Omurga Cerrahisine Anestezi Yaklaşımı - Derleme

Omurga, yapısalstabilizasyonusağlayarak omuriliğikorurvevücutağırlığını dengeleyerek, ayakta durabilmeyisağlar. Basıya bağlınörolojikdefisit, tümör ya da enfeksiyon gibi patolojik lezyonlar, skolyoz gibi pozisyon bozuklukları, travma sonrasıomurganıninstabilitesiveomurga kökenliağrılarcerrahinin başlıcanedenleridir. Bu derlemeilediskektomi, laminektomi, plaklama, korpektomigenişbircerrahiyelpazeyesahipomurga cerrahisininanestezist gözüyle önemli noktaları ele alınacaktır.

Anahtar Kelimeler:

anestezi, komplikasyon, omurga cerrahisi

Anesthetic Approach to Spine Surgery - Review

Spinal column while supplying structural stability both protects spinal cord and maintains erect posture of human being with balancing body weight. Neurological defi cits resulted from compressions, pathological lesions such as tumor, infection, posture disorders such as scoliosis, trauma related- both instability of spinal column and neuropathic pain are the main causes of spinal surgery. In this review from the anesthesiologist's perspective, major point related to spine surgery was discussed.

Keywords:

anesthesia, complication, spine surgery,

PDF

___

Konya D, Ozgen S, Gercek A, et al.: Outcomes for combined anterior and posterior surgical approaches for patients with multisegmental cervical spondylotic myelopathy. J Clin Neurosci 2009,16:404-409.
Gercek A, Lim S, Isler FB, et al.: Prediction of diff icult intubation with bedside scoring systems. Mar Med J 2004,1:32-37.
Morgan GE, Mikail MS, Murray JM.: Respiratory physiology: The eff ects of anesthesia. Morgan GE, Mi- kail MS, Murray JM (Eds.). Clinical Anesthesiology. Mc Graw-Hill, USA, 2006, pp. 537-570.
Murray GC, Persellin RH.: Cervical fracture compli- cating ankylosing spondylitis. Am J Med. 1981;70:1033- 1441.
Mangona DT.: Perioperative cardiac morbidity. Anesthesiology 1990;72:153-184.
Grottke O, Dietrich PJ, Wiegels S, et al.: Intraoperative wake-up test and postoperative emergence in patients undergoing spinal surgery: a comparison of intravenous and inhaled anesthetic techniques using short-acting anesthetics. Anesth Analg 2004;99:1521-1527.
Calder I, Calder J, Crockard HA.: Diff icult direct laryngoscopy in patient with cervical spine disease. Anesthesia 1995,50:756-763.
Saha AK, Higgins M, Walker G, et al.: Comparision of awake endotracheal intubation in patients with cervical spine disease: The lighted intubating stylet vs. Fibreoptic bronchoscope.Anesth Analg 1998,87:4477-479.
Cohn AI, Zornow MH.: Awake endotracheal intubation in patients with cervical spine disease: a comparison of the Bullard laryngoscope and fiberoptic bronchoscope. Anesth Analg 1995, 81: 1283-1286.
Watts ADJ, Gleb AW, Bach DB et al.: Comparison of the Bullard and Macintosh laryngoscope for endot- racheal intubation of patients with potential cervical spine injury. Anesthesiology 1997, 87:1335-1342.
Hasting RH, Wood PR.: Head extension and laryngeal view during laryngoscopy with cervical spi- ne stabilization maneuvers. Anesthesiology 1994, 80: 825-831.
Wahlen BM, Gercek E.: Three-dimensional cervical spine movement during intubation using the Macin- tosh and Bullard laryngoscopes, the bonfils fibrescope and