Dermatomiyozitli Bir Olguda Anestezik Yaklaşım

Year 2009, Volume: 26 Issue: 2, - , 06.12.2010

Ebru Kelsaka Binnur Sarıhasan Musa Yılmaz Acar

Abstract

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.

Keywords

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