Features of surgical treatment and anesthesiological support of a patient with Bekhterev’s disease

Rationale. In clinical observation, attention is drawn to solving problems of difficult airways, performing prolonged epidural anesthesia at the thoracic level in the treatment of a surgical oncological patient with Bekhterev’s disease (ankylosing spondylitis). Purpose. Present the clinical observation of anesthesiological support and surgical and surgical treatment of an oncological patient with Bekhterev’s disease (ankylosing spondylitis). Methods. A clinical observation of the peculiarities of surgical treatment and anesthesiological support of a patient with Bekhterev’s disease is presented. Results. The peculiarities of this observation were the difficulties of access to the respiratory tract, which required a tracheostomy, the patient with Bekhterev’s disease to undergo epidural anesthesia at the thoracic level and the difficulties of surgical access due to severe spinal deformity and the patient’s forced position on the operating table. Despite the onset of pneumothorax for the first day after surgery associated with the technical difficulties of applying a tracheostoma, perioperative anesthetic support for a technically complex traumatic operation made it possible to discharge the patient on the 10th day after surgery. Conclusion. Taking into account the peculiarities of the presented information, the following conditions and requirements must be met. Implement in full clinical recommendations, in particular, “Ensuring the patency of the upper respiratory tract in the hospital.” Protect the patient from surgical stress in traumatic surgeries with combined anesthesia. Constantly update and maintain the material and technical support of the anesthesiological, resuscitation and surgical service (including the availability of tracheostomy cannulas of various sizes). In particular, among the existing problems, the need to implement monitoring of the neuromuscular unit should be noted. It is necessary to coordinate the coordination of the work of the anesthesiological and operational team (the presence of the surgical team in the operating room before the start of anesthesia is necessary). Promptly identify and appropriately treat the developed critical incidents and complications (for example, pneumothorax), effectively carry out medical and diagnostic measures in the perioperative period (choose the optimal individual anesthesiological support).