Case Report
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SPİNAL ANESTEZİ ALTINDA YAPILAN SEZARYEN SIRASINDA ACİL TRAKEOSTOMİ GEREKEN OLGUNUN SUNUMU

Year 2021, Volume: 18 Issue: 4, 1095 - 1098, 31.12.2021
https://doi.org/10.38136/jgon.896255

Abstract

Rejyoner anestezi altında yapılan ameliyatlar sırasında hastalarda larengeal ödem görülmesi çok nadir gelişen bir olaydır. Kullanılan ilaç ve materyallere bağlı özellikle reaktif havayoluna sahip hastalarda saniyeler içinde geliştiği düşünülmektedir. Karşılaşıldığında hastanın havayolu açıklığı en kısa sürede sağlanmalıdır. Spinal anestezi uygulanıp operasyona başlanmış olan böyle olgularda öncelikle intravenöz steroid uygulanmalı, eğer hastanın oksijenasyonu sağlanamazsa hasta entübe edilmeli, son çare olarak hastaya trakeostomi açılmalıdır. Bu yazıda, spinal anestezi altında sezaryen operasyonuna başlanmış hastada laringeal ödem gelişmesi üzerine hava yolunun sağlanması amacıyla nihai olarak trakeostomi gereken olgu sunuldu.

References

  • 1. Maynard AA, Burger CF, Schlesinger JJ. Angioedema: Perioperative management. SAGE Open Med Case Rep. 2017 Jun8;5:1-4. doi: 10.1177/2050313X17713912.
  • 2. Kaya C, Köksal E, Üstün FE. Anestezi ve Yoğun Bakım Pratiğinde Trakeostomi. Harran Üniversitesi Tıp Fakültesi Dergisi 2014;11(2):172-183.
  • 3. Elçin Ersöz E, Levent Alpay L, Hakan Kıral H, Talha Doğruyol T, Volkan Baysungur V, İrfan Yalçınkaya İ. Trakeostomi Sonrasında Total Trakeal Obstrüksiyon Gelişen Olguda Bronkoskopik Tedavi. J Kartal TR 2015;26(3):251-254. doi: 10.5505/jkartaltr.2014.21033.
  • 4. Beyaz SG, Tokgöz O. Proseal laringeal maske kullanılan bir çocukta gelişen laringeal ödem. Genel Tıp Derg 2010;20(1): 27-30.
  • 5. Divatia J. V, Bhowmick K. Complications of endotracheal intubation and other airway management procedures. Indian J Anaesth 2005;49:308-318.
  • 6. Bordet F, Allaouchiche B, Lansiaux S and et al. Risk factors for airway complications during general anaesthesia in paediatric patients. Paediatr Anaesth 2002;12:762-769.
  • 7. Montgomery WW. Trakea cerrahisi. In: Montgomery WW, Cheney ML, Lazor JB, Montgomery SK, Randolph GW, Varvares MA, Weber AL editors. Surgery of the larynx, trachea, esophagus and neck. Ankara: Nobel Tıp Kitapevleri; 2004. p 190-212.
  • 8. Weisler MC, Couch ME. Trakeotomi ve entübasyon. In: Bailey BJ, Johnson JT, Newlands SD editors. Head & Neck Surgery – Otolaryngology. 4th ed. Ankara: Lippincott Williams & Wilkins; 2011. p 785-801.
  • 9. Bayı Ö, Sayla G, Korkmaz MH. Tiroid ve Paratiroid. Turkiye Klinikleri J E.N.T.-Special Topics. 2017;10(4):261-274.
  • 10. Du XY, Zhai XD, Liu Z. A clinical retrospective study of percutaneous dilatational tracheostomy without guide wire for critically ill patients. Wien Klin Wochenschr. 2021 Jan 11. doi: 10.1007/s00508-020-01799-3. Online ahead of print.
  • 11. Rosero EB, Corbett J, Mau T, Joshi GP. Intraoperative Airway Management Considerations for Adult Patients Presenting With Tracheostomy: A Narrative Review. Anesth Analg. 2020 Dec 24. doi: 10.1213/ANE.0000000000005330. Online ahead of print.

A CASE REPORT OF EMERGENCY TRACHEOSTOMY DURING INTRAOP SPINAL ANESTHESIA

Year 2021, Volume: 18 Issue: 4, 1095 - 1098, 31.12.2021
https://doi.org/10.38136/jgon.896255

Abstract

It is a very rare event to encounter laryngeal edema in patients during operations performed under regional anesthesia. Depending on the drugs and materials used, it is thought to develop with in seconds, especially in patients with reactive airways. When encountered, the patient's airway clearance should be provided as soon as possible. In such cases where spinal anesthesia has been applied and the operation has been started, intravenous steroid should be administered first, if the patient cannot be oxygenated, the patient should be intubated, and as a last resort, the patient should have a tracheostomy. In this article, we present a case that ultimately required tracheostomy in order to establish the airway due to the development of laryngeal edema in a patient who was started cesarean section unde rspinal anesthesia.

References

  • 1. Maynard AA, Burger CF, Schlesinger JJ. Angioedema: Perioperative management. SAGE Open Med Case Rep. 2017 Jun8;5:1-4. doi: 10.1177/2050313X17713912.
  • 2. Kaya C, Köksal E, Üstün FE. Anestezi ve Yoğun Bakım Pratiğinde Trakeostomi. Harran Üniversitesi Tıp Fakültesi Dergisi 2014;11(2):172-183.
  • 3. Elçin Ersöz E, Levent Alpay L, Hakan Kıral H, Talha Doğruyol T, Volkan Baysungur V, İrfan Yalçınkaya İ. Trakeostomi Sonrasında Total Trakeal Obstrüksiyon Gelişen Olguda Bronkoskopik Tedavi. J Kartal TR 2015;26(3):251-254. doi: 10.5505/jkartaltr.2014.21033.
  • 4. Beyaz SG, Tokgöz O. Proseal laringeal maske kullanılan bir çocukta gelişen laringeal ödem. Genel Tıp Derg 2010;20(1): 27-30.
  • 5. Divatia J. V, Bhowmick K. Complications of endotracheal intubation and other airway management procedures. Indian J Anaesth 2005;49:308-318.
  • 6. Bordet F, Allaouchiche B, Lansiaux S and et al. Risk factors for airway complications during general anaesthesia in paediatric patients. Paediatr Anaesth 2002;12:762-769.
  • 7. Montgomery WW. Trakea cerrahisi. In: Montgomery WW, Cheney ML, Lazor JB, Montgomery SK, Randolph GW, Varvares MA, Weber AL editors. Surgery of the larynx, trachea, esophagus and neck. Ankara: Nobel Tıp Kitapevleri; 2004. p 190-212.
  • 8. Weisler MC, Couch ME. Trakeotomi ve entübasyon. In: Bailey BJ, Johnson JT, Newlands SD editors. Head & Neck Surgery – Otolaryngology. 4th ed. Ankara: Lippincott Williams & Wilkins; 2011. p 785-801.
  • 9. Bayı Ö, Sayla G, Korkmaz MH. Tiroid ve Paratiroid. Turkiye Klinikleri J E.N.T.-Special Topics. 2017;10(4):261-274.
  • 10. Du XY, Zhai XD, Liu Z. A clinical retrospective study of percutaneous dilatational tracheostomy without guide wire for critically ill patients. Wien Klin Wochenschr. 2021 Jan 11. doi: 10.1007/s00508-020-01799-3. Online ahead of print.
  • 11. Rosero EB, Corbett J, Mau T, Joshi GP. Intraoperative Airway Management Considerations for Adult Patients Presenting With Tracheostomy: A Narrative Review. Anesth Analg. 2020 Dec 24. doi: 10.1213/ANE.0000000000005330. Online ahead of print.
There are 11 citations in total.

Details

Primary Language Turkish
Subjects Obstetrics and Gynaecology
Journal Section Case Reports
Authors

Bugra Sahin 0000-0003-0429-3085

Gizem Cura Şahin 0000-0001-5696-4683

Publication Date December 31, 2021
Submission Date March 13, 2021
Acceptance Date May 31, 2021
Published in Issue Year 2021 Volume: 18 Issue: 4

Cite

Vancouver Sahin B, Cura Şahin G. SPİNAL ANESTEZİ ALTINDA YAPILAN SEZARYEN SIRASINDA ACİL TRAKEOSTOMİ GEREKEN OLGUNUN SUNUMU. JGON. 2021;18(4):1095-8.