Principles of Anesthetic Management in patients with  Congenital Kyphoscoliosis undergoing Laparotomy

Dr. Harshad C. Dongare; Dr. Khalid I. Khatib; Dr. Ajit S. Baviskar

Volume : III, Issue : IX, September - 2013

Principles of Anesthetic Management in patients with Congenital Kyphoscoliosis undergoing Laparotomy

Dr. Harshad C. Dongare, Dr. Khalid I. Khatib, Dr. Ajit S. Baviskar

Abstract :

Kyphoscoliosis refers to lateral and posterior curvature of the spine due to which verteae are rotated and rib cage is deformed. This results in lack of normal flexibility of the spine. Kyphoscoliosis and the resultant deformity leads to significant decrease in Total Lung Volume (left>right), Vital Capacity, and Forced Expiratory Volume in 1st second (FEV1). There is permanent damage to lung parenchyma, increased pulmonary vascular resistance, and pulmonary hypertension. This ultimately leads to right ventricular failure. Kyphoscoliosis presents a challenge for anaesthetic management as the curvature of the spine and the resultant pulmonary changes pose a difficulty. We present a case of young male suffering from congenital kyphoscoliosis with superior mesenteric artery occlusion causing bowel gangrene; that was posted for exploratory laparotomy. Resection and anastomosis of the intestine was done. Preoperative assessment of kyphoscoliosis and anesthetic management of the patient are discussed.