İlker Öngüç AYCAN, Aysun YILBAŞ ANKAY, Turgay ÖCAL, Saadet ÖZGEN, Özgür CANBAY, Şennur UZUN

Successful use of ketamin combined with remifentanil in two patients with epidermolysis bullosa

Epidermolizis bülloza (EB) aşırı hassas cildin oluşu ve ciltte ağrılı sıvı kabarcıkları oluşumuyla karakterizedir. Epidermolizis büllozalı 15 yaşında ikiz kız kardeşlerin sindaktili operasyonu sırasındaki anestetik yaklaşımımızı sunuyoruz. Premedikasyon 0.5 mg/kg nasal midazolam ile yapıldı. Yüz maskesi cilde temas ettirilmeden anestezi indüksiyonu sevofluran ile yapıldı. İntravenöz 2 mg/kg ketamine and 50 μg fentanyl veridikten sonra, intravenöz 1 mg/kg/st ketamine and 0.1 μg/kg/dk remifentanil ile anestezi idamesi yapıldı. Postoperatif ağrı kontrolü için 2 mg intravenöz morfin uygulandı. Remifentanil ile ketamin EB nın genel anestezi ve analjezi uygulaması için pratik bir yol ve hava yolu yönetiminde etkili, basit ve güvenli olarak gözükmektedir.

Epidermolizis büllozalı iki hastada remifentanil ile ketaminin birlikte başarılı kullanımı

Epidermolysis Bullosa (EB) is characterized by the presence of extremely fragile skin and painful blister formations in the skin. We present the anesthetic management of 15-years-old, twin sisters with EB during the syndactyly operation. Premedication was done with 0.5 mg/kg nasal midazolam. Anesthesia induction was performed with sevoflurane without touching the facial masks to the skin. After intravenous 2 mg/kg ketamine and 50 μg fentanyl, anesthesia was maintained by intravenous 1 mg/kg/hr ketamine and 0.1 μg/kg/min remifentanil. We injected 2 mg intravenous morphine for postoperative pain control. Ketamine with remifentanil seems to be effective, simple, and safe for airway management and practical way to provide general anesthesia and analgesia of EB.

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