özcan, sibel fırat üniversitesi - tıp fakültesi - anesteziyoloji ve reanimasyon anabilim dalı, Turkey , öner, sait fatih elaziğ eğitim ve araştırma hastanesi - anesteziyoloji ve reanimasyon kliniği, TÜRKİYE , yildiz altun, aysun fırat üniversitesi - tıp fakültesi - anesteziyoloji ve reanimasyon anabilim dalı, TÜRKİYE , demir, şükrü elaziğ eğitim ve araştırma hastanesi - ortopedi ve travmatoloji kliniği, TÜRKİYE

Spinal Anaesthesia Application with Two Different Approaches in Two Cases of Ankylosing Spondylitis

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Ankylosing Spondylitis (AS) is a subset of axial spondyloarthritis and it is involving primarily the axial skeleton and sacroiliac joints. An anaesthesia plan should be created by considering 4 important factors in patients with AS. The degree of the upper airway involvement, limited thoracic expansion, cardiac involvement and neuraxial block application difficulties need to be considered, A variety of alternative approaches such as awake video laryngoscopic intubation, laryngeal mask application, caudal anaesthesia and spinal anaesthesia with lateral approach applications as well as the standard general and neuraxial techniques were defined for these patients. We also aimed to present spinal anaesthesia that we applied with a different approach in two patients. We have also seamlessly performed spinal anaesthesia application in our first case in head up (semi-sitting) lateral position and intra-operative hemodynamic change was not observed. In the second case, we were successful with the lateral approach after unsuccessful spinal anaesthesia attempt with midline approach again in sitting position. In conclusion; by the patients with AS, it should be considered that spinal anaesthesia can be applied more easily with midline approach in lateral semi-sitting position or lateral approach in sitting-position, without insisting on the midline technique in cases where the midline technique is difficult to be performed.

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Ankylosing spondylitis , spinal anaesthesia

Fırat University Medical Journal Of Health Sciences

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