Bir Laringeal Maske Airway Komplikasyonu; Tonsil Lojunda Kanama ve Yönetimi
Özet
Sağ meme karsinomu tanısı olan 61 yaşındaki kadın hastaya; sağ meme koruyucu cerrahi ve lenf nodu diseksiyonu operasyonu planlandı. Genel anestezi indüksiyonundan sonra laringeal maske airway (LMA) yerleştirilmeye çalışıldı. İki denemeden sonra ilerletilemediği için, hastaya endotrakeal entübasyon yapıldı. Operasyon bittikten sonra, derlenmeye alınan hastada hemoptizi izlendi ve bu durum 20-30 dk devam etti. Hasta Kulak Burun Boğaz Kliniğine konsülte edildi. Dil kökünden kanama geldiği, kanama yerinin tespiti ve gerekirse koterizasyonu için direk laringoskopi yapılması planlandı. Yapılan mikrolaringosurgery (MLS) de; sol tonsil lojundan dil köküne uzanan abrazyon alanı izlendi. Elektrokoterizasyon ile kanama kontrol altına alındı. Supraglottik airway (SGA)’e bağlı komplikasyonlar arasında kanama komplikasyonu nadir olmakla birlikte çoğu zaman müdahale etmeye gerek kalmaz. Bununla birlikte, LMA’nın yerleştirilemediği veya zor ilerletildiği hastalarda daha ciddi mukozal yaralanmalar gelişebileceği ve cerrahi müdahale gerekebileceği gözönünde bulundurulmalıdır.
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