Lomber cerrahi sonrası şokta anestezik yaklaşım. Bir olgu sunumu

İyatrojenik vasküler yaralanma, lomber disk herniasyon ameliyatı esnasında nadir de olsa görülmektedir. Bu vasküler yaralanmalar, erken veya geç postoperatif dönemde tanı alabilir. Erken tanı ve tedavi bu tip olgularda hayati önem taşır. Kırk yaşındaki erkek hasta, lomber disk herniasyonu ameliyatı sonrası erken dönemde iyatrojenik vasküler yaralanma ön tanısı ile hastanemize dış bir merkezden refere edildi. Hastanın acil serviste yapılan ilk değerlendirilmesinde hemorajik şok, ciddi asidoz pH:6,58 ve hipotermi mevcuttu. Hastaya bu bulgularla acil operasyon uygulandı. Eksplorasyonda, sol ana iliyak arterde yırtık tespit edildi ve damar grefti ile onarıldı. İntraoperatif şok ve asidoz başarıyla tedavi edildi. Postoperatif dönemde yoğun bakım takibi sonrası hasta sekelsiz taburcu edildi. Sonuç olarak; hemorajik şok ve eşlik eden ciddi asidoz tablosu olan hastalarda erken müdahale, hızlı kan ve sıvı transfüzyonu sekelsiz iyileşme sağlayabilir

Anahtar Kelimeler:

Şok, hemorajik, asidoz, hipotermi

Anesthetic management due to shock after lumbar surgery: Report of a case

Iatrogenic vascular injury is rarely seen during lumbar disc surgery. These vascular injuries can be diagnosed in the early or late postoperative period. Early diagnosis and treatment has a vital role in such patients. A forty-yearold male patient was referred to our hospital with the diagnosis of iatrogenic vascular injury developed during the early period of a lumbar disc herniation surgery. Hemorrhagic shock, severe acidosis pH 6.58 and hypothermia were present in the initial evaluation of patient in the emergency room. An emergent operation was performed due to the findings. During exploration, left main iliac artery injury was detected and repaired using a vein graft. Intraoperative shock and acidosis were treated successfully. After postoperative intensive care follow-up, the patient was discharged without any sequel. In conclusion; patients with hemorrhagic shock accompanying severe acidosis can be treated without sequel with early intervention and rapid transfusion of blood and fluids

Keywords:

Shock, hemorrhagic, acidosis, hypothermia,

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