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Lomber cerrahi sonrası şokta anestezik yaklaşım. Bir olgu sunumu

Year 2011, Volume: 8 Issue: 3, 113 - 115, 01.12.2011

Abstract

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

References

  • ) Erkut B, Unlu Y, Kaygin MA, Colak A, Erdem AF. Iatrogenic vascular injury during to lumbar disc surgery. Acta Neurochir (Wien) 2007; 149: 511–6. Bingol H
  • ) Cingoz F, Yilmaz AT, Yasar M, Tatar H. Vascular complications related to lumbar disc surgery. J Neurosurg 2004; 100: 249–53.
  • ) Binnaz AY. Doğan İ.V. Yüksek Miktarda Kan Tranfüzyonu Alan İki Hasta. Türkiye Klinikleri J Anest Reanim: 2004; 2: 22–6. Prabhakar H
  • ) Bithal PK, Dash M, Chaturvedi A. Rupture of aorta and inferior vena cava during lumbar disc surgery. Acta Neurochir (Wien) 2005; 147: 327–9.
  • ) Libicher M, Bangard C, Gossmann A, Brunkwall J, Gawenda M. Retroperitoneal hemorrhage after lumbar disc surgery: Importance of followup CT for detection of vascular complications. European Journal of Radiology Extra 2008; 67: 95–7. Gentile V
  • ) Musco B, Della Giovampaola C, Lippolis PV, Seccia M. Hemorrhagic shock caused by iatrogenic aorto-cava injury. Case report Ann Ital Chir 2007; 78: –5.
  • ) Eddy VA, Morris JA, Cullinane DC. Hypotermia, coagulopathy, and acidosis. Surg Clin North Am 2000; : 845–54. Hildebrand F
  • ) Giannoudis PV, van Griensven M, Chawda M, Pape HC. Pathophysiologic changes and effects of hypothermia on outcome in elective surgery and trauma patients. Am J Surg. 2004; 187: 363–71. 9)
  • Janata A, Holzer M. Hypotermia after cardiac arrest. Prog Cardiovase Dis ; 52: 168–79.

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

Year 2011, Volume: 8 Issue: 3, 113 - 115, 01.12.2011

Abstract

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

References

  • ) Erkut B, Unlu Y, Kaygin MA, Colak A, Erdem AF. Iatrogenic vascular injury during to lumbar disc surgery. Acta Neurochir (Wien) 2007; 149: 511–6. Bingol H
  • ) Cingoz F, Yilmaz AT, Yasar M, Tatar H. Vascular complications related to lumbar disc surgery. J Neurosurg 2004; 100: 249–53.
  • ) Binnaz AY. Doğan İ.V. Yüksek Miktarda Kan Tranfüzyonu Alan İki Hasta. Türkiye Klinikleri J Anest Reanim: 2004; 2: 22–6. Prabhakar H
  • ) Bithal PK, Dash M, Chaturvedi A. Rupture of aorta and inferior vena cava during lumbar disc surgery. Acta Neurochir (Wien) 2005; 147: 327–9.
  • ) Libicher M, Bangard C, Gossmann A, Brunkwall J, Gawenda M. Retroperitoneal hemorrhage after lumbar disc surgery: Importance of followup CT for detection of vascular complications. European Journal of Radiology Extra 2008; 67: 95–7. Gentile V
  • ) Musco B, Della Giovampaola C, Lippolis PV, Seccia M. Hemorrhagic shock caused by iatrogenic aorto-cava injury. Case report Ann Ital Chir 2007; 78: –5.
  • ) Eddy VA, Morris JA, Cullinane DC. Hypotermia, coagulopathy, and acidosis. Surg Clin North Am 2000; : 845–54. Hildebrand F
  • ) Giannoudis PV, van Griensven M, Chawda M, Pape HC. Pathophysiologic changes and effects of hypothermia on outcome in elective surgery and trauma patients. Am J Surg. 2004; 187: 363–71. 9)
  • Janata A, Holzer M. Hypotermia after cardiac arrest. Prog Cardiovase Dis ; 52: 168–79.
There are 9 citations in total.

Details

Primary Language Turkish
Journal Section Case Report
Authors

Habib Bostan This is me

Hızır Kazdal This is me

Yakup Tomak This is me

Publication Date December 1, 2011
Published in Issue Year 2011 Volume: 8 Issue: 3

Cite

Vancouver Bostan H, Kazdal H, Tomak Y. Lomber cerrahi sonrası şokta anestezik yaklaşım. Bir olgu sunumu. Harran Üniversitesi Tıp Fakültesi Dergisi. 2011;8(3):113-5.

Harran Üniversitesi Tıp Fakültesi Dergisi  / Journal of Harran University Medical Faculty