Yavuz DEMİRARAN, Ziya SALİHOĞLU, Şener DEMİROLUK, Saffet KARACA, Gazihan ÇAĞLAR

Feokromositoma operasyonunda supraventriküler taşikardi ile birlikte hipertansiyonda diltiazem kullanımı

Feokromositoma cerrahisinde anestezi uygulaması birçok potansiyel güçlük taşımaktadır. Tümör eksizyonu sırasında ameliyatta maniplasyonla açığa çıkan katekolaminlere bağlı oluşan hipertansiyon krizinin kontrolü bazen çok zor olabilmektedir. Hipertansiyonu kontrol etmek için nitrogliserin, nitroprussid infüzyonları, fentolamin, nikardipin, labetolol gibi farklı pek çok ilaç önerilmektedir. Diltiazem sık kullanılan bir kalsiyum antagonisti olup, diğer kalsiyum antagonistleri atriyoventriküler noda etki ederken, ditiazemin etkisi sinüs nodunadır.Olgumuzda supraventriküler taşikardi ile birlikte olan hipertansiyonda diltiazem infüzyonu uygulanarak, hipertansiyon basan ile kontrol altına alınmıştır.

Supraventricular tachycardia and uncontrolled hypertension during the pheochromocytoma surgery and use of diltiazem

Background and Design.- Anaesthesia management in pheochromocytoma surgery has many potentialproblems. It is hard to control the hypertension crises following the releasing of catecholamines during excision of tumour. Administration of nitroglycerin, nitroprusside, phentholamine, nicardipine, labetolol and such drugs are suggested for controlling hypertension. Diltiazem is a commonly used calcium antagonist and shows its effect on the sinus node, while other calcium antagonists show their effect on atrioventriculer node. It is especially advised to use for hypertension associated with the supraventriculer tachycardia. In our case, we applied to manage the hypertension and supraventriculer tacycardia with diltiazem infusion, and it was been controlled successfully.

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