Özet:

The coronavirus disease 2019 pandemic has shown us that the number of intensive care beds can be seriously limited for postoperative tracking of high-risk patients. This situation has led to the need to develop a perioperative plan without intensive care support in the management of high-risk abdominal emergencies that will not be delayed. In this series of phenomena, we shared our experience of awakening laparotomy under combined spinal epidural anesthesia in four cases in the relevant patient group. The patient’s age and ARISCAT score median (min-max) values were 73 years (56-85) and 68 (52-74), ASA scores III and all of them were high in the direction of lung complications. The expected hospitalization period with mortality and serious complications was 23% (11-36%), 40% (34-48%), 15,5 (13,5-19) days, respectively. Patients are planned to be operated under combined spinal-epidural anesthesia. Epidural kateters were placed in such a way as to cover the dermatom range of the planned surgical section. Spinal anesthesia dose and first-level target were individualized according to the age and hemodynamic condition of patients with 0.5% heavy-bupivakain. All patients were applied gastrointestinal resection from different levels and with anastomosis or stoma opening. The median time of surgery (min-max) was 155 (120-210) minutes. No new clinical condition that would require intensive care in the patient's service follow-up or not in the preoperative period was observed. The hospital stay period was monitored by 7.5 (5-13) days.

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