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[The Harrington scoliosis operation: the anesthesiological problems in the perioperative phase]
1Klinikum Lindenhof, Mannheim, Germany.
Abstract:
85 histories of scoliosis patients who had the operation with Harrington rod instrumentation were analysed retrospectively in order to reveal perioperative anaesthesiological problems. The cardiovascular and pulmonary alterations represented in addition to the length and the area involved eo ipso was a risk during narcosis. The neurolept analgesia in combination with inhalation anaesthetics after introduction with a barbiturate proved to be a safe procedure. The tachycardia turned out to be the main cardiovascular postoperative complication, which also characterised the situation after one week. In contrast, the blood pressure remained relatively stable. The average blood loss of 1.75 l was responsible for a postoperative anaemia, whilst serious depletions of hemoglobin below 8 mg% could be corrected immediately. Temperatures above 40 degrees C were not noticed. There was no indication for renal damage. The electrolytes did not show serious imbalances in comparison with the extreme fluid fluctuations. The blood gas analysis spoke for a bias to partially compensated respiratory alkalosis during the operation and acidosis postoperatively. The vital capacity was improved significantly by preoperative training. Depressed values of the vital capacity were still measured one week after spondylodesis. In conclusion, the results showed that moderate tachycardia was the most frequent complication of the Harrington operation. The Harrington procedure was a safe therapeutical option.