MASSIVE BLEEDING DURING SPINE SURGERY IN A PATIENT WITH ANKYLOSING-SPONDYLITIS

Citation
Je. Tetzlaff et al., MASSIVE BLEEDING DURING SPINE SURGERY IN A PATIENT WITH ANKYLOSING-SPONDYLITIS, Canadian journal of anaesthesia, 45(9), 1998, pp. 903-906
Citations number
14
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Anesthesiology
ISSN journal
0832-610X
Volume
45
Issue
9
Year of publication
1998
Pages
903 - 906
Database
ISI
SICI code
0832-610X(1998)45:9<903:MBDSSI>2.0.ZU;2-H
Abstract
Purpose: Ankylosing spondylitis is associated with pathophysiology tha t has important anaesthetic implications, We report a case where the s equelae of ankylosing spondylitis may have been responsible for massiv e bleeding during emergency spine surgery. Clinical Features: A 69 yr old man with long standing ankylosing spondylitis sustained a complex fracture of the lumbar spine in a fail, and was scheduled for stabiliz ation of the spine. Under general anaesthesia, prone positioning was d ifficult because of the extreme spinal deformity. During exploration, dilatation of epidural veins was encountered and sustained haemorrhage was encountered throughout the surgical procedure. Estimated blood lo ss was 17,000 ml which was replaced with 31 units of packed red blood cells, 3200 ml of salvaged blood, 18 units of fresh frozen plasma, 26 units of platelets, 1,000 ml of albumin and 9,000 ml of crystalloid. C onclusions: Extreme deformity of the spine led to positioning difficul ties that may have contributed to massive blood loss during complex sp ine surgery. Difficulties with placement in the prone position in-pati ents with advanced ankylosing spondylitis should be anticipated.