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Case 45 - Complexspine surgery for a Jehovah's Witness

from Section I - Neuroanesthesia

Published online by Cambridge University Press:  03 May 2011

By
Matthew Martin  and
Vijay Tarnal
Edited by
George A. Mashour  and
Ehab Farag
George A. Mashour
Affiliation:
University of Michigan
Ehab Farag
Affiliation:
Cleveland Clinic
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Summary

Jehovah's Witness (JW) is an evangelical Christian denomination best known to physicians for beliefs regarding the refusal of all blood product transfusions. This chapter presents a case study of a 54-year-old female with a history of obstructive sleep apnea, hyperlipidemia, and scoliosis who presented for T10-L5 posterior spinal fusion. The arterial blood gas analysis was used not only to assess respiratory and metabolic state but also the hematocrit. The antifibrinolytic drug aminocaproic acid was infused during the case to reduce blood loss. Erythropoietin is a blood-stimulating hormone normally synthesized in the kidney that stimulates red blood cell production in the bone marrow. While complex spine procedures in the JW patient may be challenging, successful outcomes can be achieved. With active preoperative assessment, communication, blood conservation strategies, proper positioning and meticulous surgical and anesthetic technique, complex spine surgeries are possible in the JW population.

Keywords

intraoperative painintraoperative seizurefrontal brain tumorcortical stimulationepilepsy surgery
Type
Chapter
Information
Case Studies in Neuroanesthesia and Neurocritical Care , pp. 146 - 148
Publisher: Cambridge University Press
Print publication year: 2011

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