Age 107, hepatobiliary surgery and thoracic epidural anesthesia: a successful experience.

Öz

The anesthesia management of chronic obstructive pulmonary disease (COPD) patients in upper abdominal surgery is fairly difficult. The application of general anesthesia includes post-operative pulmonary and cardiac complications. We aim to share our experience of a good alternative to general anesthesia in a stage four COPD geriatric patient with thoracic epidural block.

Anahtar Kelimeler

• Upper abdominal surgery,epidural anesthesia

107 yaş, hepatobilier cerrahi ve torakal epidural anestezi: başarılı bir deneyim.

Öz

Üst abdominal cerrahide kronik obstrüktif akciğer hastalığı (KOAH)’lı hastaların anestezi yönetimi oldukça zordur. Genel anestezi uygulaması postoperatif pulmoner ve kardiyak komplikasyonları da beraberinde getirmektedir. Biz bu yazımızda genel anesteziye iyi bir alternatif amacıyla Evre 4 KOAH geriatrik hastada sedasyon eşliğinde torakal epidural anestezi deneyimimizi paylaşmayı amaçladık.

Anahtar Kelimeler

• Üst abdominal cerrahi,epidural anestezi

Kaynakça

1. Referans 1. Van Lier F, Van der Geest PJ, Hoeks SE, Van Gestel YR, Hol JW, Sin DD, et al. Epidural analgesia is associated with improved health outcomes of surgical patients with chronic obstructive pulmonary disease. Anaesthesiology 2011; 115(2):315–321.
2. Referans 2. Consani G, Amorese G, Boggi U, Comite C, Avagliano E. Laparotomic sub-total gastrectomy under awake thoracic epidural anaesthesia: a successfulexperience. Updates Surg 2013; 65(3):255–256.
3. Referans 3. Gonzalez-Mendibil I, Postigo-Morales S, Gonzalez-Larrabe I, Arizaga-Maguregi A. Thoracic epidural anesthesia for open cholecystectomy in severe lung disease. Description of a case and review of the literatüre. Rev Esp Anestesiol Reanim. 2015; 62(10):576-579.
4. Referans 4. Abd Elrazek E1, Thornton M, Lannigan A. Effective awake thoracic epidural anesthetic for major abdominal surgery in two high-risk patients with severe pulmonary disease-a case report. Middle East J Anaesthesiol. 2010; 20(6):891 -895.
5. Referans 5. Pöpping DM, Elia N, Marret E, Remy C, Tramèr MR. Protective effects of epidural analgesia on pulmonary complications after abdominal and thoracic surgery: a meta-analysis. Arch Surg 2008; 143(10):990–1000.