| Přispěvatelé: |
Türe, H., Koner, Ö., Aykaç, B., Türe, U., Yeditepe Üniversitesi |
| Popis: |
Aim: We aimed to investigate the stages of surgical procedure at which venous air embolism might occur, and complications related to echocardiography probe, anesthesia and position of the patient, and also to determine the incidence of venous air embolism during craniotomy performed in the sitting position under monitorization with transesophagial echocardiography (TEE) using our standard anaesthesia protocol. Material and Methods: Sixty ASA I- II patients, aged 18-70 years scheduled for elective craniotomy in the sitting position were enrolled into the study. TEE was used for monitorization of venous air embolism in patients receiving standard anesthesia protocol. Air embolism seen on the monitor of TEE was classified as mild, moderate, severe and very severe (mild: If only air can be seen on screen, moderates if end-tidal carbon dioxide value falls >3 mmHg accompanied with air observed on the screen, severe: increase in heart rate or reduction in blood pressure accompanied with air seen on the screen, and very severe: hemodynamic deterioration requiring cardiopulmonary resuscitation). During the operation, air embolism, as well as any associated hemodynamic changes, precautions taken to prevent entry of air, therapeutic approaches to remove air embolism, and complications of anesthesia were recorded. The findings were expressed as means±SD. Results: In all patients, vena cava, right atrium, right ventricle and venous air entry could be easily monltorlzed echocardiographically. The frequency of air embolism was determined as 35% (n:21) (mild, n=12; moderate, n=9) in 14 of these patients, air entry was detected.during more than one surgical stage. During the postoperative period, pneumocephalus (n=1 ), and discoloration secondary to TEE probe (n=1 ) were found. Conclusions: In this study, air embolism could be detected easily with TEE, which is used for monitoring air embolism during craniotomy in the sitting position in all patients. Minor side effects related to TEE were reported. |
