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Title:DIFUZIJA DUŠIKOVEGA OKSIDULA V TESNILNI MEŠIČEK SAPNIČNEGA TUBUSA MED SPLOŠNO ANESTEZIJO
Authors:ID Obran, Simona (Author)
ID Križmarić, Miljenko (Mentor) More about this mentor... New window
ID Kamenik, Mirt (Comentor)
Files:.pdf MAG_Obran_Simona_2014.pdf (1,80 MB)
MD5: D64BE3B05BA6FF0F0E3B8CE3C2683166
 
Language:Slovenian
Work type:Master's thesis/paper
Typology:2.09 - Master's Thesis
Organization:FZV - Faculty of Health Sciences
Abstract:Dušikov oksidul med daljšimi splošnimi anestezijami difundira v tesnilni mešiček sapničnega tubusa (dihalne cevke), ga razširi in posledično poveča tlak v mešičku. To povzroča ishemične poškodbe na sluznici sapnika, kar se izraža z bolečim grlom ali hripavostjo po operaciji s splošno anestezijo. Namen raziskave je bil ugotoviti in raziskati vpliv difuzije dušikovega oksidula v tesnilni mešiček. Raziskovalna metodologija: raziskava je temeljila na kvantitativni eksperimentalni metodologiji, ki je potekala v Splošni bolnišnici Ptuj. V raziskavo je bilo vključenih 45 bolnikov, operiranih v abdomnu. Z manometrom smo spremljali spremembe tlaka v mešičku in jih merili ob intubaciji (vstavitev dihalne cevke), ter v intervalih po 10 minut do konca anestezije. V drugem delu raziskave smo s kratko telefonsko anketo preverili, kakšna je praksa po drugih bolnišnicah v Sloveniji glede na nadzor nad tlakom v mešičku. Rezultati: Naraščanje tlaka v tesnilnem mešičku tubusa se začne po 15 minutah uporabe dušikovega oksidula. Večje naraščanje tlaka je bolj opazno pri višjih koncentracijah dušikovega oksidula (55 % in 60 %), ko lahko tlak naraste dva- do trikrat po 50 minutah uporabe dušikovega oksidula. Ugotovili smo, da obstaja statistična razlika med časom in tlaki v mešičku sapničnega tubusa med splošno anestezijo ob uporabi 60 % dušikovega oksidula (p < 0,05). Sklep: Uvedba nadziranja in merjenja tlaka v mešičkih sapničnih tubusov med splošno anestezijo z dušikovim oksidulom bi morala postati ustaljena praksa – standard v zdravstveni negi, saj bi tako bolniku po ekstubaciji v pooperativnem obdobju preprečili bolečine in neprijetne občutke v grlu.
Keywords:dušikov oksidul, tesnilni mešiček sapničnega tubusa, splošna anestezija, difuzija
Place of publishing:Maribor
Publisher:[S. Obran]
Year of publishing:2014
PID:20.500.12556/DKUM-43784 New window
UDC:616-089.5(043.2)
COBISS.SI-ID:2001316 New window
NUK URN:URN:SI:UM:DK:C58QREBU
Publication date in DKUM:02.04.2014
Views:2429
Downloads:272
Metadata:XML DC-XML DC-RDF
Categories:FZV
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Secondary language

Language:English
Title:DIFFUSION OF NITROUS OXIDE INTO TRACHEAL TUBE CUFF DURING GENERAL ANESTHESIA
Abstract:During longer general anesthesia nitrous oxide diffuses into the seal cuff of the endotracheal tube (breathing tube), widens it and consequently increases the pressure in the cuff. This causes ischemic injuries to the tracheal mucosa, which results in a sore throat or hoarseness following surgery under general anesthesia. The aim of the research was to determine and study the influence of nitrous oxide diffusion into the seal cuff. Research method: The research was based on a quantitative experimental methodology, carried out at the General hospital in Ptuj. 45 abdominal surgery patients were included in the research. We monitored the pressure changes within the cuff with a manometer and measured it at the intubation (insertion of the breathing tube) and then in 10 minute intervals throughout the entire anesthesia process. For the second part of the research we conducted a short telephone poll to inquire about the cuff pressure monitoring practices in other hospitals across Slovenia. Results: The pressure in the seal cuff of the tube starts increasing after 15 minutes of administering nitrous oxide. The pressure increase is more prominent with higher nitrous oxide concentrations (55% and 60%), where the pressure can increase by a factor of 2 to 3 after 50 minutes of administering nitrous oxide. We identified a static difference between the time and pressure within the seal cuffs of the endotracheal tube during general anesthesia with the use 60% nitrous oxide (p<0,05). Conclusion: The introduction of monitoring and measuring of pressure in endotracheal tube cuffs during general anesthesia with nitrous oxide should become customary practice - a standard in health care that prevents postoperative throat pain and discomfort with patients following the extubation.
Keywords:nitrous oxide, seal cuff of the endotracheal tube, general anesthesia, diffusion


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