MENEKŞE OKŞAR, Orhan KANBAK

Fatal anaphylactic response to intramuscular diclofenac for postoperative analgesia

Kanıta dayalı klinik uygulamalara ilişkin kılavuzlarda, nonsteroidal antiinflamatuar ilaçlar (NSAII), perioperatif ağrı kontrolü için, kontrendike olmadıkça tüm hastalara önerilmektedir. Bu ilaçlar yaygın olarak postoperatif analjezi için yalnız veya opioidlerle veya lokal anestetiklerle kombine olarak kullanılmaktadır. Multimodal yaklaşımın bir parçası olarak, NSAII' lar ağrı skorlarını ve opioide bağlı yan etkileri azaltabilir (1); bununla beraber, anaflaksi gibi şiddetli yan etkiler meydana getirebilirler (2). Biz bu makalede postoperatif analjezi için intramuskuler diklofenak enjeksiyonunu takiben serebellar iskemi gelişen ölümcül bir anaflaksi vakasını sunuyoruz.

Postoperatif analjezi amacıyla uygulanan intramuskuler diklofenak'a bağlı fatal anaflatik reaksiyon

In evidence-based, clinical practice guidelines, non-steroidal anti-inflammatory drugs (NSAIDs), unless contraindicated, are recommended for perioperative acute pain control for all patients. They are commonly used for postoperative analgesia alone or in combination with opioids or local anesthetics. As part of a multimodal approach, NSAIDs can reduce pain scores and reduce opioid-related side effects (1); however, they may have serious adverse effects such as anaphylaxis (2). In this manuscript, we report an anaphylaxis case that developed cerebellar ischemia and death after im diclophenac injection for postoperative analgesia.

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