Anesthetic implications for surgical correction of scoliosis.
Patients undergoing surgical correction of scoliosis present many challenges to anesthetists because of the pathophysiologic derangements caused by the disease and the demanding nature of the anesthetic care that is required. A thorough understanding of the pathophysiology of the disease, intraoperative concerns specific to the procedure, and the efficacy of various anesthetic management techniques is required by anesthetists to optimally care for patients undergoing surgical correction of scoliosis. This literature review focuses on key considerations for anesthetists, including common comorbidities in patients with scoliosis, the need for induced hypotension, large surgical blood loss, the need for transfusion of blood and blood products, possible autologous blood donation and acute normovolemic hemodilution, patient positioning, possible intraoperative wake-up testing to assess motor function, spinal cord monitoring, and hypothermia.
Gambrall
Melissa A
MA
University of Iowa, Department of Anesthesia, Iowa City, USA. Melissa-gambrall@uiowa.edu
D000758:Anesthesia / Q000009:adverse effects / Q000379:methods* / Q000451:nursing; D016063:Blood Loss, Surgical; D015897:Comorbidity; D019054:Evoked Potentials, Motor; D005073:Evoked Potentials, Somatosensory; D006801:Humans; D007022:Hypotension / Q000209:etiology / Q000517:prevention & control; D007035:Hypothermia / Q000209:etiology / Q000517:prevention & control; D008991:Monitoring, Physiologic / Q000379:methods / Q000451:nursing; D009719:Nurse Anesthetists; D010243:Paralysis / Q000209:etiology / Q000517:prevention & control; D018579:Patient Selection; D019990:Perioperative Care / Q000379:methods / Q000451:nursing; D011187:Posture; D012600:Scoliosis / Q000145:classification / Q000209:etiology / Q000601:surgery*; D013123:Spinal Fusion / Q000009:adverse effects / Q000379:methods / Q000451:nursing