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Alt ekstremite periferik sinir blokları, ortopedik cerrahi işlemler başta olmak üzere mortalite ve morbiditeyi ciddi oranda azaltabilen uygulamalardır. Bu uygulamalar, nöroaksiyal bloklar ve genel anesteziye göre daha az komplikasyona sahip olmaları, hastalara etkin postoperatif analjezi temin etmeleri ve hastaların mobilizasyonlarını hızlandırmaları nedeniyle sıklıkla kullanılan üstün anestezi ve analjezi uygulamalarıdır. Bu olgu sunumundaki geriatrik hastada lomber pleksus bloğu güvenle kullanılarak hastanın cerrahisi tamamlanmıştır. 78 yaşında 75 kg olan erkek hasta düşme sonucu sol femur fraktürü gelişmesi nedeniyle ortopedi servisine yatırılmıştır. Hastanın yapılan preoperatif değerlendirilmesinde alzheimer hastası olduğu, akut bronşit tanısıyla göğüs hastalıkları tarafından tedavi başlandığı, hipertansiyon, kardiyak aritmi, diabetes mellutus tanılarının olduğu ve tedavi aldığı öğrenildi. Bu olgu sunumunda, American Society of Anesthesiologists’e göre ASA 4 sınıflandırmasında yer alan geriatrik kalça cerrahisi yapılacak hastaya anestezi yöntemi olarak lomber pleksus bloğu uygulandı. Lomber pleksus bloğu ile hastada operasyon için etkin analjezi sağlandı. Hastanın operasyon süresince hemodinamisi stabil olarak seyretti ve güvenli bir anestezi sağlandı. Hastanın yüksek ASA’ya sahip olması genel anestezi ve spinal anestezi için riskli bulunmuştur. Bundan dolayı, geriatrik hastalarda ve ortopedik cerrahilerde periferik blokların diğer anestezi yöntemlerine göre güvenli bir alternatif olacağı düşüncesindeyiz.
The peripheral nerve blocks of the lower extremity, ortopedic surgical procedures, are applications that can seriously reduce mortality and morbidity, primarily. These applications are superior anesthesia and analgesia practices that are commonly used because they have less complications than neurotoxic blocks and general anesthesia, provide patients with effective postoperative analgesia and accelerate the mobilization of patients. In the geriatric patient in the presentation of this phenomenon, the patient's surgery is completed by safe use of the lombary plexus block. The 78-year-old man with a weight of 75 kg was placed in the ortopedic service due to the development of the left femur fractures. The preoperative assessment of the patient was found that he had Alzheimer's disease, acute bronchitis diagnosis began with breast diseases, hypertension, heart rate, diabetes mellitus diagnosis and received treatment. In the presentation of this fact, the American Society of Anesthesiologists said that the lombary plexus block was applied as an anesthetic method for the patient to be performed a geriatric column surgery included in the ASA 4 classification. The patient was given an effective analgesic for surgery with the Lomber plexus block. The patient's hemodynamics was stable during the operation and a safe anesthesia was provided. The patient’s high ASA has been found to be at risk for general anesthesia and spinal anesthesia. Therefore, we believe that peripheral blocks in geriatric patients and ortopedic surgeons will be a safe alternative to other methods of anesthesia.
Lower extremity peripheral nerve blocks are applications that can significantly reduce mortality and morbidity, especially orthopedic surgical procedures. These applications have less complication than neuroaxial block and general an-esthesia. They are frequently used because of the need to provide effective post-operative analgesia and to accelerate patient mobilizations. In this case report, the patient's surgery was completed using the lumbar plexus block safely. A 78-year-old male patient was admitted to the department of orthopedics due to the left femur fracture. Preoperative evaluation of the patient revealed that he had Alzheimer's Disease, acute bronchitis diagnosed by chest diseases, hypertension, cardiac arrhyth-mia, Diabetes Mellutus diagnosis and treatment. In this case report, a lumbar plexus block was applied as anesthesia to the patient to be treated by geriatric hip surgery according to American Society of Anesthesiologists ASA 4 classification. The lomber plexus block provided effective analgesia for patient during operation. During the op-eration, the hemodynamics remained stable and safe anesthesia was achieved. The high ASA of the patient was found to be risky for both general and spinal anesthesia. Therefore, we think that peripheral blocks are safer than other anesthesia methods in geriatric patients and orthopedic surgeries.
Alan : Sağlık Bilimleri
Dergi Türü : Uluslararası
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