Respiratory Depression after Caudal Anesthesia for a Case Operated Owing to Sipina Bifida

Öz

The aim of this case report is to discuss the respiratory depression after caudal anesthesia for a case operated previously owing to spina bifida. Neural tube defects are malformations of central nervous system of which spina bifida is the most common. This group is characterized by the protrusion of the meninges and-or the spinal cord through open vertebral arches. Spina bifida can be treated with orthotic treatment, physical therapy or surgical treatment. A 9400 -gr-, 11 month old baby to be operated owing to inguinal hernia was administered caudal anesthesia with bupivacaine, %0,25 at 1 ml.kg-1 , after 1 mg midazolam and 25 mg propofol administration intravenously. Respiratory depression occurred 25 min after caudal anesthesia. Endotracheal entubation was administered and the case was ventilated mechanically. The case was extubated 145 min after caudal anesthesia, first tobe taken to the recovery room, second tobe taken to pediatric surgery unit and discharged from hospital at 2 days following surgery. The use of low volume local anesthetic could decrease the complications in and patients. Key words: Caudal anesthesia, Spina bifida.

Anahtar Kelimeler

• Caudal anesthesia, Spina bifida.

Spina Bifida Nedeniyle Operasyon Geçirmiş Bir Olguda Kaudal Anestezi Sonrası Solunum Depresyonu

Öz

Bu olgu sunumunda sipina bifida nedeniyle operasyon geçirmiş bir olguda kaudal anestezi sonrası meydana gelen solunum depresyonunun tartışılması amaçlandı. Nöral tüp defektleri santral sinir sistemi malformasyonlarındandır. Spina bifida en sık görülen gruptur. Bu grup nöral tüp defekti meninkslerin ve-veya spinal kordun, açık olan vertebral arktan dışarıya doğru çıkmaları ile karakterizedir. Spina bifida ortotik tedavi, fizik tedavi veya cerrahi ile düzeltilebilmektedir. 11 aylık 9400 gram bir ağırlığında inguinal herni operasyonu yapılacak erkek bebeğe i.v. 1 mg midazolam ve toplam 25 mg propofol verildikten sonra kaudal epidural aralığa %0,25'lik bupivakainden 1 ml.kg-1 uygulandı. Kaudal anesteziden 25 dk sonra hastada solunum depresyonu meydana geldi. Olguya endotrakeal entübasyon yapılarak mekanik ventilatöre bağlandı. Kaudal anesteziden 145 dk sonra ekstübe edilerek ayılma odasına, daha sonra servise, 2 gün sonra da servisten evine taburcu edildi. Bu hastalarda daha düşük volümde lokal anestezik kullanımı komplikasyonları azaltacaktır. Anahtar kelimeler: Kaudal anestezi, Spina bifida.

Anahtar Kelimeler

• Kaudal anestezi, Spina bifida.

Kaynakça

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