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2 - Retrospective investigation of the anaesthesia in spinal surgery patients
G. Ulufer Sivrikaya, Mehmet Tezer, Ayşe Hancı, İrfan Öztürk, Melahat Karatmanlı Erol, Leyla Türkoğlu Kılınç
Objective: The aim of this retrospective trial is to investigate the anaesthetic records of the 133 operations of 111 patients undergoing spinal surgery with general anaesthesia from January.1990 to June.2001 at Şişli Etfal Research and Education Hospital.
Study design: The demographic data of the patients, indications, preanaesthetic assessment and premedication, duration of anaesthesia-operation, anaesthetic techniques were investigated. Methods which was used for observation of vital parameters and amount of blood loss, products used for blood transfusion and fluid replacement, complications, the postoperative analgesic methods were searched.
Results: 54 female, 57 male patients aged between 1.5-78 years were investigated. The most frequent indication for surgery was fractures (in 73 patients-66%). In 7 cases (6%) anterior, 71 cases (64%) posterior, and 33 cases (30%) combined anterior- posterior approaches were preferred. Mean duration of anaesthesia and operation were 305.71 and 256.65 minutes respectively. Balanced anaesthetic technique was used in 80 procedures (60%). Induced hypotension in 25 procedures (19%) and wake-up test in 10 procedures (8%) were used. In 108 procedures (81%) patients were monitorized invasively. Homologous blood transfusion in ¡11 procedures (83%), ototransfusion technique in 10 procedures (8%) were used. Crystalloid solutions alone in 85 procedures (64%) and combined with colloid solutions in 48 procedures (36%) were infused. In 20 procedures (15%) patients were transferred to the intensive care unit. The postoperative analgesia was provided with classical methods in 100 procedures (75%).
Conclusion: The preanaesthetic assessment should include neurological examination in patients undergoing spinal surgery. The anaesthetic technique should minimize the peroperative bleeding and allow the neurophysiological tests to be done safely. Also invasive monitorization should be performed, adequate postoperative analgesia should be provided. The patients should be interned in intensive care unit for 24-48 hours to follow up and apply supportive treatment.
Keywords: Spinal surgery, anaesthesia
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