Anesthetic management of a patient with Bartter syndrome

Year 2012, , 449 - 451, 01.09.2012

Harun Aydoğan Tekin Bilgiç Mahmut Alp Karahan Şaban Yalçın

https://doi.org/10.5798/diclemedj.0921.2012.03.0179

Abstract

Bartter's syndrome is a rare disorder characterized by severe hypochloremic metabolic alkalosis, hypokalemia, hyponatremia, hyperaldosteronism, elevation in plasma renin activity and insensitivity to angiotensin II. Electrolyte imbalances such as hypomagnesemia, hyponatremia might make anesthetic management difficult in Bartter syndrome. A 4 years old patient underwent surgery for inguinal hernia with caudal anesthesia using bupivacaine 0.25%. In this case report, it was aimed to discuss the anesthetic management of a patient with Bartter syndrome.

Keywords

Regional anesthesia, Bartter syndrome, inguinal hernia surgery, pediatric anesthesia

Bartter sendromlu hastada anestezi yaklaşımı: Olgu sunumu

Abstract

Bartter Sendromu; ciddi hipokloremik metabolik alkaloz, hipokalemi, hiponatremi, hiperaldosteronizm, plazmada artmış renin aktivitesi, anjiotensin II\'ye karşı duyarsızlıkla karakterize nadir görülen bir hastalıktır. Bartter sendromlu hastalarda hipomagnezemi, hiponatremi gibi anestezik yaklaşımı zorlaştıracak elektrolit bozuklukları mevcuttur. İnguinal herni nedeniyle opere edilecek 4 yaşındaki hastaya %0,25 bupivakainle kaudal anestezi uygulandı. Bu olgu sunumunda Bartter sendromlu bir hastada anestezi yaklaşımının tartışılması amaçlandı.

Keywords

Rejyonel anestezi, Bartter Sendromu, inguinal herni ameliyatı, pediatrik anestezi

References

• Ledingham JGG. Disorders of potassium metabolism. In: WeatheraU DJ, Ledingham JGG, Warrell DA, eds. Oxford Textbook of Medicine, Vol. 2, 2nd edn. Oxford: Oxford University Press, 1989:18.31-3.
• Lure GM, Todd JK, O’Brien D. Kidney and urinary tract. In: Kempe CH, Silver HK, O’Brien D, Fulginti VA, eds. Current Pediatric Diagnosis & Treatment 1987, 9th edn. Norwalk: Appleton & Lange, 1993:615.
• Rasmussen GE, Bell C. Pediatric syndromes and anesthetic implication. In: Bell C, Hughes CW, Oh TH, eds. The Pe- diatric Anesthesia Handbook. St. Louis: Mosby Year Book, 1991: 361.
• Madrigal G, Saborio P, Mora F, Rincon G, Guay-Woodford LM. Bartter syndrome in Costa Rica: a description of 20 cases. Pediatr Nephrol 1997;11(3):296-301.
• White MG. Bartter’s syndrome-a manifestation of renal tu- bular defects. Arch Intern Med 1972;129(1):41-7
• Brimacombe JR, Breen DP. Anesthesia and Bartter’s syn- drome: a case report and review. AANAJ 1993;61(2):193-7.
• Vetrugno L, Cheli G, Bassi F, Giordano F. Cardiac anesthesia management of a patient with Bartter’s Syndrome. J Car- diothorac Vasc Anesth 2005;19 (3):373-6.
• Rodriguez-Soriano J. Tubular disorders of electrolyte regula- tion. In: Barratt TM, Avner ED, Harmon WE, eds. Pediat- ric Nephrology, 4th ed. Baltimore: Lippincott Williams & Wilkins, 1999:545-63.
• Wong KC, Sperry R. What is an acceptable preopera- tive serum potassium level for surgery? Anesthesiology 1994;81(1):269
• Vitez T. Potassium and the anaesthetist. Can J Anaesth 1987;34(1):30-1.
• Bevan DR Acute biochemical disorders. In: Vickers MD, Jones RM, eds. Medicine for Anaesthetists, 3rd ed. Oxford: BlaekweU Scientitie Publications, 1989:362-3.
• Gönen H, Türköz A. Bartter Sendromlu Çocukta Aneste- zi Yönetimi. Turkiye Klinikleri J Anest Reanim 2011;9 (3):219-21.
• Kannan S, Delph Y, Moseley HS. Anaesthetic management of a child with Bartter’s syndrome. Can J Anaesth 1995;42 (9):808-12.