Prematüre retinopatisi ve anestezik yaklaşım

Prematüre ve düşük doğum ağırlıklı bebeklerin hastalığı olan prematüre retinopatisi (ROP), doğum ağırlığı 1000 gr'ın altındaki bebeklerin yaklaşık %70'inde, 1500 gr'ın altındaki bebeklerin yaklaşık %25-35'inde görülür. Özellikle 24-26 haftalık bebeklerde ROP oranı %80'lere çıkmaktadır. Artan yaşam oranları ile birlikte prematürelerde retinopati sıklığı artmıştır. Önceleri sadece oksijen tedavisi sorumlu tutulmuştur, ancak hiç oksijen tedavisi almayan prematürelerde bile görülmesi esas olarak retinal immatüritenin sorumlu olduğunu düşündürmektedir. ROP vakalarının önlenmesi için seri oftalmolojik muayeneler yapılmalıdır. Evre III plus hastalık saptanırsa 72 saat içinde tedavi uygulanmalıdır. Tedavide indirekt laser fotokoagülasyonu ya da krioterapi kullanılmaktadır. Hem tedavi hem de muayene işlemleri sırasında prematüre bebekler analjezi ve anesteziye ihtiyaç duyarlar. Küçük prematüre bebeklerde, ROP muayenesi sırasında kardiyovasküler arrest, oksijen desatürasyonu, ciddi bradikardi ve apne gibi hayatı tehdit edici potansiyel olaylar nadir de olsa meydana gelebilir. Bu işlemler sırasında seçilecek anestezi yöntemleri ve ilaçları merkezlere göre farklar göstermektedir. Seçimlerin üstünlüğünü koşullar ve deneyim belirlemektedir.

Anahtar Kelimeler:

Süt çocuğu, düşük doğum ağırlıklı, Süt çocuğu, prematür, hastalıklar, Oksijen inhalasyon tedavisi, Prematüre retinopatisi, Risk faktörleri, Anestezi

Anesthetic management for premature retinopathy

Premature retinopathy, a disease of premature and low birth weight babies, is seen in 70% of babies whose weight is less than 1000 gr and aproximately 25-30% of babies whose weight is less than 1500 gr. Especially in 24-26 weeks old &âbies, ROP incidence reaches almost 80%. Due to increasing survival rates, the frequency of retinopathy in prematures is increased. Formerly, only oxygen treatment was thought to be responsible for premature retinopathy, but the fact that it can be seen in babies without a history of oxygen treatment, makes us think that retinal immaturity may also be responsible for it. Cryotherapy must be performed within 72 hours if Grade III plus disease is diagnosed. Indirect Laser Phototherapy is being used by some authors. Both in treatment and examination, premature babies need analgesia as well anesthesia. Potential complications that can lead to mortality such as cardiyovascular arrest, oxygen desaturation, serious bradycardia, and apnea are observed very infrequently during premature retinopathy examination. Anesthesia techniques and drugs used during these interventions differ according to institution. The conditions and experiences determine the superiority of preferences.

Keywords:

Infant, Low Birth Weight, Infant, Premature, Diseases, Oxygen Inhalation Therapy, Retinopathy of Prematurity, Risk Factors, Anesthesia,

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