Halit ÖZKAYA, ABDULLAH BARIŞ AKCAN, Gökhan AYDEMİR, MERT AKBAŞ

Düşük doz meperidin uygulamasına bağlı konvulsiyon: Olgu sunumu

Meperidin pediatride çeşitli durumlarda kullanılan opoid analjeziktir. Meperidinin aktif metaboliti olan normeperidin merkezi sinir sistemi üzerine uyarıcı etkilidir. Meperidinin irritabilite, hiperrefleksi, tremor, miyoklonus ve nadiren konvülsif nöbete yol açabildiği literatürde yer almaktadır. Bu risk özellikle yüksek meperidin dozunda, hepatik enzimleri indükleyen ilaç kullanımında, böbrek yetersizliğinde ve nöbet eşiğini düşüren fenotiazinlerin kullanımı durumunda artmaktadır. Böbrek işlevi normal hastalarda meperidin kullanımına bağlı konvülsif nöbet literatürde nadir olarak bildirilmektedir. Femur kırığına bağlı şiddetli postoperatif ağrıları olan ve bu amaçla tedavide düşük doz meperidine kullanılan ve meperidine bağlı tonik-klonik konvülsif nöbet geçiren böbrek fonksiyonları normal 10 yaşındaki erkek hastayı sunmayı uygun bulduk.

Convulsion due to application of low dose meperidine: A case report

Meperidine is an opiod analgesic used in a variety of clinical situations. The active metabolite, normeperidine, is a central nervous system excitatory agent and has the ability to cause irritability, hyperreflexia, tremor, myoclonus and seizures. Previously identified risk factors for the development of meperidine-related seizures include renal failure, high meperidine dosages, and co-adminestration of hepatic enzyme inducing medications or phenothiazines which decreases seizure treshold. Patients with normal renal function rarely manifest seizure activity when given meperidine. Here we report a 10 year old boy with a femur fraction who had normal renal function. We used low dose meperidine due to post operative pains.

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