Dermatomiyozitli Bir Olguda Anestezik Yaklaşım

Dermatomiyozitli Bir Olguda Anestezik Yaklaşım

Dermatomiyozit, simetrik, proksimal kas gruplarının güçsüzlüğü ve cildin kronik inflamasyonu ile karakterize progresif bir hastalıktır. Genel anestezi uygulanması gereken bu olgularda blok süresinin uzama riski nedeniyle daha az kas gevşetici ilaç kullanılmalı ve nöromüsküler monitörizasyon yapılmalıdır. Aynı zamanda aspirasyon pnömonisi, solunum kaslarının güçsüzlüğüne bağlı pulmoner komplikasyonların görülme sıklığı yüksektir. Bu olgu sunumunda intrakraniyal menengiom nedeniyle kraniyotomi yapılacak olan dermatomiyozitli bir hastada, tümörün frontal bölgede lokalize olması, kuvvet kaybının ve cerrahi sırasında motor fonksiyonların takibinin zorunlu olması nedeniyle uyanık kraniyotomi planlandı. Operasyon sırasında sadece remifentanil kullanılarak hasta takip edildi ve girişim problemsiz sonlandırıldı. Anesthetic management in a patient with dermatomyositis Dermatomyositis is a progressive disease associated with symmetrical weakness of proximal muscle groups and chronic inflammation of skin. Due to weakness of inspiratory muscles, aspiration pneumonia and incidence of pulmoner complications are high. In patients requiring general anesthesia less neuromuscular agents as well as neuromuscular monitorization should be used in order to decrease the risk of prolonged paralyses. In this case with dermatomyositis and intracranial menengioma, due to frontal localization of tumor and the necessity for evaluation of motor function during surgery, we planned awake craniotomy. Patient was followed with remifentanil infusion alone during operation and no complication occured during procedure.
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Journal of Experimental and Clinical Medicine-Cover
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 1980
  • Yayıncı: Ondokuz mayıs Üniversitesi Tıp Fakültesi