Mehlika P. BESLER, Melek ÇELİK, Nükhet BİLGİNER, Turgay KEPÇE

Gerçek hermafroditli bir hastada değişen atrakuryum gereksinimi (Olgu sunumu)

Unusual dosage need of atracurium in a real hermaphroditismus patient (Case report)

In this case report; atracurium besylate's time to onset and duration differentiations were emphasized in a 15 years old and phenotypically male case of whom had two surgical operations under general anaesthesia to define the clinical diagnosis. On the first operation, atracurium's time to onset and duration were found to be prolonged clinically. The same nondepolarizing agent was given under TOF monitorization on the second operation; TO was 180 sec., and T25 returned back after 60 min. Finally, especially in the cases of sexual differentiation, difficulties should be kept in mind that muscle relaxant's effects might be changed; and neuromuscular monitorization should not be neglected.

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1. Cooper R, Mirakhur RK, Clarke RSJ, Boules J: Comparison of intubating conditions after administration of ORG 9426 (rocuronium) and suxamethonium. Br J Anaesth 1992; 69:463.
2. Migeon CJ, Berkovitz GD, Brown TR, editors: The diagnosis and treatment of endocrine disorders in childhood and adolescence. 4th ed, Springfield Illinois: Charles C Thomas Publisher;1997; p.628.
3. Fechner R: Report of a kindred with x-linked (or autosomal dominant sex limited) 46 XY partial gonadal dysgenesis. J Clin Endocrinol Metab 1993a; 76:1248.
4. Robinson BJ, Lee E, Rees D, Purdie GL, Galletly DC: Betamethasone-induced resistance to neuromuscular blockade: a comparison of atracurium and vecuronium in vitro. Anesth Analg 1992; 74(5):762.
5. Luleci N, Akturk G, Kalac N: Resistance to atracurium: Wegener’s granulomatosis-a case report: Middle East J Anesthesiol 1994; 12(5):511.
6. Rimaniol JM, Dhonneur G, Sperry L, Duvaldestin P: A comparison of the neuromuscular blocking effects of atracurium, mivacurium, and vecuronium on the adductor pollicis and the orbicularis oculi muscle in humans. Anesth Analg 1996; 83:808.
7. Ferres CJ, Crean PM, Mirakhur RK: An evaluation of ORG NC 45 (vecuronium) in paediatric anaesthesia. Anaesthesia 1983; 38:943.
8. Knuttgen D, Jahn M, Zeidler D, Doehn M: Atracurium during thoracic surgery: impaired efficiency in septic processes. J Cardiothorac Vasc Anesth 1999; 13(1):26.
9. Türköz A, Ersoy A: Testiküler feminizasyonda vekuronyum rezistansı (Olgu sunumu). TARK 98 Özet Kitabı, Antalya 1998; 221:96.
10. McCoy EP, Mirakhur RK, Connolly FM, Loan PB: The influence of the duration of control stimulation on the onset and recovery of neuromuscular block. Anesth Analg 1995; 80(2):364.
11. Donati F: Onset of action of relaxants. Can J Anaesth 1988; 35:S52.
12. Harrison GA, Junius S: The effect of circulation time on the neuromuscular action of suxamethonium. Anaesth Intens Care 1972; 1:33.
13. Bevan JC, Donati F, Bevan DR: Attemped acceleration of the onset of pancuronium. Effect of divided doses in infants and children. Can J Anaesth 1987; 34:555.
14. Vallinthout LEH, Booij LHDJ, van Egmond J, Robertson EN: Effects of isoflurane and sevoflurane on the magnitude and time course of neuromuscular block produced by vecuronium, pancuronium and atracurium. Br J Anaesth 1996; 76(3):389.