South Clin Ist Euras. 2017; 28(3): 241-244 | DOI: 10.14744/scie.2017.52714

Diyafragma Hernisi ve Obstrüktif Uyku Apsesi Olan Hastada Anestezi: Olgu Sunumu

Feriha Temizel¹, Tamer Kuzucuoðlu¹, Gülten Arslan¹, Serkan Uçkun¹, Banu Eler Çevik¹, Recep Demirhan^2
1Saðlýk Bilimleri Üniversitesi Dr. Lütfi Kýrdar Kartal Eðitim ve Araþtýrma Hastanesi, Anesteziyoloji ve Reanimasyon Kliniði, Ýstanbul
²Saðlýk Bilimleri Üniversitesi Dr. Lütfi Kýrdar Kartal Eðitim ve Araþtýrma Hastanesi, Göðüs Cerrahisi Kliniði, Ýstanbul

Travmatik diyafragma hernisi (TDH) torakoabdominal travmalardan sonra görülen ve kolaylýkla atlanýlabilen komplike bir durumdur. TDH’nin tedavisi cerrahidir ve operasyonda torakotomi yaklaþýmý ile diyafragma onarýmý yapýlýr. Torakotomide tek akciðer ventilasyonu ile ameliyat edilen taraftaki akciðer kollabe edilir. Bu durum cerrahýn iþini kolaylaþtýrýrken anestezi uygulamasýný zorlaþtýrmaktadýr. Obstrüktif uyku apne sendromu (OUAS); uyku sýrasýnda üst hava yolunda kýsmi ya da tam obstrüksiyon sonucu apne ve hipoapne ataklarýnýn görüldüðü bir hastalýktýr. Obstrüktif uyku apne sendromlu olgularda anestezi uygulamasý; ventilasyon ve entübasyonun güç olmasý ayrýca ameliyat sonrasý dönemde solunum problemleri görülebilmesi gibi özellikleri içermektedir. Biz bu olgu sunumunda geçirdiði travmadan bir yýl sonra TDH tanýsý konulan OUAS’li 46 yaþýnda erkek hastanýn anestezi uygulamasýnda karþýlaþtýðýmýz önemli konularý literatür eþliðinde tartýþmayý amaçladýk.

Anahtar Kelimeler: Anestezi, obstrüktif uyku apne sendromu, travmatik diyafragma hernisi.

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Anesthesia in a Patient with Diaphragmatic Hernia and Obstructive Sleep Apnea: Case Report

Feriha Temizel¹, Tamer Kuzucuoðlu¹, Gülten Arslan¹, Serkan Uçkun¹, Banu Eler Çevik¹, Recep Demirhan^2
1Department of Anesthesiology and Reanimation, Health Science University, Kartal Dr. Lütfi Kýrdar Kartal Training and Research Hospital, Ýstanbul, Turkey
²Department of Thoracic Surgery, Health Science University, Kartal Dr. Lütfi Kýrdar Kartal Training and Research Hospital, Ýstanbul, Turkey

Traumatic diaphragmatic hernia (TDH) is a serious, frequently overlooked complication observed secondary to a thoracoabdominal trauma. The treatment of TDH is surgical and diaphragmatic repair, usually performed with a thoracotomy approach. During a thoracotomy, the lung on the operation side is collapsed and single-lung ventilation is employed. This procedure facilitates the work of the surgeon; however, it makes the administration of anesthesia more difficult. Obstructive sleep apnea (OSA) is a disorder characterized by attacks of apnea and hypopnea due to partial or complete obstruction of the upper respiratory tract during sleep. Administration of anesthesia to patients with OSA involves several difficulties with respect to ventilation and intubation, as well as potential respiratory complications during the postoperative period. In this case report, critical issues faced during the administration of anesthesia to a 46-year-old male patient with OSA who was diagnosed with TDH 1 year after a trauma were discussed in the context of the literature.

Keywords: Anesthesia, obstructive sleep apnea; traumatic diaphragmatic hernia.

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