Pages 26-29

Öz

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Anahtar Kelimeler

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Lokal Anestezik Enjeksiyonu Sonrası Gelişen Şiddetli Vazovagal Senkop ve Kardiyak Arrest

Öz

Vazovagal senkop, arteriyel vazodilatasyona bağlı olarak ani bilinç kaybı gelişmesidir. Arteriyel vazodilatasyona bağlı beyin kan akımı azalmakta ve daha sonra hipotansiyon ve bradikardi ortaya çıkmaktadır. Operasyon odasında vazovagal senkop sıklıkla tespit edilir. Muhtemel vazovagal senkop nedenleri; yüksek doz lokal anestezik yada opioid ajan kullanımı, lokal anesteziklerin venöz enjeksiyonu, hipoksemi, hiperkarbi, yoğun sedasyona bağlı sempatik blokaj ve iğne korkusu olarak sayılabilir. Bu olgu sunumunda, 45 yaşında, regional anestezi altında ingiunal herni operasyonu planlanan kadın hastaya, spinal enjeksiyondan önce lokal anestezik ajan verilirken gelişen senkop olgusu tartışılmıştır

Anahtar Kelimeler

• Regional anestezi, Spinal anestezi, Komplikasyon: Vazovagal senkop

Kaynakça

1. Kinsella SM, Tuckey JP. Perioperative bradycardia and vasovagal syncope and the Bezold-Jarisch reflex. Br J Anaesth. 2001 Jun;86(6):859-68. Review.
2. Prakash ES, Madanmohan. When the heart is stopped for good: hypotension-bradycardia paradox revisited. Adv Physiol Educ. 2005 Mar;29(1):15-20.
3. Sprung J, Abdelmalak B, Schoenwald PK. Vasovagal cardiac arrest during the insertion of an administration Anesth Analg. 1998 Jun;86(6):1263-5. medication. epidural
4. Watkins EJ, Dresner M, Calow CE. Severe vasovagal attack during regional anaesthesia for caesarean Jan;84(1):118-20. J Anaesth. 2000
5. Alboni P, Brignole M, Degli Uberti EC. Is vasovagal Europace. 2007 Feb;9(2):83-7. a disease?
6. Hargreaves AD, Muir AL. Lack of variation in venous tone potentiates vasovagal syncope. Br Heart J. 1992 Jun;67(6):486-90.
7. Hargreaves AD, Kolettis T, Jacob AJ, Flint LL, Turnbull LW, Muir AL, Boon NA. Early vasodilator treatment in myocardial infarction: appropriate for the majority or minority? Br Heart J. 1992 Oct;68(4):369-73.
8. Fernandes PP. Rapid desensitization for needle phobia. Psychosomatics. 2003;44(3):253-4.

9. Mimura T, Funatsu H, Yamagami S, Usui T, Ono K, Araie M, Amano S. Vasovagal syncope evoked by needle phobia when inserting a contact Ophthalmic Physiol Opt. 2005 Mar;25(2):171-3. Review. lens.
10. Klasen J, Junger A, Hartmann B, Benson M, Jost A, Banzhaf A, Kwapisz M, Hempelmann G. Differing incidences of relevant hypotension with combined spinal-epidural anesthesia and spinal May;96(5):1491-5. Analg. 2003
11. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th Edn. Washington, DC: American Psychiatric Association, 1994.
12. Hampl KF, Schneider MC. Vasovagal asystole before induction of general anaesthesia. Eur J Anaesthesiol. 1994 Mar;11(2):131-3.
13. Keane TK, Hennis PJ, Bink-Boelkens MT. Non- drug related asystole associated with anaesthetic induction. Anaesthesia. 1991 Jan;46(1):38-9.
14. Samniah N, Sakaguchi S, Lurie KG, Iskos D, Benditt DG Efficacy and safety of midodrine hydrochloride vasovagal Am J Cardiol. 2001 Jul 1;88(1):A7, 80-3. syncope.
15. Sutton R. How and when to pace in vasovagal syncope. J Cardiovasc Electrophysiol. 2002 Jan;13(1 Suppl):S14-6. Review.
16. McConachie I. Vasovagal asystole during spinal anaesthesia. Anaesthesia. 1991 Apr;46(4):281-2.
17. Nurgül Kömerik . Dental Practıtıoners And Medıcal Emergencıes. Turkiye Klinikleri J Dental Sci 2003;9(2).
18. Win NN, Kohase H, Miyamoto T, Umino M. Decreased bispectral index as an indicator of syncope before hypotension and bradycardia in two patients with needle phobia. Br J Anaesth. 2003 Nov;91(5):749-52.