Abstract

RIVERA DIAZ, Roberto Carlo; LONDONO, Wilson; GONZALEZ OBREGON, María Patricia  and  CIFUENTES HOYOS, Valentina. Anesthesia and severe idiopathic scoliosis correction in Jehova witness patients. Case revision article. Rev. colomb. anestesiol. [online]. 2012, vol.40, n.4, pp.323-331. ISSN 0120-3347.  https://doi.org/10.1016/j.rca.2012.04.002.

Scoliosis is a complex, three dimension rotational deformity that involves the column in a sagittal, coronal and axial planes. It may be congenital, neuromuscular or idiopathic. The main symptom in 90% of cases is back pain, and initial management is fairly conservative. However, it may be severe enough as to cause other symptoms, neurologic deficit or necessity of surgical intervention. In such cases, surgery implies a great risk because of the complications that have been reported, including severe bleeding and nervous injury. Rigorous preoperative assessment is mandatory, as well as intraoperative planning aimed at complication risk reduction. Patients may also have comorbidities that increase risks or religious beliefs that forbid blood component transfusions, further complicating patient management. The present article is a revision of scientific literature on major column surgery in Jehova witness patients, emphasizing blood optimization techniques. This research was carried out because of a case of severe idiopathic scoliosis with severe pulmonary compromise in the past year and functional class detriment in a Jehova witness. The patient underwent corrective surgery at Clínica CES in the city of Medellín (Colombia), which achieved a positive clinical outcome with no blood component transfusion.

Keywords : Scoliosis; Blood transfution; Hemodilution; Erythropoietin.

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