Oksipital Ensefalosel cerrahisi geçiren yenidoğanda anestezi deneyimimiz: Olgu sunumu

Year 2016, Volume: 13 Issue: 2, 195 - 199, 29.08.2016

Yakup Aksoy Ömer Fatih Şahin Erhan Gökçek Ayhan Kaydu Cem Kıvılcım Kaçar

Abstract

İntrakraniyal yapıların bir kese içerisinde kraniumdan dışarı çıkmasıyla karakterize bir nöral tüp defekti
olan ensefalosel olgusunda anestezi yönetimimizi sunmayı amaçladık. 4 günlük, 3100 gr. yenidoğan
bebek 21x18 cm. çapında oksipital bölgede ensefalosel operasyonu için ameliyathaneye alındı. Hastanın
ek nörolojik arazı veya konjenital anomalisi saptanmadı. Hasta için zor entübasyon ihtimaline karşı
hazırlıklar yapılıp standart monitorizasyon sonrası anestezi indüksiyonu ile entübasyon işlemine başlandı.
Hastanın omuz altı gövdesine yuvarlanmış bezler konularak supin pozisyonda bir asistan yardımıyla başı
tutuldu. Yeterli ekstansiyon sağlanan hasta ilk denemede başarılı olarak entübe edildi. Postoperatif hasta
yenidoğan yoğun bakım ünitesine entübe halde gönderildi. Ensefalosel hastalarında görülebilecek
problemleri en aza indirmek için operasyon öncesinden başlanarak itina ile hazırlık yapılmalı ve ekip
çalışması şeklinde yaklaşım gerekmektedir. 

Keywords

Ensefalosel, Yenidoğan, Zor Entübasyon, Anestezi

Anesthesia experience of neonate with occipital encephalocele surgery : Case report

Abstract

We aimed to present our anesthetic management of encephalocele which is characterized by a neural tube
defect that intracranial structures herniated through a defect in cranium. We report such a case in which a
four-day-old neonate weighing 3100 grams presented with a large cystic swelling measuring 21 × 18 cm
arising from the occipital region. There was no neurological deficit and no other congenital abnormality.
After standard monitorization and ​preparations for difficult intubation, the anesthesia was induced. The
patient's head was kept in the supine position with the help of an assistant after patient's shoulder and body
placed over a rolled-up blanket. After adequate extension of head and neck, the patient was intubated
successfully on the first try. Postoperatively, the patient was sent to the neonatal intensive care unit intubated. İn order to minimize the problems with anesthetic challenge of encephalocele; careful preparation and
teamwork approach shuold be done

Keywords

Encephalocele, Neonate, Difficult Intubation, Anesthesia

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