Akut bronşitli tıkanma ikteri olgusunda kolesistektomi için spinal anestezi

Laparoskopik kolesistektomi operasyonlarında genel anestezi tercih edilmektedir, fakat alt seviye torakal epidural ve lumbal spinal anestezi gibi rejyonel teknikler, genellikle belirgin sistemik hastalığı olan hastaların idaresinde kullanılabilir. Ciddi akciğer hastalığı olan akut kolesistitli bir olguda kombine spinal-epidural anestezi uygulamasını sunmaktayız.

Spinal anesthesia for a patient with obstructive jaundice and acute bronchitis

Laparoscopic cholecystectomy is generally performed under general anesthesia, but regional techniques, such as low thoracic epidural and lumbar spinal, usually have been used to manage patients with significant medical problems. We discussed our management of combined spinal-epidural anesthesia for a case, who had acut cholecysistitis with severe pulmonary disease in the context of the literature.

___

  • 1. Gramatica L Jr, Brasesco OE, Mercado Luna A ve ark. Laparoscopic cholecystectomy performed under regional anesthesia in patients with chronic obstructive pulmonary disease. Surg Endosc 2002; 16(3): 472-5. Epub 2001 Nov 30.
  • 2. van Zundert AAJ, Stultiens G, Jakimowicz JJ, van den Borne BEEM, van der Ham WGJM, Wildsmith JAW. Segmental spinal anaesthesia for cholecystectomy in a patient with severe lung disease. Br J Anaesth 2006; 96: 464-6.
  • 3. van Zundert AAJ, Stultiens G, Jakimowicz JJ ve ark. Laparoscopic cholecystectomy under segmental thoracic spinal anaesthesia: a feasibility study. Br J Anaesth 2007; 98: 682-6.
  • 4. Hamad MA, Ibrahim El-Khattary OA. Laparoscopic cholecystectomy under spinal anesthesia with nitrous oxide pneumoperitoneum: a feasibility study. Surg Endosc 2003; 17(9): 1426-8. Epub 2003 Jun 17.
  • 5. Morgan GE, Mikhail MS, Murray MJ, Larson CP. Anesthesia for patients with respiratory disease. In: Morgan GE, Mikhail MS, Murray MJ, Larson CP, (eds.) Clinical Anesthesiology, 3rd Ed., New York, McGraw-Hill Companies 2002; 511-524.
  • 6. Tzovaras G, Fafoulakis F, Pratsas K, Georgopoulou S, Stamatiou G, Hatzitheofilou C. Spinal vs general anesthesia for laparoscopic cholecystectomy: interim analysis of a controlled randomized trial. Arch Surg 2008; 143(5): 497-501.
  • 7. Luchetti M, Palomba R, Sica G, Massa G, Tufano R. Effectiveness and safety of combined epidural and general anesthesia for laparoscopic cholecystectomy. Reg Anesth 1996; 21(5): 465-9.
  • 8. Pursnani KG, Baza Y, Calleja M, Mughal MM. Laparoscopic cholecystectomy under epidural anesthesia in patients with chronic respiratory disease. Surg Endosc 1998; 12(8): 1082-4.
  • 9. Savas JF, Litwack R, Davis K, Miller TA. Regional anesthesia as an alternative to general anesthesia for abdominal surgery in patients with severe pulmonary impairment. Am J Surg 2004; 188(5):603-5.
  • 10. Tzovaras G, Fafoulakis F, Pratsas K, Georgopoulou S, Stamatiou G, Hatzitheofilou C. Laparoscopic cholecystectomy under spinal anesthesia: a pilot study. Surg Endosc 2006; 20(4): 580-2. Epub 2006 Jan 25.
  • 11. Tzovaras G, Fafoulakis F, Pratsas K, Georgopoulou S, Stamatiou G, Hatzitheofilou C. Spinal vs general anesthesia for laparoscopic cholecystectomy: interim analysis of a controlled randomized trial. Arch Surg 2008; 143(5): 497-501.
  • 12. Sinha R, Gurwarw AK, Gupta SC. Laparoscopic surgery using spinal anesthesia. JSLS 2008; 12(2): 133-8.
  • 13. Yuksek YN, Akat AZ, Gozalan U ve ark. Laparoscopic cholecystectomy under spinal anesthesia. Am J Surg 2008; 195(4): 533-6.