. 2011; 17(4): 91-95 | DOI: 10.5222/GKDAD.2011.091 | ||||
Çok Yüksek Riskli Koroner Arter Hastalığı ve Dejeneratif Kalp Kapağı Olan Bir Hastanın Acil Spinal Cerrahisinde Başarılı Bir Anestezi UygulamasıMurat Karcıoğlu1, Kasım Tuzcu1, Işıl Davarcı1, Yusuf Bolkan Bozdoğan1, Selim Turhanoğlu1, Adnan Burak Akçay2, Murat Altaş31Mustafa Kemal Üniversitesi Tıp Fakütesi, Anesteziyoloji Anabilim Dalı, Antakya2Mustafa Kemal Üniversitesi Tıp Fakütesi, Kardiyoloji Anabilim Dalı, Antakya 3Mustafa Kemal Üniversitesi Tıp Fakütesi, Beyin Cerrahi Anabilim Dalı, Antakya Kardiyak hastanın nonkardiyak cerrahisinde preoperatif değerlendirme konusundaki bütün çabalar olası komplikasyonları tahmin etmek ve onlardan korunmak içindir. A Successful Administration of Anesthesia in An Urgent Spinal Surgery of a Patient with a High Risk of Coronary Artery and Degenerative Cardiac Valvular DiseasesMurat Karcıoğlu1, Kasım Tuzcu1, Işıl Davarcı1, Yusuf Bolkan Bozdoğan1, Selim Turhanoğlu1, Adnan Burak Akçay2, Murat Altaş31Mustafa Kemal University Medical Fakütesi, Anesthesiology Department, Antioch2Mustafa Kemal University Medical Fakütesi, Cardiology Department, Antioch 3Mustafa Kemal University Medical Fakütesi, Department Of Neurosurgery, Antioch In noncardiac surgery of cardiac patients, all efforts during the preoperative assessment are to predict, and prevent potential complications An urgent operation was decided to be performed on a 80-year-old female patient with the diagnosis of depression fracture of L1. During assessment of the patient before anesthesia, we learned that patient had coronary artery disease. During the physical examination, pulmonary edema was detected secondary to the congestive heart failure. The patient was sent to coronary intensive care unit after talking with patient’s relatives and the attending surgeon. After aggressive treatment about a week, blood gas values were improved and hemodynamic values were stabilized. In this condition, we decided operation for the patient. Invasive monitorization was performed in the operation room. For induction of anesthesia, midazolam, fentanyl, rocuronium, and lidocaine were given. The maintenance of anesthesia provided with sevoflurane plus 50 % of air and 50 % of oxygen. The patient remained stable during the operation. A three-hour operation was completed without any problem, and she was remained at a steady state up to the discharge. As a conclusion, each patient should be questioned and examined carefully about cardiac manifestations during the preoperative assessment. In the presence of any sign or symptom of congestive heart failure (CHF), noncardiac surgeries should be postponed if it is not urgent. Such patients should be treated aggressively during the perioperative period according to the functional degree of CHF. In case of emergency, consultation with cardiologists should arrive at a consensus, and patients should be operated under optimal conditions. Keywords: coronary artery disease, urgent noncardiac surgery, congestive heart failure, pulmonary edemaMurat Karcıoğlu, Kasım Tuzcu, Işıl Davarcı, Yusuf Bolkan Bozdoğan, Selim Turhanoğlu, Adnan Burak Akçay, Murat Altaş. A Successful Administration of Anesthesia in An Urgent Spinal Surgery of a Patient with a High Risk of Coronary Artery and Degenerative Cardiac Valvular Diseases. . 2011; 17(4): 91-95 Sorumlu Yazar: Murat Karcıoğlu, Türkiye |
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