CENGİZ KAYA, Sekban Nurdan SAYKAL, Süreyya AYDIN, Saliha AVCI

Bilateral kombine (yüzeysel ve derin) servikal pleksus bloğu ile total tiroidektomi ameliyatı

Tiroidektomi ameliyatı sıklıkla genel anestezi altında endotrakeal entübasyon uygulanarak yapılır. Bununla birlikte seçilmiş olgularda servikal pleksus bloğu uygulanabilir. Boyun bölgesi anatomik olarak incelendiğinde servikal pleksusun süperfisiyal dalları boyun ve omuz cildi ile yüzeyel dokuları, derin dalları ise ön boyun kaslarını, diğer derin dokuları ve diyafragmayı innerve eder. Özellikle kardiyopulmoner sorunları olan hastalarda sedasyon eşliğinde bilateral kombine (yüzeysel ve derin) servikal pleksus bloğu (SPB) genel anesteziye tercih edilebilir. Biz de ileri derecede kronik obstrüktif akciğer hastalığı (KOAH) ve sol akciğerde kistik lezyonları bulunan, genel anestezi almasının riskli olduğunu düşündüğümüz hastaya bilateral kombine (derin ve yüzeysel) servikal pleksus bloğu uyguladık. Cerrahi sırasında propofol ve remifentanil infüzyonu ile sedasyon verildi. Ameliyat sorunsuz bir şekilde başarıyla tamamlandı.

Bilateral combined (superficial and deep) cervical plexus block for thyroidectomy

Thyroidectomy has been often performed under general anesthesia via introducing endotracheal entubation. However, cervical plexus block can be applied in selected cases. An anatomical examination of the neck shows that the superficial branches of the cervical plexus innervate neck and shoulder skin and the superficial tissues while the deep branches of the cervical plexus innervate the deep structures of the neck, muscles of tke anterior neck and the diaphragm. Bilateral combined (deep and superficial) cervical plexus block (CPB) can be prefered with sedation especially in the patients with cardiopulmonary diseases rather than general anesthesia. We performed bilateral combined (deep and superficial) cervical plexus block for the patient, who we assumed, would be under risk taking general anesthesia as he had cystic lesions on the left lung and was suffering from advanced chronic obstructive pulmonary disease (COPD). Sedation with propofol and remifentanil infusions were given during surgery. The operation was successfully carried out with uncomplicated.

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