Anesthesia Management of Patients with Mental Retardation

Year 2015, Volume: 2 Issue: 4, 239 - 43, 06.05.2015

Nureddin Yuzkat , Muhammed Cegin

Abstract

Mental retardation is a condition likely to develop secondarily to several genetic diseases or to some negative conditions and diseases that occur before, during or after birth. Anaesthetic practices start with the preoperative visit of a patient and are then followed by premedication, preoperative preparation, intraoperative procedures and postoperative periods. All these steps with mentally retarded patients involve separate characteristics. The MR patients must be kept under observation in the recovery rooms for longer periods of time and must also be definitely re-evaluated by an experienced anaesthetist before being transferred to the service department. Since there may be several challenges/difficulties likely to be experienced at each stage of the mentally retarded patients’ anaesthesia, far more care and patience is required. A pre-anaesthetic evaluation involving a physical examination in depth and a detailed questioning should be performed. During the pre-medication period, a little amount of midazolam mixed with a proper drink can be used. Prior to applying the neuromuscle blocking agents, the airway opening must be maintained. In the presence of muscular dystrophies, the doses of neuromuscular blocking agents must be equalized. The MR patients must be kept under observation in the recovery rooms for longer periods of time and must also be definitely re-evaluated by an experienced anaesthetist before being transferred to the service department. 

Keywords

Anesthesia management; Mental retardation; Intelligence quotient

Anesthesia Management of Patients with Mental Retardation

Abstract

References

• - Cagiran EY, Efeoglu C, Balcioglu T, KOCA H. Dental Treatment in Patients with Mental Reatardation: A Retrospective Study. Turkiye Klinikleri J Med Sci 2011;31(4)
• - Koroglu E. Genellikle İlk Kez Bebeklik, Çocukluk ya da Ergenlik Döneminde Tanisi Konan Bozukluklar. DSM_IV_TR Tani Olçutleri (2rd ed). Ankara: Hekimler Yayin Birligi, 2000
• - Tuzuner F. Preoperatif Hazirlik ve Ilac Tedavi Takiplerinde Prensipler. In: Anestezi Yoğun Bakim Agri (1rd ed). Ankara: MN Medikal ve Nobel Tip Kitap Sarayi, 2010, pp 107-115
• - Butterwoth J, Mackey D, Wasnick J. Preoperative Assessment, Premedication and Perioperative Documentation. In: Clınıcal Anesthesıology (5rd ed). North America: McGraw-Hill, 2013, pp 295-308
• - Kayhan Z. Anestezi ve Ameliyat Oncesi Degerlendirme ve Hazirlik. In: Klinik Anestezi (3rd ed). Istanbul: Logos Yayıncılık, 2007, pp 16-36
• - Yalcin S, Aydogan H, Karahan MA et al. Williams Sendromlu Hastada Anestezik Yaklasim: Olgu Sunumu. Journal of Anesthesia 2012; 20 (1): 48-50
• - Saritas T, Babacan K, Sarkılar G et al. Rett Sendromlu Bir Olguda Anestezik Yaklasim. Turk Anest Rean Der Dergisi 2011; 39(3): 153-158
• - Ozgul U, Begec Z, Yucel A et al. Cornelia de Lange Sendromlu Iki Olguda Anestezi Yonetimimiz. Journal of Anesthesia 2012; 20 (2): 106-109
• - Gunduz C, Cogulu O, Ozkınay C et al. Investigation of Fragile X Syndrome in Idiopathic Mental Retardation. EgeTipDergisi 2000; 39(2): 97-104
• - Paul G. Barash, Bruce F. Gullen, Robert K. Stoelting, et al. Preoperatif Degerlendirme ve Yonetim. In: Klinik Anestezi (5rd ed), 2007, p 477-501
• - Shah S, Shah S, Apuya J, Gopalakrishnan S et al. Combination of oral ketamine and midazolam as a premedication for a severely autistic and combative patient. J Anesth 2009; 23:126–128
• - Chan WP, Chilvers CR. Induction of Anesthesia in home. Anaesth Intensive Care 2002; 30:809-812
• - Tuzuner F. Ameliyathane Disinda Anestezi. In: Anestezi Yoğun Bakım Ağrı (1rd ed). Ankara: MN Medikal ve Nobel Tıp Kitap Sarayı, 2010, pp 1127-1136
• - Ozlem CS. Nonopioid Intravenoz Anestezikler. In: Temel Anestezi. Yuksel K, Alkıs N, Yorukoglu D, Alanoglu Z. Ankara: Gunes Tip Kitapevi, 2012 pp 97-117
• - Başartelkin H. Opioidler. In: Temel Anestezi. Yuksel K, Alkıs N, Yorukoglu D, Alanoglu Z. Ankara: Gunes Tip Kitapevi, 2012 pp 87-95
• - Butterwoth J, Mackey D, Wasnick J. Intravenous Anesthetics In: Clinical Anesthesiology (5rd ed). North America: McGraw-Hill, 2013, pp 175-188
• - Butterwoth J, Mackey D, Wasnick J. Analgesic Agents In: Clinical Anesthesiology (5rd ed). North America: McGraw-Hill, 2013, pp 189-198
• - Ponnudurai RN, Clarke-Moore A, Ekulide I et al. A Prospective Study of Bispectral Index Scorring in Mentally Retarded Patients Receiving Gneral Anesthesi. J Clin Anest 2010; 22: 432-436 Cross Reff.
• - Butterwoth J, Mackey D, Wasnick J. Airway Management In: Clinical Anesthesiology (5rd ed). North America: McGraw-Hill, 2013, pp 309-341
• - Ring H. Epilepsy in Intellectual Disabilities. ACNR 2013 September/October 13 (5): 14-15
• - Sulemanji DS, Donmez A, Akpek EA et al. Vascular Cathetherization is Difficult in İnfant with Down Syndrome. Acta Anaesthesiol Scand 2009; 53: 98-100 Cross Reff.
• - Tuzuner F. Postoperatif Erken Donem. In: Anestezi Yogun Bakim Agri (1rd ed). Ankara: MN Medikal ve Nobel Tip Kitap Sarayı, 2010, pp 1137-1152