Hidrosefali ve sakral agenezi olgusunda üçlü femoral blok
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Tarih
2011
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Cilt Başlığı
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Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Hidosefali, sakral agenezi ve spina bifida anomalileri olan femur fraktürlü hastamızda, başarılı üçü bir yerde femoral sinir bloğu uygulamasını sunmayı amaçladık. Üç yaşında kız hastamızda travmatik sağ femur fraktürü mevcuttu. Klinik muayenesinde zor havayolu bulguları olan mikrognati ve makroglossi saptandı. Birlikte saptanan ileri derecede hidrosefali, alt etkstremitelerde motor paralizi, spina bifida ve sakral agenezi genel anestezi veya nöroaksiyal blok uygulamalarını güçleştirmişti. Hastamıza hafif sedasyon altında üçü bir yerde femoral blok uygulamaya karar verdik. Damar yolu bulunduktan sonra 0,05 mg kg1 intravenöz midazolam uygulandı. Femoral sinir bloğu sinir stimülasyonu tekniği ile 7,5 ml % 0,5 levobupivakain serum fizyolojik 10 ml'ye tamamlanarak uygulandı. Eksternal fiksasyon ek analjezik gereksinimi olmaksızın başarılı bir şekilde uygulandı. Hastanın vital bulguları operasyon süresi ve erken postoperatif dönemde stabil seyretti. Hasta postoperatif dönemde altı saat süre ile ağrısız bir dönem geçirdi. Periferik sinir blokları uygulama olanağı bulunduğunda güç havayolu olgularında cerrahi ve postoperatif dönem için etkili ve güvenli bir alternatif olduğu kanısındayız.
We aimed at presenting successful 3 in 1 femoral nerve block in a patient with hydrocephalus, spina bifida and sacral agenesis, who had femur fracture. A three years old girl has traumatic fracture on right femur. Clinical examination revealed sins for difficult airway including micrognathia and macroglossia. Giant hydrocephalus, spina bifida and sacral agenesis with motor paralysis on lower extremities were concomitant findings that might be problematic in performing general anesthesia or central nerve blocks. We therefore decided to perform 3 in 1 femoral nerve block under light sedation, Midazolam 0.05 mg kg' was administered via venous access and a total of 10 ml local anesthetic mixture including 7.5 ml 0.5% levobupivacaine in saline dilution was injected with increments after contractions from quadriceps muscle were elucidated. External fixation was successfully performed without complication and analgesic requirement. Vital signs were stable throughout the surgery and during the early postoperative period. Patient was pain free for six hours during the postoperative period. Peripheral nerve blocks, whenever possible are considered as efficient and safe alternative for anticipated difficult airway in both for surgery and postoperative analgesia.
We aimed at presenting successful 3 in 1 femoral nerve block in a patient with hydrocephalus, spina bifida and sacral agenesis, who had femur fracture. A three years old girl has traumatic fracture on right femur. Clinical examination revealed sins for difficult airway including micrognathia and macroglossia. Giant hydrocephalus, spina bifida and sacral agenesis with motor paralysis on lower extremities were concomitant findings that might be problematic in performing general anesthesia or central nerve blocks. We therefore decided to perform 3 in 1 femoral nerve block under light sedation, Midazolam 0.05 mg kg' was administered via venous access and a total of 10 ml local anesthetic mixture including 7.5 ml 0.5% levobupivacaine in saline dilution was injected with increments after contractions from quadriceps muscle were elucidated. External fixation was successfully performed without complication and analgesic requirement. Vital signs were stable throughout the surgery and during the early postoperative period. Patient was pain free for six hours during the postoperative period. Peripheral nerve blocks, whenever possible are considered as efficient and safe alternative for anticipated difficult airway in both for surgery and postoperative analgesia.
Açıklama
Anahtar Kelimeler
Cerrahi
Kaynak
Anestezi Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
19
Sayı
3
Künye
Apan, A., Babadağ, Y., Çetik, Ö. (2011). Hidrosefali ve sakral agenezi olgusunda üçlü femoral blok. Anestezi Dergisi, 19(3), 191 - 193.
