Intravenous general anesthesia in the prone position for a patient with a stab wound

Abstract

The position of the patient has an important role in facilitating the development of a surgical intervention. In the case of patients with a stab, the wound can limit the possibilities while positioning the patient. We present the anesthesiology management of a woman who underwent emergency surgical treatment for having a stab wound in the gluteal region. The patient was a 22-year-old white woman with a past medical history of hypertension under treatment, who was taken to the emergency department with a stab wound in the left gluteal region, after being attacked with a knife, still present in that region. She had a moderate pain, and was lying on a stretcher in the prone position, with a mild bleeding and an adequate movement of the left lower limb. Emergency surgical treatment was decided. Intravenous general anesthesia was used to perform the surgical procedure, supported by face mask oxygen. During the operation the patient remained with a cardiorespiratory stability. The surgical time lasted 35 minutes, the final bleeding was 100 ml and the fluid reposition with a physiological salt solution. After the operation the patient was placed in the supine position, the effects of benzodiazepine were reverted to normal and the patient went out of the operating room with ten stitches in the Alderete score. At the second day after operation she was discharged without complications. The case shows that sometimes it is possible to use safe and effective intravenous general anesthesia in a patient in the prone position with a facial mask.