Mehmet İlke BÜGET, İLKER EREN, Süleyman KÜÇÜKAY

Regional anaesthesia in a Duchenne muscular dystrophy patient for upper extremity amputation

Duchenne musküler distrofisi, (DMD) nöromusküler hastalıklar arasında en sık görülen rahatsızlıktır. Ciddi kardiyak rahatsızlık- lar, yüksek rabdomyoliz gelişme ihtimali ve genel anestezinin hayati risk olasılığı yüksek komplikasyonlarıyla, DMD, anestezistler için genellikle sıkıntı oluşturmaktadır. Genel anesteziyle ilşkili muhtemel morbiditeden kaçınmak için hastamızda supraklaviküler blok uyguladık. Bu raporda, masi f rabdomyosarkomu olan ve amputasyon endikasyonu mecut olan, 17 yaşındaki Duchenneli bir hastayı sunmayı amaçladık. Ameliyat sonrası dönemde, kısa süre içinde geçen, malign hipertermi benzeri bir reaksiyon gelişimini tespit ettik. Biz ortopedik cerrahi geçirecek DMDli hastalarda genel anesteziye güvenli bir alternati f olarak rejyonel anestezi uygu- lamalarını önermekteyiz.

Duchenne musküler distrofili hastada üst ekstremite amputasyonu için bölgesel anestezi

Duchenne muscular dystrophy (DMD) is the most common of the neuromuscular disorders. DMD is usually a challenge for the anaesthesiologist, with poor cardiac function, a high risk of developing rhabdomyolysis, and the probable life-threatening complications of general anaesthesia. To avoid possible morbidity associated with general anaesthesia, we applied a supracla- vicular blockade. In this report, we present a 17-year-old DMD patient with a massive rhabdomyosarcoma, for whom a left arm amputation was indicated. In the post-operative period, a malignant hyperthermia-like reaction occurred, which resolved in a short time. We suggest a regional blockade as a safer alternative to general anaesthesia for the management of high risk DMD patients during orthopedic procedures

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