karşılaştırıldı. Bulgular: Demografik veriler gruplar arasında benzerdi. Pandemik grupta (n=236) gerçekleşen acil cerrahilerde, pandemi öncesi gruba (n=337) göre %30 oranında azalma gözlendi. Her iki dönemde en fazla gerçekleşen acil cerrahi sezaryen olmakla birlikte, sezaryen dışındaki acil operasyonlarda pandemi döneminde azalma gözlendi. Pandemik grupta travma nedenli cerrahi, açık cerrahi teknik, spinal anestezi tercihi, serviste kalış süresi ve mortalite yüksek saptanırken, yoğun bakım ünitesinde kalış süresi düşüktü. Pandemik gruptaki hastaların %7,2'si (n=17) COVID19 pozitifti. Bu hastalarda travma nedenli cerrahiye rastlanmadı ve tüm cerrahiler açık teknikle gerçekleştirildi. Sonuç: COVID-19 pandemisinin erken döneminde, acil cerrahi operasyonların sayısında ve sezaryen dışındaki acil operasyonlarda medikal tedavi ve takibin de etkisiyle azalma görülmüştür. Bununla birlikte, pandemi döneminde daha çok travma nedenli cerrahi gerçekleşmiş, mortalite daha yüksek saptanmıştır. Laparoskopik cerrahi teknik anlamlı olarak azalırken spinal anestezi tercihi anlamlı olarak yükselmiştir.

Anahtar Kelimeler: Acil; anestezi; cerrahi girişim; COVID-19; pandemik
ABSTRACT
 Objective: During the coronavirus disease-2019 (COVID19) pandemic, elective surgical operations were postponed, affecting emergency operations. This study aims to compare emergency surgical operations, anesthesia preferences, and patient outcomes in the early pandemic period with the pre-pandemic period and to investigate the effect of the pandemic on emergency operations. Material and Methods: Emergency surgical operations, surgical techniques, anesthesia preferences, and patient outcomes performed in the pandemic period between March 15-April 15, 2020, were compared with the emergency surgeries in the same period of 2019, which is the pre-pandemic period. Results: Demographic data were similar between groups. A 30% decrease was observed in the emergency surgeries performed in the pandemic group (n=236) compared to the pre-pandemic group (n=337). Although the cesarean section was the most common emergency surgery in both periods, a decrease was observed in emergency operations other than cesarean section during the pandemic. While trauma surgery, open surgical technique, spinal anesthesia preference, length of stay in the service, and mortality were high in the pandemic group, the length of stay in the intensive care unit was low. 7.2% of the patients (n=17) in the pandemic group were COVID-19 positive. Trauma surgery was not encountered in these patients, and all surgeries were performed with an open technique. Conclusion: In the early period of the COVID-19 pandemic, a decrease has been observed in the number of emergency surgical operations and emergency operations other than cesarean section, with the effect of medical treatment and follow-up. However, while more trauma surgery was performed during the pandemic, mortality was higher. While the laparoscopic technique decreased significantly, the preference for spinal anesthesia increased significantly.

Keywords: Emergencies; anesthesia; surgery; COVID-19; pandemic
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