Çimen G. OLGUNER, Hakan KİLERCİK, Nagehan DAMAR, Sevda ÖZKARDEŞLER, Pelin KARTAL, Feza AKGÜR, Zahide ELAR

Pektus ekskavatum cerrahisinde genel anestezi ve epidural analjezi kombinasyonu(Olgu sunumu)

Pektus ekskavatum, ağır formları ciddi kardiyopulmoner fonksiyon bozuklukları ile ortaya çıkan konjenital bir göğüs duvarı deformitesidir. Cerrahi tedavi yöntemleri, Ravitch operasyonu ve Nuss onarımı'dır. Minimal invaziv olması ve uzun dönemde mükemmel kozmetik sonuç avantajlarıyla Nuss onarımı yaygın olarak uygulanmaktadır. Ancak tüm bu avantajlarının yanı sıra, Nuss onarımı sonrasında izlenen şiddetli postoperatif ağrının yol açabileceği atelektazi ve akciğer infeksiyonu gibi komplikasyonlann önlenebilmesi amacıyla torakal epidural analjezi (TEA) uygulanması önerilmektedir. Bu yazıda, ülkemizde ilk kez Fakültemiz Çocuk Cerrahisi Anabilim Dalı tarafından uygulanan Nuss operasyonu ile onarılan 6 yaşındaki bir pektus ekskavatum olgusunda, torakal epidural analjezi ile kombine edilen genel anestezi uygulaması ve postoperatif analjezi deneyimimiz sunulmuştur

Anahtar Kelimeler:

Analjezi, epidural, Huni göğüs, Anestezi, genel, Cerrahi işlemler, operatif

Combination of general anesthesia and epidural analgesia in surgical repair of pectus excavatum (Case report)

Pectus excavatum is the most common congenital chest wall deformity which can cause cardiopulmonary dysfunction in severe forms. Ravitch and Nuss procedures are the surgical treatment modalities for correction ofpectus excavatum. Nuss procedure has been widely accepted because of being minimally invasive and having excellent cosmetic results. However, the procedure may cause intense pain during postoperative period leading to atelectasis and pulmonary infection. Therefore, thoracic epidural analgesia is the preferred methodforpain management in these patients. We present our experience in general anesthesia combined with thoracic epidural analgesia and postoperative analgesia for Nuss repair in a six year old girl with pectus excavatum deformity performed for thefirst time in our country.

Keywords:

Analgesia, Epidural, Funnel Chest, Anesthesia, General, Surgical Procedures, Operative,

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