Öz
Postoperatif
deliryum diffüz beyin tutulumu ile karakterize bir sendromdur. Görülme sıklığı %9 ile %87 arasında değişmektedir. Nedeni tam
anlaşılamamakla birlikte, anestezi uygulamaları sırasında da sıklıkla
kullanılan antikolinerjik etkili ilaçlara bağlı olarak ortaya çıktığı
düşünülmektedir. Tanısı klinik şüphe ve gözlem ile konulabilir. Hızlı tanı
konulamadığında postoperatif deliryum postoperatif komplikasyonlar da artmaya, hastanede kalış süresinin uzamasına ve
morbidite artışına neden olabilmektedir. Propofol anestezi pratiğinde sık
kullanılan bir ilaçtır. Muskarinik reseptörler üzerine etkili olduğu
gösterilmiştir. Bu yazıda üst gastroitestinal sistem endoskopi işlemi ve Oocyte
pick up (OPU) işlemi için propofol uygulanmasını takiben deliryum gelişen iki
hastayı sunmayı ve postoperatif deliryuma dikkat çekmeyi amaçladık.
Anahtar Kelimeler
Kaynakça
- 1. Ruiz- Neto PP, Moreira NA, Furlaneto ME. Postanesthetic delirium. Rev Bras Anestesiol. 2002 Apr;52(2):242-250.
- 2. Robinson TN, Eiseman B. Postoperative delirium in the elderly: diagnosis and management. Clinical interventions in Aging 2008:3(2) 344-351
- 3. Mohri-Ikuzawa Y, Inada H, Takahashi N, Kohase H, Jinno S, Umino M. Delirium during intravenous sedation with midazolam alone and with propofol in dental treatment. Anesth Prog. 2006; 53: 95-97.
- 4. Brown KE, Mirrakhimov AE, Yeddula K, Kwatra MM. Propofol and the risk of delirium: Exploring the anticholinergic properties of propofol. Medical Hypotheses 2013;81: 536–539
- 5. European Delirium Association, American Delirium Society. The DSM-5 criteria, level of arousal and delirium diagnosis: inclusiveness is safer. BMC Med. 2014 Oct 8;12:141 6. Han L, McCusker J, Cole M, Abrahamowicz M, Primeau F, Elie M. Use of medications with anticholinergic effect predicts clinical severity of delirium symptoms in older medical inpatients. Arch Intern Med 2001;161:1099–105.
- 7. Nagase Y, Kaibara M, Uezono Y, Izumi F, Sumikawa K, Taniyama K. Propofol inhibits muscarinic acetylcholine receptor-mediated signal transduction in Xenopus Oocytes expressing the rat M1 receptor. Jpn J Pharmacol 1999;79:319–25.
- 8. Murasaki O, Kaibara M, Nagase Y, et al. Site of action of the general anesthetic propofol in muscarinic M1 receptor-mediated signal transduction. J Pharmacol Exp Ther 2003;307:995–1000
- 9. Gadalla F, Spencer J. Prolonged delirium after propofol. Can J Anaesth 1996;43:877.
- 10. Cohen S, Hunter CW, Yanni B, Striker P, Hijazi RH. Central anticholinergic syndrome strikes again. J Clin Anesth 2006;18:399–400.
Öz
Postoperative delirium which is characterized
by diffuse involvement of the brain is a syndrome. Delirium incidence ranged
between 9% and 87%. It is thought that the cause is due to anticholinergic
drugs which are frequently used during anesthesia applications, together with
the fact that they are not fully understood. It can be diagnosed with clinical
suspicion and observation. If it cannot be diagnosed in a timely manner, postoperative delirium can
cause the increase postoperative complications, longer length of stay and much
higher rates of morbidity. Propofol is a commonly used drug in anesthesia
practice. It has been shown to
be effective on muscarinic receptors.
In this case report, we aimed to present two
patients with delirium during Upper gastrointestinal system endoscopy and Oocyte
pick up (OPU) procedure and drew attention to postoperative delirium.
Anahtar Kelimeler
Kaynakça
- 1. Ruiz- Neto PP, Moreira NA, Furlaneto ME. Postanesthetic delirium. Rev Bras Anestesiol. 2002 Apr;52(2):242-250.
- 2. Robinson TN, Eiseman B. Postoperative delirium in the elderly: diagnosis and management. Clinical interventions in Aging 2008:3(2) 344-351
- 3. Mohri-Ikuzawa Y, Inada H, Takahashi N, Kohase H, Jinno S, Umino M. Delirium during intravenous sedation with midazolam alone and with propofol in dental treatment. Anesth Prog. 2006; 53: 95-97.
- 4. Brown KE, Mirrakhimov AE, Yeddula K, Kwatra MM. Propofol and the risk of delirium: Exploring the anticholinergic properties of propofol. Medical Hypotheses 2013;81: 536–539
- 5. European Delirium Association, American Delirium Society. The DSM-5 criteria, level of arousal and delirium diagnosis: inclusiveness is safer. BMC Med. 2014 Oct 8;12:141 6. Han L, McCusker J, Cole M, Abrahamowicz M, Primeau F, Elie M. Use of medications with anticholinergic effect predicts clinical severity of delirium symptoms in older medical inpatients. Arch Intern Med 2001;161:1099–105.
- 7. Nagase Y, Kaibara M, Uezono Y, Izumi F, Sumikawa K, Taniyama K. Propofol inhibits muscarinic acetylcholine receptor-mediated signal transduction in Xenopus Oocytes expressing the rat M1 receptor. Jpn J Pharmacol 1999;79:319–25.
- 8. Murasaki O, Kaibara M, Nagase Y, et al. Site of action of the general anesthetic propofol in muscarinic M1 receptor-mediated signal transduction. J Pharmacol Exp Ther 2003;307:995–1000
- 9. Gadalla F, Spencer J. Prolonged delirium after propofol. Can J Anaesth 1996;43:877.
- 10. Cohen S, Hunter CW, Yanni B, Striker P, Hijazi RH. Central anticholinergic syndrome strikes again. J Clin Anesth 2006;18:399–400.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | OLGU SUNUMLARI / CASE REPORTS |
| Yazarlar | |
| Yayımlanma Tarihi | 7 Mart 2018 |
| Yayımlandığı Sayı | Yıl 2018 Cilt: 40 Sayı: 2 |