2023 Maraþ depreminde þehir hastanesindeki travma hastalarýna anestezik yaklaþým

AMAÇ: 6 Þubat 2023 Kahramanmaraþ depremi ülkemizde ciddi bir yýkým yaratmýþtýr. 50 binden fazla kiþi hayatýný kaybetmiþ, binlere kiþi yaralanmýþ ve saðlýk kuruluþlarý hasar almýþtýr. Depremzedeler tedavi için baþka illerdeki hastanelere transfer edilmiþtir. Bu çalýþma ile 3. basamak hastanemize nakledilen yaralýlarda uygulanan anestezi yaklaþýmýný deðerlendirmeyi amaçladýk.
GEREÇ VE YÖNTEM: 6-20 Þubat 2023 tarihleri arasýnda opere edilen hastalarýn verileri retrospektif olarak incelenmiþtir. Çalýþmaya acil travma cerrahisi geçiren, 10 yaþ ve üzerindeki depremzede hastalar dahil edilmiþtir. Hastalarýn hastaneye kabul tarihi, demografik bilgileri, ameliyat türü, ameliyat bölgesi, anestezi tekniði, periferik blok tercihi, laboratuvar deðerleri, diyaliz ve yoðun bakým ihtiyaçlarý, saðkalýmlarý kaydedilmiþtir. Verilerin analizi için IBM® SPSS® 26.0 programý kullanýlmýþtýr.
BULGULAR: Çalýþmaya 375 vaka dahil edilmiþtir. 323 hasta ekstremite, 35 hasta vertebra yaralanmasý nedeniyle opere edilmiþtir. Ekstremite yaralanmalarýnýn %61.6’sý alt ekstremite, %17.1’i üst ekstremitedir. 147 hastaya debridman, 49 hastaya fasiyotomi ve 33 hastaya ampütasyon uygulanmýþtýr. Hastalarýn 352’sine genel anestezi, 19’una spinal anestezi ve 4’üne sedoanaljezi uygulanmýþtýr. 33 hastaya periferik sinir bloðu yapýlmýþtýr. 105 hastaya diyaliz tedavisi uygulanmýþtýr. 26 hasta tedavi sürecinde kaybedilmiþtir. Ýntraoperatif hasta kaybý olmamýþtýr.
SONUÇ: Depremzedelerde en sýk ekstremite yaralanmalarýnýn görülmesi rejyonal anesteziye eðilimi arttýrmaktadýr. Temel anestezi becerilerine Plan A bloklarýnýn eklenmesi ile afet durumlarýnda rejyonal anestezi tercihi artabilir. Ayrýca yaralýlarýn ileri merkezlere transferi ile morbiditenin azalacaðý düþünülebilir.

Anesthetic approach to trauma patients in the city hospital after the 2023 Maraþ earthquake

BACKGROUND: The February 6, 2023, Kahramanmaraþ earthquake caused significant destruction across our country. More than 50,000 people lost their lives, thousands were injured, and health facilities were damaged. Victims were transferred to hospitals in other provinces for treatment. This study evaluates the anesthesia approach applied to the injured who were transferred to our tertiary hospital.
METHODS: We retrospectively reviewed the data of patients who underwent surgery between February 6 and February 20, 2023. The study included earthquake victims who underwent emergency trauma surgery, aged 10 years and above. We recorded the date of admission to the hospital, demographic information, type of surgery, surgical site, anesthesia technique, preference for peripheral block, laboratory values, dialysis and intensive care needs, and survival rates. Data analysis was performed using the IBM® Statistical Package for the Social Sciences (SPSS®) Version 26.0.
RESULTS: A total of 375 cases were included in the study. Of these, 323 patients underwent surgery for extremity injuries, and 35 for vertebral injuries. Among the extremity injuries, 61.6% were to the lower extremities, and 17.1% to the upper extremities. Debridement was performed on 147 patients, fasciotomy on 49 patients, and amputation on 33 patients. General anesthesia was applied to 352 patients, spinal anesthesia to 19 patients, and sedoanalgesia to four patients. Peripheral nerve block was performed on 33 patients. Dialysis treatment was administered to 105 patients. Twenty-six patients were lost during the treatment process. There were no intraoperative patient deaths.
CONCLUSION: The predominance of extremity injuries among earthquake victims increases the inclination towards regional anesthesia. Incorporating Plan A blocks into basic anesthesia skills could enhance the preference for regional anesthesia in disaster situations. Furthermore, transferring the injured to advanced centers may reduce morbidity.