OPERASYON ODASINDA STRES: AC‹L VE ELEKT‹F CERRAH‹LER

Abstract

Amaç: Stres anksiyeteyi art›ran bir faktördür ve operasyon odas›nda ekibin dikkatini azalt›r. Bu makalenin amac› acil ve elektif operasyonlarda stresin seviyesini de¤erlendirmek ve ekipler üzerine etkisini kalitatif ve kantitatif olarak de¤erlendirmektir. Yöntem: Çal›flmaya 64 ameliyata kat›lan ekipler al›nd›. Operasyonlar›n 32’si acil, 32’si elektif idi. Ekiplerin kalp h›z›, tükrük kortizol ölçümleri ve ‘State Trait Anxiety Inventory-Short Form’ (STAI-SF) skalas› kullan›larak bireysel stres seviyeleri belirlendi. ‘Observational Teamwork Assessment for Surgery’ (OTAS) skalas› ile tak›m çal›flmalar› de¤erlendirildi. Bulgular: Bütün ekiplerin operasyon öncesi dönemde ortalama kalp h›zlar› acil vakalarda elektiflere göre daha yüksek bulundu (p<0.05). Hem cerrahi hem de anestezi tak›m›n acil cerrahi öncesi STAI-SF skorlar› elektiflere göre daha yüksekti (p<0.05). Acil ameliyatlar s›ras›ndaki OTAS skorlar› elektif ameliyatlardaki ile karfl›laflt›r›ld›¤›nda, anestezi tak›m›n›n operasyon öncesi ve sonras› cerrahi tak›m›n ise operasyon öncesi ve s›ras›nda daha düflük bulundu (p<0.01). Sonuç: Acil ameliyatlar›n elektiflere göre tak›m çal›flmas›n› kötü etkiledi¤i ve özellikle operasyon öncesi dönemin tak›mlar aras›nda oldukça ciddi stres oluflturdu¤u kan›s›na var›ld›.

Özet

Objective: Stress increases anxiety, and reduces attention in operation rooms. The aim of this study was to evaluate the level of stress and the effect of stress on teamwork in operating rooms, by utilizing quantitative and qualitative assessment. Method: The study was performed on anesthesia and surgery teams that participated in 64 surgeries (emergency; 32, elective: 32). Stress levels were assessed individually using heart rate, saliva cortisol levels, and the "State-Trait Anxiety Inventory-Short Form" (STAI-SF), while team work was assessed using the "Observational Teamwork Assessment for Surgery" (OTAS) tool. Results: Mean heart rate of all team members in emergency surgeries was significantly higher than in elective surgeries during preoperative period (p<0.05). Members of both teams had significantly higher STAI-SF scores before emergency surgeries (p<0.05). Anesthesia teams had lower OTAS scores in preoperative and postoperative period whereas surgery teams had lower scores in preoperative and intraoperative period during emergency surgeries compared to elective surgeries (p<0.01). Conclusion: Emergency surgeries had a more negative effect on teamwork than electives. The preoperative period of emer- gency surgeries was particularly more stressful for both teams.