Sevofluran ve malign hipertermi: Geciken dantrolen tedavisi

Malign hipertermi (MH), çoğunlukla anestezi ile ilişkili olan, volatil anestezikler ve depolarizan kas gevşeticilerle tetiklenen, hipertermi, taşikardi, asidoz ve kas rijiditesi ile karakterize bir durumdur. Bu olguda, serebral palsi nedeniyle alt extremite spastisitesinin tedavisi için ameliyat edilecek 5 yaşındaki kız çocuğu sunulmaktadır. Sevoşuran ile yapılan maske indüksiyonundan 60 dakika sonra MH’den şüphelendiren semptomlar görülmüş ve hasta ancak 36 saat sonra temin edilebilen dantrolen ile tedavi edilerek sekelsiz iyileşmiştir. Malign hiperterminin klinik belirtilerinden şüphelenilmesinin hızlı tanı ve tedaviye olanak sağlayacağı kanaatindeyiz. özellikle ülkemizdeki anestezi kliniklerinde, dantrolenin ulaşılabilir olmasının önemi belirtilmek istenmiştir.

Sevoflurane and malignant hyperthermia: Delayed dantrolene treatment

Malignant hyperthermia (MH) is almost associated with anesthesia, triggered by volatile anesthetics, depolarizing neuromuscular blockers and is characterized by hyperthermia, tachycardia, acidosis and muscle rigidity. In this case report, we present a five-year-old girl who was operated for treatment approaches for lower extremity spasticity in cerebral palsy. After sixty minutes of anesthesia induction with only sevoflurane via facemask, symptoms of suspicious malignant hyperthermia was seen in the patient and she was treated with dantrolene that was found thirty-six hours later the acute crisis and she recovered without sequel. We think that suspecting clinical signs of malignant hyperthermia would allow fast diagnosis and treatment. Here, we want to mention the importance of dantrolene availability in the anesthesia clinics especially in our country.

Kaynakça

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