Mehmet GAMLI, Aydın SELÇUK, Eyüp HORASANLI, Yaşar PALA, Murat ÖZCAN

İleri derecede kifoskolyozlu femur kırığı olgusunda unilateral spinal anestezi

Kifoskolyoz, solunum sisteminde meydana getirdiği olumsuz değişiklikler, olast ventilasyon problemi ve entübasyon güçlüğü nedeniyle anestezi açısından önemli morbidite riski taşımaktadır. Biz ileri derecede kifoskolyozu, beraberinde obstrüktif ve restriktif akciğer hastalığı olan, femur kırığı nedeniyle parsiyel kalça artroplastisi operasyonu gerçekleştirilecek olguda, 12,5 mg hiperbarik bupivakainle (%0,5) unilateral spinal anestezi uyguladık. Gerek peroperatif, gerekse postoperatif dönemde önemli bir komplikasyon gözlemedik. Bu olgu sunumunda anestezi teknikleri, kalça artroplastisi operasyonunun hastada oluşturabileceği morbiditeler ve unilateral spinal anestezi tercihimizin sebeplerini tartıştık. Sonuç olarak, unilateral spinal anestezinin kifoskolyotik hastalarda, alt ekstremite cerrahisinde alternatif bir anestezi tekniği olarak denenebileceği düşüncesine vardık.

Unilateral spinal anesthesia in a case of femur fracture with severe kyphoscoliosis

Unilateral Spinal Anesthesia in a Case of Femur Fracture With Severe Kyphoscoliosis Kyphoscoliosis, with pulmonary complications, possible ventilation problems and intubation difficulties, has high risks of morbidity for anesthesia. We performed unilateral spinal anesthesia with 12.5 mg of hyperbaric bupivacaine (0.5%) in a severely kyphoscoliotic patient who was suffering from obstructive-restrictive pulmonary disease and underwent partial hip arthroplasty operation due to femur fracture. There was no complication in either the peroperative or postoperative period. In this case report, the anesthesia techniques for kyphoscoliotic patients, morbidities due to hip arthroplasty and the reasons for our preference for unilateral spinal anesthesia are discussed. In conclusion, unilateral spinal anesthesia may be an alternative anesthesia technique in kyphoscoliotic patients undergoing lower extremity surgery.

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