İbrahim ÖZTÜRK, Jülide ERGİL, Derya ÖZKAN, Eylem OĞUZ, Mesut BAKIR

Ankilozan Spondilitli Hastada Paramedian Yaklaşımla Spinal Anestezi Uygulaması

Ankilozan Spondilit, cerrahi hastalarda nadir görülen ve hem genel hem de rejyonal anestezi uygulamasının zor olduğu bir kronik, ilerleyici seronegatif spondiloartropatidir. Sol spermatosel nedeni ile elektif cerrahi planlanan, 38 yaşında ve 170 cm boyunda, 82 kg ağırlığında, Amerikan Anestezistler Derneği fiziksel sınıflaması (ASA) II olan erkek hastada yaklaşık 14 yıldan beri Ankilozan spondilit bulunmaktaydı. Servikal eklemlerinde ciddi düzeyde ekstansiyon kısıtlaması olduğundan spinal anestezi planlandı. Ancak lomber düzleşme ve sindezmofit oluşumu nedeni ile median yaklaşımla iğne girişi mümkün olmayan hastaya L4-5 aralığından paramedian yaklaşımla spinal anestezi uygulandı. Sonuç olarak ileri safhadaki Ankilozan Spondilitli hastalarda paramedian yaklaşımla spinal anestezi başarı oranının artabileceği kanısındayız

Anahtar Kelimeler:

Ankilozan spondilit, spinal anestezi, paramedian yaklaşım

Spinal Anesthesia Application in a Patient with Ankylosing Spondylitis By Paramedian Approach

Ankylosing spondylitis is a chronic, progressive seronegative spondyloarthropathy that is rare among surgical patients and in which application of both general and regional anesthesia is difficult. A 38 years-old, and 170 cm height, 82 kg weight, ASA class II male patient assigned for an elective left spermatocell surgery, has been followed for Ankylosing Spondylitis since 14 years. Spinal anesthesia was planned beacuse of serious limitation of extension at cervical joints. However, spinal anesthesia was applied to patient, in whom insertion of needle was impossible because of lumbar flattening and formation of syndesmophytes, by paramedain approach at L4-5 spinal space. In conclusion we think that success rate may increase by paramedian approach in patients with advanced stage Ankylosing Spondylitis.

Keywords:

Ankylosing spondylitis, spinal anesthesia, paramedian approach,

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