Operasyon Öncesi ve Sonrası Bakım
Özet
Operasyon yapılması gereken bir hastanın uygun şekilde iyileşebilmesi için operasyon öncesi bakım, uygun operasyon prosedürü ve operasyon sonrası bakım süreçlerinin tam ve eksiksiz uygulanması gerekmektedir. Operasyon öncesi bakım hastanın hastaneye girişinden anesteziye alınıp operasyon masasında ensizyonun atılmasına kadar olan süreci; operasyon sırası hastaya ensizyonun yapılmasından son dikiş atılmasına kadar olan süreci; operasyon sonrası bakım ise hastanın son dikişi atıldıktan sonra anesteziden uyandırma için yapılması gereken uygulamalardan başlayıp tamamen iyileşene kadar olan süreci kapsamaktadır. Operasyon öncesi bakıma önem verilmemesi hastaya yanlış anestezi protokolü, yanlış operasyon kararı ve yanlış operasyon prosedürünün seçilmesine; operasyon sonrası bakımın doğru yapılmaması ise başarılı geçen bir operasyon sürecinin olumsuz bir şekilde sonuçlanmasına neden olabilir. Operasyon sonrası süreçle ilgili sıklıkla dikkatten kaçan konulardan biri hasta sahibine bilgi aktarımının tam ve eksiksiz yapılmaması veya hasta sahibinin bu durumu önemsememedir. Bu durum hasta için olumsuz sonuçlara neden olur ve hastaya ikinci bir operasyon gerekebilir. Burada unutulmaması gereken konulardan biri operasyonu başarılı geçen bir hastanın iyileşmesi için operasyon prosedürünün doğruluğu kadar operasyon sonrası bakım da önemlidir. Özetle operasyon başarısını etkileyen faktörler arasında operasyon öncesi ve sonrası bakım önemli bir yere sahiptir. Bu bölümde operasyon öncesi ve sonrası bakımda yapılması ve yapılmaması gereken uygulamalar hakkında bilgi verilmiştir.
For a patient requiring surgery to recover effectively, it is essential to implement complete and thorough preoperative care, an appropriate surgical procedure, and postoperative care processes. Preoperative care is the period from the patient's admission to the hospital until they are anesthetized and positioned on the operating table for the incision. Intraoperative care is the period from the incision to the final suture, while postoperative care starts with the procedures required to wake the patient from anaesthesia after the final suture and continues until complete recovery. Failure to pay attention to preoperative care may lead to an incorrect anaesthesia protocol, wrong decisions regarding the operation, and selection of an inappropriate surgical procedure, while inadequate postoperative care may result in negative outcomes, even after a successful operation. One of the most overlooked aspects of the postoperative period is either not providing complete and accurate information to the patient's owner or the patient's owner not taking the given information seriously. This can lead to negative outcomes for the patient and may require a second operation. One of the key points to remember here is that postoperative care is just as important as the accuracy of the surgical procedure in ensuring a proper recovery process for a patient who has undergone a successful operation. In summary, among the factors affecting the success of the operation, preoperative and postoperative care holds significant importance. This section provides information about practices that should and should not be performed in preoperative and postoperative care.
Referanslar
Pratschke K. Preoperative assessment. In: Baines SJ, Lipscomb V, Hutchinson T (Eds.) BSAVA Manual of Canine and Feline Surgical Principles A Foundation Manual. Quedgeley, Gloucester: British Small Animal Veterinary Association; 2012. p. 75-87.
Swanson EA, Mann FA. Preoperative patient assessment. In: Mann FA, Constantinescu GM, Yoon HY (Eds.) Fundamentals of Small Animal Surgery. Chichester: Blackwell Publishing; 2011. p. 3-7.
MacPhail CM. Preoperative and Intraoperative Care of the Surgical Patient. In: Fossum TW, Dewey CW, Radlinsky MG, Horn CV, Schutz KS, Johnson AL, Willard MD, MacPhail CM (Eds.) Small Animal Surgery. St. Louis, Missouri: Elsevier; 2013. p. 27-38.
Lyons BM, Waddell LS. Fluid Therapy in Hospitalized Patients, Part 1: Patient Assessment and Fluid Choices 2018. (29.09.2024 tarihinde https://todaysveterinarypractice.com/internal-medicine/fluid-therapy-patient-assessment-and-fluid-choices/ adresinden ulaşılmıştır).
Hansen B, DeFrancesco T. Relationship between hydration estimate and body weight change after fluid therapy in critically ill dogs and cats. Journal of Veterinary Emergency and Critical Care. 2002;12(4): 235-243. doi:10.1046/j.1435-6935.2002.t01-1-00050.x
Humm K, Adamantos S. Fluid therapy, and electrolyte and acid–base abnormalities. In: Baines SJ, Lipscomb V, Hutchinson T (Eds.) BSAVA Manual of Canine and Feline Surgical Principles A Foundation Manual. Quedgeley, Gloucester: British Small Animal Veterinary Association; 2012. p. 104-126.
Ridgway MD. Physical Examination. In: Merrill L (Ed.) Small Animal Internal Medicine for Veterinary Technicians and Nurses. Chichester: John Wiley & Sons; 2012. p. 1-10
Kaestner S. Anesthesia. In: Montavon PM, Voss K, Langley-Hobbs SJ (Eds.) Feline Orthopedic Surgery and Musculoskeletal Disease. London: Elsevier; 2009. p. 177-197.
Newton CD. Postoperative Patient Management. In: Newton CD, Nunamaker DM (Eds.) Textbook of Small Animal Orthopedics. Philadelphia: Lippincott Williams and Wilkins; 1985.
Brady CA, King LG. Postoperative management of the emergency surgery small animal patient. Veterinary Clinics: Small Animal Practice, 2000;30(3): 681-698.
House A, Goggs R. Postoperative management. In: Baines SJ, Lipscomb V, Hutchinson T (Eds.) BSAVA Manual of Canine and Feline Surgical Principles A Foundation Manual. Quedgeley, Gloucester: British Small Animal Veterinary Association; 2012. p. 148-167.
Hamilton J. Nursing the patient in recovery. In: Welsh E (Ed.) Anaesthesia for Veterinary Nurses. Oxford: Blackwell Publishing; 2003. p. 247-270.
Crompton S, Hill P. Post-operative recovery of the surgical patient. The Veterinary Nurse. 2011;2(4): 190–198. doi:10.12968/vetn.2011.2.4.190
Dohoo SE, Dohoo IR. Postoperative use of analgesics in dogs and cats by Canadian veterinarians. The Canadian Veterinary Journal. 1996;37(9): 546-551.
Gómez AP. Postoperative pain management in companion animals: an update 2017. (01.10.2024 tarihinde https://www.vettimes.co.uk/article/postoperative-pain-management-in-companion-animals-an-update/ adresinden ulaşılmıştır.)
Hansen BD, Hardie EM, Carroll GS. Physiological measurements after ovariohysterectomy in dogs: what’s normal?, Applied Animal Behaviour Science. 1997;51(1-2): 101-109. doi:10.1016/S0168-1591(96)01079-9
Bockstahler B. The orthopedic patient: conservative treatment, physiotherapy and rehabilitation. In: Iams clinical nutrition symposium, 10 February 2006, Montreux, Switzerland, (pp. 25-30).
Pascoe PJ. Opioid analgesics. Veterinary Clinics: Small Animal Practice. 2000;30(4): 757-772.
Luna SPL, Basílıo AC, Steagall PVM, et al. Evaluation of adverse effects of long-term oral administration of carprofen, etodolac, flunixin meglumine, ketoprofen, and meloxicam in dogs. American Journal of Veterinary Research. 2007;68(3): 258-264. doi:10.2460/ajvr.68.3.258
Gurney MA. Pharmacological options for intra-operative and early postoperative analgesia: an update. Journal of Small Animal Practice. 2012;53(7): 377–386. doi:10.1111/j.1748-5827.2012.01243.x
Frendın JH, Boström IM, Kampa N, et al. Effects of carprofen on renal function during medetomidine-propofol-isoflurane anesthesia in dogs. American Journal of Veterinary Research. 2006;67(12): 1967-1973. doi:10.2460/ajvr.67.12.1967
Webb ST, Allen JSD. Perioperative renal protection. Continuing Education in Anaesthesia, Critical Care & Pain. 2008;8(5): 176-180. doi:10.1093/bjaceaccp/mkn032
Kukanich B, Bıdgood T, Knesl O. Clinical pharmacology of nonsteroidal anti-inflammatory drugs in dogs. Veterinary Anaesthesia and Analgesia. 2012;39(1): 69-90. doi:10.1111/j.1467-2995.2011.00675.x
Mathews KA. Nonsteroidal anti-inflammatory analgesics in pain management in dogs and cats. The Canadian Veterinary Journal. 1996;37(9): 539-545.
Baltzer WI. Rehabilitation of companion animals following orthopaedic surgery. New Zealand veterinary journal. 2020;68(3): 157-167. doi:10.1080/00480169.2020.1722271
Akgun K, Korpinar MA, Kalkan MT, et al. Temperature changes in superficial anddeep tissue layers with respect to time of cold gelpack application in dogs. Yonsei Medical Journal. 2004;45(4): 711–718.
Rexing J, Dunning D, Siegel AM, et al. Effects of cold compression, bandaging, and microcurrent electrical therapy after cranial cruciate ligament repair in dogs. Veterinary Surgery. 2010;39(1): 54–58. doi:10.1111/j.1532-950X.2009.00620.x
Martin SS, Spindler KP, Tarter JW, et al. Cryotherapy: an effective modality for decreasing intraarticular temperature after knee arthroscopy. The American Journal of Sports Medicine. 2001;29(3): 288–291. doi:10.1177/03635465010290030501
Arndt J, Clavert P, Mielcarek P, et al. Immediate passive motion versus immobiliz-ation after endoscopic supraspinatus tendon repair: a prospective randomized study. Orthopaedics & Traumatology:Surgery & Research. 2012;98(6): S131–138. doi:10.1016/j.otsr.2012.05.003
Millis DL, Ciuperca IA. Evidence for canine rehabilitation and physical therapy. Veterinary Clinics: Small Animal Practice. 2015;45(1): 1–27. doi:10.1016/j.cvsm.2014.09.001
Achten M. The benefits of physiotherapy during revalidation after orthopedic surgery in small animals. Doctoral dissertation, Ghent University. 2018.
Kirkby Shaw K, Alvarez L, Foster SA, et al. Fundamental principles of rehabilitation and musculoskeletal tissue healing. Veterinary Surgery. 2020; 49(1): 22-32. doi: 10.1111/vsu.13270
Sharp B. Feline physiotherapy and rehabilitation: 1. principles and potential. Journal of Feline Medicine and Surgery. 2012;14(9): 622-632. doi:10.1177/1098612X12458209
Steiss JE, Levine D. Physical agent modalities. Veterinary Clinics: Small Animal Practice. 2005; 35(6): 1317–1333.
Saunders DG. Therapeutic exercise. Clinical Techniques in Small Animal Practice. 2007;22(4): 155–159. doi: 10.1053/j.ctsap.2007.09.003
Levine D, Bockstahler B. Electrical stimulation. In: Millis D, Levine D (Eds.) Canine Rehabilitation and Physical Therapy. Philidelphia: Elsevier; 2014. p. 342–358.
Yang KH, Park SC. Stimulation of fracture healing in a canineulna full-defect model by low-intensity pulsed ultrasound. Yonsei Medical Journal. 2001;42(5): 503–508.
Durant A, Millis DL. Applications of extracorporeal shockwave in small animal rehabilitation. In: Millis D, Levine D (Eds.) Canine Rehabilitation and Physical Therapy. Philidelphia: Elsevier; 2014. p. 381-392.
Millis DL. Getting the dog moving after surgery. Journal of the American Animal Hospital Association. 2004;40(6): 429–436. doi:10.5326/0400429
Bertocci G, Smalley C, Brown N, et al. Aquatic treadmill water level influence on pelvic limb kinematics in cranial cruciate ligament-deficient dogs with surgically stabilised stifles. Journal of Small Animal Practice. 2018;59(2): 121–127. doi:10.1111/jsap.12770
Monk ML, Preston CA, McGowan CM. Effects of early intensive postoperative physiotherapy on limb function after tibial plateau levelling osteotomy in dogs with deficiency of the cranial cruciate ligament. American Journal of Veterinary Research. 2006;67(3): 529–536. doi:10.2460/ajvr.67.3.529
Jeong IS, Piao Z, Rahman MM, et al. Canine thoracolumbar intervertebral disk herniation and rehabilitation therapy after surgical decompression: a retrospective study. Journal of Advanced Veterinary and Animal Research. 2019;6(3): 394-402. doi:10.5455/javar.2019.f359
Jeong IS, Rahman MM, Choi GC, et al. A retrospective study of canine cervical disk herniation and the beneficial effects of rehabilitation therapy after ventral slot decompression. Veterinarni Medicina. 2019;64(6): 251–259. doi:10.17221/114/2018-VETMED
Olby N, Halling KB, Glick TR, et al. Rehabilitation for the neurologic patient. Veterinary Clinics: Small Animal Practice. 2005;35(6): 1389–1409.
Bennaim M, Porato M, Jarleton A, et al. Preliminary evaluation of the effects of photobiomodulation therapy and physical rehabilitation on early postoperative recovery of dogs undergoing hemilaminectomy for treatment of thoracolumbar intervertebral disk disease. American Journal Of Veterinary Research. 2017;78(2): 195-206. doi:10.2460/ajvr.78.2.195
Referanslar
Pratschke K. Preoperative assessment. In: Baines SJ, Lipscomb V, Hutchinson T (Eds.) BSAVA Manual of Canine and Feline Surgical Principles A Foundation Manual. Quedgeley, Gloucester: British Small Animal Veterinary Association; 2012. p. 75-87.
Swanson EA, Mann FA. Preoperative patient assessment. In: Mann FA, Constantinescu GM, Yoon HY (Eds.) Fundamentals of Small Animal Surgery. Chichester: Blackwell Publishing; 2011. p. 3-7.
MacPhail CM. Preoperative and Intraoperative Care of the Surgical Patient. In: Fossum TW, Dewey CW, Radlinsky MG, Horn CV, Schutz KS, Johnson AL, Willard MD, MacPhail CM (Eds.) Small Animal Surgery. St. Louis, Missouri: Elsevier; 2013. p. 27-38.
Lyons BM, Waddell LS. Fluid Therapy in Hospitalized Patients, Part 1: Patient Assessment and Fluid Choices 2018. (29.09.2024 tarihinde https://todaysveterinarypractice.com/internal-medicine/fluid-therapy-patient-assessment-and-fluid-choices/ adresinden ulaşılmıştır).
Hansen B, DeFrancesco T. Relationship between hydration estimate and body weight change after fluid therapy in critically ill dogs and cats. Journal of Veterinary Emergency and Critical Care. 2002;12(4): 235-243. doi:10.1046/j.1435-6935.2002.t01-1-00050.x
Humm K, Adamantos S. Fluid therapy, and electrolyte and acid–base abnormalities. In: Baines SJ, Lipscomb V, Hutchinson T (Eds.) BSAVA Manual of Canine and Feline Surgical Principles A Foundation Manual. Quedgeley, Gloucester: British Small Animal Veterinary Association; 2012. p. 104-126.
Ridgway MD. Physical Examination. In: Merrill L (Ed.) Small Animal Internal Medicine for Veterinary Technicians and Nurses. Chichester: John Wiley & Sons; 2012. p. 1-10
Kaestner S. Anesthesia. In: Montavon PM, Voss K, Langley-Hobbs SJ (Eds.) Feline Orthopedic Surgery and Musculoskeletal Disease. London: Elsevier; 2009. p. 177-197.
Newton CD. Postoperative Patient Management. In: Newton CD, Nunamaker DM (Eds.) Textbook of Small Animal Orthopedics. Philadelphia: Lippincott Williams and Wilkins; 1985.
Brady CA, King LG. Postoperative management of the emergency surgery small animal patient. Veterinary Clinics: Small Animal Practice, 2000;30(3): 681-698.
House A, Goggs R. Postoperative management. In: Baines SJ, Lipscomb V, Hutchinson T (Eds.) BSAVA Manual of Canine and Feline Surgical Principles A Foundation Manual. Quedgeley, Gloucester: British Small Animal Veterinary Association; 2012. p. 148-167.
Hamilton J. Nursing the patient in recovery. In: Welsh E (Ed.) Anaesthesia for Veterinary Nurses. Oxford: Blackwell Publishing; 2003. p. 247-270.
Crompton S, Hill P. Post-operative recovery of the surgical patient. The Veterinary Nurse. 2011;2(4): 190–198. doi:10.12968/vetn.2011.2.4.190
Dohoo SE, Dohoo IR. Postoperative use of analgesics in dogs and cats by Canadian veterinarians. The Canadian Veterinary Journal. 1996;37(9): 546-551.
Gómez AP. Postoperative pain management in companion animals: an update 2017. (01.10.2024 tarihinde https://www.vettimes.co.uk/article/postoperative-pain-management-in-companion-animals-an-update/ adresinden ulaşılmıştır.)
Hansen BD, Hardie EM, Carroll GS. Physiological measurements after ovariohysterectomy in dogs: what’s normal?, Applied Animal Behaviour Science. 1997;51(1-2): 101-109. doi:10.1016/S0168-1591(96)01079-9
Bockstahler B. The orthopedic patient: conservative treatment, physiotherapy and rehabilitation. In: Iams clinical nutrition symposium, 10 February 2006, Montreux, Switzerland, (pp. 25-30).
Pascoe PJ. Opioid analgesics. Veterinary Clinics: Small Animal Practice. 2000;30(4): 757-772.
Luna SPL, Basílıo AC, Steagall PVM, et al. Evaluation of adverse effects of long-term oral administration of carprofen, etodolac, flunixin meglumine, ketoprofen, and meloxicam in dogs. American Journal of Veterinary Research. 2007;68(3): 258-264. doi:10.2460/ajvr.68.3.258
Gurney MA. Pharmacological options for intra-operative and early postoperative analgesia: an update. Journal of Small Animal Practice. 2012;53(7): 377–386. doi:10.1111/j.1748-5827.2012.01243.x
Frendın JH, Boström IM, Kampa N, et al. Effects of carprofen on renal function during medetomidine-propofol-isoflurane anesthesia in dogs. American Journal of Veterinary Research. 2006;67(12): 1967-1973. doi:10.2460/ajvr.67.12.1967
Webb ST, Allen JSD. Perioperative renal protection. Continuing Education in Anaesthesia, Critical Care & Pain. 2008;8(5): 176-180. doi:10.1093/bjaceaccp/mkn032
Kukanich B, Bıdgood T, Knesl O. Clinical pharmacology of nonsteroidal anti-inflammatory drugs in dogs. Veterinary Anaesthesia and Analgesia. 2012;39(1): 69-90. doi:10.1111/j.1467-2995.2011.00675.x
Mathews KA. Nonsteroidal anti-inflammatory analgesics in pain management in dogs and cats. The Canadian Veterinary Journal. 1996;37(9): 539-545.
Baltzer WI. Rehabilitation of companion animals following orthopaedic surgery. New Zealand veterinary journal. 2020;68(3): 157-167. doi:10.1080/00480169.2020.1722271
Akgun K, Korpinar MA, Kalkan MT, et al. Temperature changes in superficial anddeep tissue layers with respect to time of cold gelpack application in dogs. Yonsei Medical Journal. 2004;45(4): 711–718.
Rexing J, Dunning D, Siegel AM, et al. Effects of cold compression, bandaging, and microcurrent electrical therapy after cranial cruciate ligament repair in dogs. Veterinary Surgery. 2010;39(1): 54–58. doi:10.1111/j.1532-950X.2009.00620.x
Martin SS, Spindler KP, Tarter JW, et al. Cryotherapy: an effective modality for decreasing intraarticular temperature after knee arthroscopy. The American Journal of Sports Medicine. 2001;29(3): 288–291. doi:10.1177/03635465010290030501
Arndt J, Clavert P, Mielcarek P, et al. Immediate passive motion versus immobiliz-ation after endoscopic supraspinatus tendon repair: a prospective randomized study. Orthopaedics & Traumatology:Surgery & Research. 2012;98(6): S131–138. doi:10.1016/j.otsr.2012.05.003
Millis DL, Ciuperca IA. Evidence for canine rehabilitation and physical therapy. Veterinary Clinics: Small Animal Practice. 2015;45(1): 1–27. doi:10.1016/j.cvsm.2014.09.001
Achten M. The benefits of physiotherapy during revalidation after orthopedic surgery in small animals. Doctoral dissertation, Ghent University. 2018.
Kirkby Shaw K, Alvarez L, Foster SA, et al. Fundamental principles of rehabilitation and musculoskeletal tissue healing. Veterinary Surgery. 2020; 49(1): 22-32. doi: 10.1111/vsu.13270
Sharp B. Feline physiotherapy and rehabilitation: 1. principles and potential. Journal of Feline Medicine and Surgery. 2012;14(9): 622-632. doi:10.1177/1098612X12458209
Steiss JE, Levine D. Physical agent modalities. Veterinary Clinics: Small Animal Practice. 2005; 35(6): 1317–1333.
Saunders DG. Therapeutic exercise. Clinical Techniques in Small Animal Practice. 2007;22(4): 155–159. doi: 10.1053/j.ctsap.2007.09.003
Levine D, Bockstahler B. Electrical stimulation. In: Millis D, Levine D (Eds.) Canine Rehabilitation and Physical Therapy. Philidelphia: Elsevier; 2014. p. 342–358.
Yang KH, Park SC. Stimulation of fracture healing in a canineulna full-defect model by low-intensity pulsed ultrasound. Yonsei Medical Journal. 2001;42(5): 503–508.
Durant A, Millis DL. Applications of extracorporeal shockwave in small animal rehabilitation. In: Millis D, Levine D (Eds.) Canine Rehabilitation and Physical Therapy. Philidelphia: Elsevier; 2014. p. 381-392.
Millis DL. Getting the dog moving after surgery. Journal of the American Animal Hospital Association. 2004;40(6): 429–436. doi:10.5326/0400429
Bertocci G, Smalley C, Brown N, et al. Aquatic treadmill water level influence on pelvic limb kinematics in cranial cruciate ligament-deficient dogs with surgically stabilised stifles. Journal of Small Animal Practice. 2018;59(2): 121–127. doi:10.1111/jsap.12770
Monk ML, Preston CA, McGowan CM. Effects of early intensive postoperative physiotherapy on limb function after tibial plateau levelling osteotomy in dogs with deficiency of the cranial cruciate ligament. American Journal of Veterinary Research. 2006;67(3): 529–536. doi:10.2460/ajvr.67.3.529
Jeong IS, Piao Z, Rahman MM, et al. Canine thoracolumbar intervertebral disk herniation and rehabilitation therapy after surgical decompression: a retrospective study. Journal of Advanced Veterinary and Animal Research. 2019;6(3): 394-402. doi:10.5455/javar.2019.f359
Jeong IS, Rahman MM, Choi GC, et al. A retrospective study of canine cervical disk herniation and the beneficial effects of rehabilitation therapy after ventral slot decompression. Veterinarni Medicina. 2019;64(6): 251–259. doi:10.17221/114/2018-VETMED
Olby N, Halling KB, Glick TR, et al. Rehabilitation for the neurologic patient. Veterinary Clinics: Small Animal Practice. 2005;35(6): 1389–1409.
Bennaim M, Porato M, Jarleton A, et al. Preliminary evaluation of the effects of photobiomodulation therapy and physical rehabilitation on early postoperative recovery of dogs undergoing hemilaminectomy for treatment of thoracolumbar intervertebral disk disease. American Journal Of Veterinary Research. 2017;78(2): 195-206. doi:10.2460/ajvr.78.2.195
