Suprainguinal Fasya İliaka ve Anterior Siyatik Sinir Bloklarının Kombinasyonuyla Yüksek Riskli Alt Ekstremite Amputasyonunda Anestezi Yönetimi
Özet
Alt üriner sistem obstrüksiyonu tanısı konulan 18 haftalık fetus için, gebeliğin 18. haftasında vezikoamniyotik şant (VAŞ) yerleştirilmesi planlanan 32 yaşındaki, Tip 1 Diabetes Mellitus tanılı gebe hastaya genel anestezi altında işlem uygulandı. Anestezi indüksiyonu hızlı ardışık teknikle gerçekleştirildi; Sevofluran ile uteroplasental perfüzyon korunarak yeterli anestezi derinliği sağlandı. Fetal hareketsizliğin temini ve analjezi gerekliliği göz önünde bulundurularak multidisipliner ekip eşliğinde genel anestezi tercih edildi. Cerrahi girişim 40 dakika sürdü, operasyon boyunca maternal ve fetal parametreler stabil izlendi. Postoperatif dönemde hasta sorunsuz şekilde izlenip obstetri servisine transfer edildi. Bu olgu, minimal invaziv fetal cerrahilerde maternal ve fetal hemodinaminin eş zamanlı yönetildiği, genel anestezi altında başarıyla uygulanan bir VAŞ örneği sunmaktadır.
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