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LETTER TO EDITOR
Year : 2002  |  Volume : 50  |  Issue : 2  |  Page : 160

Problem of positioning in a patient with spinal deformities undergoing eye surgery



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S Saini


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PMID: 12194579

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How to cite this article:
Saini S, Malhotra N, Bolia S. Problem of positioning in a patient with spinal deformities undergoing eye surgery. Indian J Ophthalmol 2002;50:160

How to cite this URL:
Saini S, Malhotra N, Bolia S. Problem of positioning in a patient with spinal deformities undergoing eye surgery. Indian J Ophthalmol [serial online] 2002 [cited 2020 Jul 10];50:160. Available from: http://www.ijo.in/text.asp?2002/50/2/160/14798

A 65-year-old male was scheduled for cataract surgery under local anaesthesia with monitored anaesthesia care. He was a known case of thoraco-lumbar scoliosis, ankylosing spondylitis, osteoarthritis, diabetes mellitus and hypertension. The latter two were adequately controlled with treatment. His head and neck posture was fixed in flexion due to ankylosing spondylitis and his neck movements were grossly restricted (Figure 1). He could not lie supine because of scoliosis. In the operating room, the patient was placed in an unconventional position (Figure 2). Instead of the conventional operating table, he was placed over a bench with additional pillows and blankets under the neck and back. A footrest was placed under the legs, as the extension at bilateral knee joints was limited due to osteoarthritis. He was comfortable and relaxed in this position. A still surgical field was provided to the satisfaction of the operating surgeon.

Apart from adequate control of physiological derangements due to hypertension1, diabetes2 and scoliosis,3 an important concern is the proper positioning of the patient on the operating table for the particular surgical procedure.4 The role of sedation is controversial because of difficult airway and an unusual patient positioning.

In addition to various physiological and pathological derangements in elderly patients, proper positioning of the patient for the surgical procedure can at times be more challenging.This needs innovation so as to comfortably complete the necessary surgery[1],[2],[3],[4].

 
  References Top

1.
Stoelting RK, Dierdorf SF. Anesthesia and Co-Existing Diseases. 3rd ed. New York : Churchill Livingstone; 1993. pp 79-86.  Back to cited text no. 1
    
2.
Wilkey AD, Cooper GM. Perioperative management of diabetes. In : Roberts CP, Brown BR, editors. International Practice of Anaesthesia. Oxford : Butterworth - Heinemann; 1996. vol 1, pp 801-10.  Back to cited text no. 2
    
3.
Kafer ER. Respiratory and cardiovascular functions in scoliosis and the principles of anesthetic management. Anesthesiology 1980;52:339-51.  Back to cited text no. 3
[PUBMED]    
4.
Cucchiara RF, Faust RJ. Patient positioning. In : Miller RD, editor. Anesthesia. New York : Churchill Livingstone; 1994. vol 4, pp 1057-74.  Back to cited text no. 4
    




 

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