Opioid-Sensitive Pediatric Patient: A Case Report

Öz

Opioids have been used for analgesic purposes for many years; however, they are a drug group with serious side effects. We aimed to present, alongside the relevant literature, the opioid-induced sedation and antagonists used for postoperative analgesia in a patient who underwent orchiopexy and hypospadias surgery.

Anahtar Kelimeler

• opioid
• naloxone
• general anesthesia

Opioid Duyarlı Çocuk Hasta: Olgu Sunumu

Öz

Opioidler analjezi amacıyla çok uzun yıllardır kullanılmakla beraber ciddi yan etkileri olan bir ilaç grubudur. Orşiopeksi ve hipospadias ameliyatı olan hastanın postoperatif analjezi amacıyla kullanılan opioide bağlı gelişen sedasyonu ve antagonistlerini literatür eşliğinde sunmayı amaçladık.

Anahtar Kelimeler

• opioid
• nalokson
• genel anestezi

Kaynakça

1. Referans 1. Trescot AM, Datta S, Lee M, Hansen H. Opioid pharmacology. Pain Physician. 2008 Mar;11(2 Suppl):S133-53.
2. Referans 2. Klimas R, Mikus G. Morphine-6-glucuronide is responsible for the analgesic effect after morphine administration: a quantitative review of morphine, morphine-6-glucuronide, and morphine-3-glucuronide. Br J Anaesth. 2014 Dec;113(6):935-44.
3. Referans 3. Özmen H, Aydınlı B, Titiz L, Derici D. Comparing the Prevalence of Postoperative Complications in Groups of Patients Followed Up in the Recovery Room with and without the Use of the Modified Aldrete’s Scoring System (MASS): A Retrospective Study. JARSS. 28(2020):188-93.
4. Referans 4. Lötsch J, Dudziak R, Freynhagen R, Marschner J, Geisslinger G. Fatal respiratory depression after multiple intravenous morphine injections. Clin Pharmacokinet. 2006;45(11):1051-60.
5. Referans 5. Fecho K, Lunney AT, Boysen PG, Rock P, Norfleet EA. Postoperative mortality after inpatient surgery: Incidence and risk factors. Ther Clin Risk Manag. 2008 Aug;4(4):681-8.
6. Referans 6. Balyan R, Zhang X, Chidambaran V, Martin LJ, Mizuno T, Fukuda T, et al. OCT1 genetic variants are associated with postoperative morphine-related adverse effects in children. Pharmacogenomics. 2017;18(7):621-629.
7. Referans 7. Goodman AJ, Le Bourdonnec B, Dolle RE. Mu opioid receptor antagonists: Recent developments. Chem Med Chem. 2007;2:1552–70.
8. Referans 8. Longnecker DE, Grazis PA, Eggars GWN Jr: Naloxone for antagonism of morphine-induced respiratory depression. Anesth Analg. 1973;52:447–53.

9. Referans 9. Mégarbane B, Declèves X, Bloch V, Bardin C, Chast F, Baud FJ. Case report: Quantification of methadone induced respiratory depression using toxicokinetic/toxicodynamic relationships. Critical Care. 2007;11:5.
10. Referans 10. van Lemmen M, Florian J, Li Z, van Velzen M, van Dorp E, Niesters M, et al. Opioid Overdose: Limitations in Naloxone Reversal of Respiratory Depression and Prevention of Cardiac Arrest. Anesth. 2023 Sep 1;139(3):342-353.
11. Referans 11. van Dorp E, Yassen A, Sarton E, Romberg R, Olofsen E, Teppema L, et. Al. Naloxone reversal of buprenorphine-induced respiratory depression. Anesth. 2006;105:51–7.
12. Referans 12. Lucyk S, Nelson LS. Opioid receptor antagonists. Critical Care Toxicology. 2017; 2907-2911.