Canan BALCI, H. Selim KARABEKİR, Ercan GÜRSES, R. Gül SIVACI, Hülya SUNGURTEKİN

HELLP sendromunda rejyonal anestezi uygulaması

Amaç: HELLP (Hemolysis, Elevated Liver Enzymes, Low Platelet Count) Sendromlu hastalara obstetrik anestezi uygulamalarında spinal anestezinin güvenle uygulanabileceği bir olgu sunumu ile tartışılması amaçlandı. Olgu sunumu: 22 yaşında, 70 kg ve 23. gebelik haftasında olan, HELLP Sendromu tanısı konan hastaya acil sezaryen cerrahisi için tek doz spinal anestezi uygulandı. Sonuç: Trombositleri sınırda ve koagülopatisi olmayan HELLP sendromlu hastalara spinal anestezinin güvenle uygulanabileceğini düşünüyoruz.

Anahtar Kelimeler:

HELLP sendromu, Anestezi, obstetrik, Anestezi, spinal, Trombositopeni, Erişkin, Kadın

Application of regional anesthesia in HELLP syndrome

Objective: In obstetric anesthesia applications use of spinal anesthesia safely for patients who have HELLP (Hemolysis, Elevated Liver Enzymes, Low Platelate Count) syndrome was aimed to discusse with a case report. Case report: One dose spinal anesthesia applicated to patient whom 22 year-old, 70 kg and 23rd gestational week with diagnosis of HELLP syndrome. Result: We conclude that we can apply spinal anesthesia safely if HELLP syndrome patients do not have coagulopathy and have border trombocyte count.

Keywords:

HELLP Syndrome, Anesthesia, Obstetrical, Anesthesia, Spinal, Thrombocytopenia, Adult, Female,

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1. Haram K, Bjørge L, Guttu K. HELLP syndrome. Tidsskr Nor Laegeforen 2000;120:1433-6.
2. Kathula S, Bolla S, Magann E. HELLP syndrome leading to a diagnosis of pregnancy. South Med 2002; 95:934-5.
3. Bhagwanjee S, Paruk F, Moodley J. Intensive care unit morbidity and mortality from eclampsia: An evaluation of the acute physiology and chronic health evaluation II score and the Glasgow coma scale score. Crit Care Med 2000;28:120-4.
4. Lindheimer M, Grunfeld J, Davison J. Renal disorders. In Barron W, Lindheimer M, Davison J, eds. Medical disorders during pregnancy. 3rd ed. St. Louis, Mosby; 2000:39-70.
5. Sibai B, Ramadan M. Acute renal failure in pregnancies complicated by hemolysis, elevated liver enzymes, and low platelets. Am J Obstet Gynecol 1993;168:1682-90.
_____ı >6. Rath W, Faridi A, Dudenhausen JW. HELLP syndrome_____ı >. J Perinat Med_____ı > 2000;28:249-60._____ı >
7. Wolf G, Wenzel U, Stahl RA, Hüneke B. Hypertensive disorders in pregnancy_____ı >. Med Klin 2001;96: 8-86.
8. Calderon EG, Khawar S, Cunningham JA, Russell LD, Alpert MA. Pulmonary artery thrombus and subcapsular liver hematoma in a patient with HELLP syndrome: A therapeutic conundrum. Am J Med Sci 2002;323:151-4.
9. Miyamoto N, Kawamata M, Okanuma M, Kawana S, Namiki. Obstetrical anesthesia for parturient patients with HELLP syndrome. Masui_____ı > 2002;5:968-72.
10. O'Brien JM, Shumate SA, Satchwell SL. Maternal benefit of corticosteroid therapy in patients with HELLP (hemolysis, elevated liver enzymes, and low platelet count) syndrome: Impact on the rate of regional anesthesia. Am J Obstet Gynecol 2002;186:507-22.
11. Santos A.Spinal anesthesia in severely preeclamptic women: When is it safe? Anesthesiology 1999;90:1252-4.
12. Wallace DH, Leveno KJ, Cunningham FG. Randomized comparison of general and regional anesthesia for cesarean delivery in pregnancies complicated by severe preeclampsia. Obstet Gynecol 1995;86:193-9.
13. Mallampati SR, Gatt SP, Gugino LD. A clinical sign to predict difficult tracheal intubation: A prospective study. Canadian Anaesthetic Society J 1985;32:429-34.
14. Ramanathan J, Bennett K. Pre-eclampsia: fluids, drugs, and anesthetic management. Anesthesiol Clin North America 2003;21:145-63.
15. Varon J, Marik PE. The diagnosis and management of hypertensive crises. Chest 2000;118:564-9.
16. Ezri T, Abouleish E, Lee C, Evron S. Intracranial subdural hematoma following dural puncture in a parturient with HELLP syndrome. Can J Anaesth 2002;49:820-3.
17. Afessa B, Green B, Delke I. Systemic inflammatory response syndrome, organ failure, and outcome in critically ill obstetric patients treated in an ICU. Chest 2001; 120:1271-7.
18. Mabie WC, Sibai RM. Treatment in an obstetric intensive care unit. Am J Obstet Gynecol 1990;162:1-4.