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Huntington koresi olan bir hastada epidural anestezi

Year 2012, Volume: 18 Issue: 2, 113 - 114, 01.03.2012

Abstract

Huntington's chorea (HC) is a rare, autosomal, dominant hereditary disorder of the nervous system. Symptoms occur in the third and fourth decade of life and manifest as involuntary choreiform movements, ataxia, and progressive mental deterioration. Only a few case reports have been published describing the anesthetic management of patients with HC. Patients are at greater risk for some intraoperative complications (e.g., regurgitation and pulmonary aspiration), poor respiratory function, prolonged response to succinylcholine and thiopental, increased sensitivity to midazolam, and postoperative shivering leading to rigid spasms. All these factors make an ideal anesthesiological management necessary for this group of patients to guarantee an absolute airway protection during all the anesthesia and a fast and safe recovery. To the best of our knowledge, epidural anesthesia in HC patients has not been reported in the literature. Herein, we present our successful experience using epidural anesthesia in a HC patient.

References

  • 1. Bloch M, Adam S, Fuller A, Kremer B, Welch JP, Wiggins S, et al. Diagnosis of Huntington disease: a model for the stages of psychological response based on experience of a predictive testing program. Am J Med Genet 1993;47(3):368-74
  • 2. Rodrigo MR. Huntington’s chorea: midazolam, a suitable induction agent? Br J Anaesth 1987;59(3):388-9
  • 3. Kaufman MA, Erb T. Propofol for patients with Huntington’s chorea? Anaesthesia 1990;45(10):889-90
  • 4. Nagele P, Hammerle AF. Sevoflurane and mivacurium in a patient with Huntington’s chorea. Br J Anaesth 2000;85(2):320- 1
  • 5. Fernandez IG, Sanchez MP, Ugalde AJ, Hernandez CM. Spinal anaesthesia in a patient with Huntington’s chorea. Anaesthesia 1997;52(4):391
  • 6. Gaubatz CL, Wehner RJ. Anesthetic considerations for the patient with Huntington’s disease. AANA J 1992;60(1):41-4
  • 7. MacPherson P, Harper I, MacDonald I. Propofol and remifentanil total intravenous anesthesia for a patient with Huntington disease. J Clin Anesth 2004;16(7):537-8
  • 8. Gilli E, Bartoloni A, Fiocca F, Dall'Antonia F, Carluccio S
  • Anaesthetic management in a case of Huntington's chorea
  • Minerva Anestesiol 2006;72(9):757-62
  • 9. Stoelting RK, Dierdorf SF, Mccammon RL. Anesthesia and coexisting disease. New York: Churchill Livingstone 1988:307
  • 10. Qin ZH, Wang J, Gu ZL. Development of novel therapies for Huntington’s disease: hope and challenge. Acta Pharmacol Sin 2005;26(2):129-42
  • 11. Kivela JE, Sprung J, Southorn PA, Watson JC, Weingarten TN
  • Anesthetic management of patients with Huntington disease
  • Anesth Analg 2010;110(2):515-23

Epidural anesthesia in a patient with Huntington’s chorea

Year 2012, Volume: 18 Issue: 2, 113 - 114, 01.03.2012

Abstract

Huntington koresi (HK) nadir görülen otozomal dominant geçiş gösteren sinir sistemi bozukluğudur. Semptomları hayatın 3. ve 4. dekatlarında istemsiz koreiform hareketleri, ataksi ve ilerleyici mental bozulma olarak gösterir. HK tanılı olgularda anestezi yönetimi ile ilgili sadece birkaç olgu sunumu yayınlanmıştır. Hastalar bazı intraoperatif komplikasyonlar (regürjitasyon ve pulmoner aspirasyon gibi), zayıf respiratuar fonksiyon, uzamış suksinilkolin ve tiyopental cevabı, midazolama karşı yükselmiş sensitivite, ve rijit spazmlara yol açan titremeler gibi postoperatif komplikasyonlar açısından yüksek risk altındadırlar.Tüm bunlar güvenli geri dönüş ve anestezi sırasında güvenli havayolu sağlamak için ideal anestezi yönetimi gerektirmektedir. Bildiğimiz kadarıyla, literatürlerde HK’li hastalarda epidural anestezi uygulanması bulunmamaktadır. Burada, HK tanılı olgumuzda başarılı epidural anestezi deneyimimizi sunmayı amaçladık.

References

  • 1. Bloch M, Adam S, Fuller A, Kremer B, Welch JP, Wiggins S, et al. Diagnosis of Huntington disease: a model for the stages of psychological response based on experience of a predictive testing program. Am J Med Genet 1993;47(3):368-74
  • 2. Rodrigo MR. Huntington’s chorea: midazolam, a suitable induction agent? Br J Anaesth 1987;59(3):388-9
  • 3. Kaufman MA, Erb T. Propofol for patients with Huntington’s chorea? Anaesthesia 1990;45(10):889-90
  • 4. Nagele P, Hammerle AF. Sevoflurane and mivacurium in a patient with Huntington’s chorea. Br J Anaesth 2000;85(2):320- 1
  • 5. Fernandez IG, Sanchez MP, Ugalde AJ, Hernandez CM. Spinal anaesthesia in a patient with Huntington’s chorea. Anaesthesia 1997;52(4):391
  • 6. Gaubatz CL, Wehner RJ. Anesthetic considerations for the patient with Huntington’s disease. AANA J 1992;60(1):41-4
  • 7. MacPherson P, Harper I, MacDonald I. Propofol and remifentanil total intravenous anesthesia for a patient with Huntington disease. J Clin Anesth 2004;16(7):537-8
  • 8. Gilli E, Bartoloni A, Fiocca F, Dall'Antonia F, Carluccio S
  • Anaesthetic management in a case of Huntington's chorea
  • Minerva Anestesiol 2006;72(9):757-62
  • 9. Stoelting RK, Dierdorf SF, Mccammon RL. Anesthesia and coexisting disease. New York: Churchill Livingstone 1988:307
  • 10. Qin ZH, Wang J, Gu ZL. Development of novel therapies for Huntington’s disease: hope and challenge. Acta Pharmacol Sin 2005;26(2):129-42
  • 11. Kivela JE, Sprung J, Southorn PA, Watson JC, Weingarten TN
  • Anesthetic management of patients with Huntington disease
  • Anesth Analg 2010;110(2):515-23
There are 15 citations in total.

Details

Primary Language Turkish
Journal Section Articles
Authors

Mesut Erbaş This is me

Burhan Dost This is me

Bekir Sami Karapolat This is me

Publication Date March 1, 2012
Published in Issue Year 2012 Volume: 18 Issue: 2

Cite

APA Erbaş, M., Dost, B., & Karapolat, B. S. (2012). Epidural anesthesia in a patient with Huntington’s chorea. Gaziantep Medical Journal, 18(2), 113-114.
AMA Erbaş M, Dost B, Karapolat BS. Epidural anesthesia in a patient with Huntington’s chorea. Gaziantep Medical Journal. March 2012;18(2):113-114.
Chicago Erbaş, Mesut, Burhan Dost, and Bekir Sami Karapolat. “Epidural Anesthesia in a Patient With Huntington’s Chorea”. Gaziantep Medical Journal 18, no. 2 (March 2012): 113-14.
EndNote Erbaş M, Dost B, Karapolat BS (March 1, 2012) Epidural anesthesia in a patient with Huntington’s chorea. Gaziantep Medical Journal 18 2 113–114.
IEEE M. Erbaş, B. Dost, and B. S. Karapolat, “Epidural anesthesia in a patient with Huntington’s chorea”, Gaziantep Medical Journal, vol. 18, no. 2, pp. 113–114, 2012.
ISNAD Erbaş, Mesut et al. “Epidural Anesthesia in a Patient With Huntington’s Chorea”. Gaziantep Medical Journal 18/2 (March 2012), 113-114.
JAMA Erbaş M, Dost B, Karapolat BS. Epidural anesthesia in a patient with Huntington’s chorea. Gaziantep Medical Journal. 2012;18:113–114.
MLA Erbaş, Mesut et al. “Epidural Anesthesia in a Patient With Huntington’s Chorea”. Gaziantep Medical Journal, vol. 18, no. 2, 2012, pp. 113-4.
Vancouver Erbaş M, Dost B, Karapolat BS. Epidural anesthesia in a patient with Huntington’s chorea. Gaziantep Medical Journal. 2012;18(2):113-4.