Pediatrik Nöroloji Hastalarında Perioperatif Anestezi Yönetimi
Özet
Çocuk nöroloji hastalarının anestezi uygulamaları; epilepsi, sendromik bozukluklar, serebral palsi ve nöromüsküler hastalıklar gibi komorbiditelerin varlığı nedeniyle yüksek risk taşır. Başarılı bir perioperatif yönetim, çocuk nöroloji uzmanı, cerrah ve anestezistin multidisipliner bir yaklaşımla hastayı detaylı değerlendirmesine dayanır. Havayolu güçlüğü, ilaç etkileşimleri ve malign hipertermi gibi olası komplikasyonların önceden planlanması, hasta güvenliği için kritiktir. Preoperatif hazırlık süreci, hastanın spesifik nörolojik durumuna ve mevcut hastalıkların şiddetine göre bireyselleştirilmeli ve yönetilmelidir.
Anesthesia management for pediatric neurology patients presents high risks due to comorbidities such as epilepsy, syndromic disorders, cerebral palsy, and neuromuscular diseases. Successful perioperative care relies on a multidisciplinary approach involving pediatric neurologists, surgeons, and anesthesiologists to thoroughly evaluate the patient's condition. Planning for potential complications like airway difficulties, adverse drug interactions, and malignant hyperthermia is critical to ensuring patient safety. Preoperative preparation must be highly individualized, carefully tailoring protocols to the patient's specific neurological status and the severity of their existing conditions.
Referanslar
Short JA, Malik D. Preoperative assessment and preparation for anesthesia in children. Anesth Intens Care Med. 2009;10:489-494.
Evans L, Prosser DP. Preoperative assessment and preparation for anesthesia in children. Anesth Intens Care Med. 2006;7:375-379.
Gürsoy F, Doruk N. Pediatrik anestezi.Çocuklarda preoperatif değerlendirme ve Premedikasyon (Editör; Özcengiz D, Barış S). 2014; 207-224.
Tobias JD. Preoperative anesthesia evaluation. Semin Pediatr Surg. 2018;27(2):67-74
Weiss M, Engelhardt. Proposal fort he management of the unexpected difficult pediatric airway. Pediatr Anaesth. 2010;20:454-464.
Adawale L. Anatomy and assesment of the pediatric airway. Pediatric Anesth. 2009;19:1-8.
Fiadjoe JE, Nishisaki A, Jagannathan N, Hunyady AI, Greenberg RS, Reynolds PI, Matuszczak ME.Airway management complications in children with difficult tracheal intubationf rom the Pediatric et al. Difficult Intubation (PeDI) registry: a prospective cohort analysis. Lancet Respir Med. 2016;4(1):37-48.
Banerjee PN, Filippi D, AllenHauser W. The descriptive epidemiology of epilepsy-a review. Epilepsy Res.2009;85:31e45.
Wang YC, Lin IH, Huang CH, Fan SZ. Dental anesthesia for patients with special needs. Acta Anaesthesiol Taiwan. 2012;50(3):122-5.
Perks A, Cheema S, Mohanraj R. Anaesthesia and epilepsy. Br J Anaesth. 2012 Apr;108(4):562-71.
Patsalos PN, Perucca E. Clinically important drug interactions in epilepsy: interactions between antiepileptic drugs and other drugs. Lancet Neurol.2003;2:473–481.
Ofke WA. Anesthetic management of the patient with epilepsy or priorseizures. Curr Opin Anesthesiol.2010;23:391–399.
Vaughn LK, Pruhs RJ. Strain-dependent variability in nitrousoxide withdrawalseizurefrequency. Life Sci.1995;57:1125–1130.
Artru AA, Lettich E, Colley PS, Ojemann GA. Nitrousoxide: suppression of focal epileptiformactivity during inhalation, and spreading of seizure activity following withdrawal. J NeurosurgAnesthesiol.1990;2:189 –193.
Modica PA, Tempelhoff R, White PF. Pro- and anticonvulsant effects of anesthetics (Part I). Anesth Analg.1990;70:303–315.
Constant I, Seeman R, Murat I. Sevoflurane and epileptiform EEG changes. Paediatr Anaesth.2005;15:266 –274.
Constant I, Seeman R, Murat I. Sevoflurane and epileptiform EEG changes. Pediatr Anesth.2005;15:266-274.
Mirsattari SM, Sharpe MD, Young GB. Treatment of refractory status epilepticus with inhalational anasthetic agents isoflurane and desflurane. Arch Neurol.2004;61:1254-1259.
Yillar DO, Akkan AG, Akcasu A, Ozuner Z, Eskazan E, Kucukhuseyin C. The effect of oral and subcutaneous meperidine on the maximal electroshock seizure (MES) in mice. J Basic Clin Physiol Pharmacol. 2009;20:159 –168
Lowenstein D, Aminoff M, Simon R. Barbiturate anesthesia in the treatment of status epilepticus: clinical experience with 14 patients. Neurology.1988;38:395–400.
Propofol treatment in adult refractory status epilepticus. Mortality risk and outcome. Epilepsy Res.2011;94:53–60.
Myslobodsky MS, Golovchinsky V, Mintz M. Ketamine: convulsantor anti-convulsant? Pharmacol Biochem Behav.1981;14:27–33.
Modica PA, Tempelhoff R, White PF. Pro- and anticonvulsant effects of anesthetics (Part II). Anesth Analg.1990;70:433 –44.
Doyle L, Colletti JE. Pediatric procedural sedation and analgesia. Pediatr Clin North Am. 2006;53(2):279-92.
Ren WHP. Anesthetic management of epileptic pediatric patients. Int Anesthesiol Clin, 2009:47:101-116.
Irchberger K, Schmitt H, Hummel C et al. Clonidine and methohexital induced epileptic magnetoencephalographic discharges in patients with focal epilepsies. Epilepsia, 1998;39:841-849.
Mehta UC, Patel I, Castello FV. EEG sedation for children with autism. J Dev Behav Pediatr. 2004;25:102-104.
Mason KP, O’Mahony E, Zurakowsk D et al. Effects of dexmedetomidine sedation on the EEG in children. Pediatr Anesth.2009;19:1175-1183.
Oda Y, Toriyama S, Tanaka K et al. The effect of dexmedetomidine on electrocorticography in patients with temporal lob epilepsy under sevoflurane anesthesia. Anesth Analg. 2007;105:1272-1277.
Biaga JE, Moya F, Wikinski JA, Wikinski R, Usubiaga LE. Relationship between the passage of local anaesthetics across the blood–brain barrier and their effects on the central nervous system. Br J Anaesth.1967;39:943–947.
ldiz B, Citak A, Uc¸sel R, Karaborcuoglu M, Aydinli N, Uzel N. Lidocaine treatment in pediatric convulsive status epilepticus. Pediatr Int.2008;50:35–39.
Spacek A, Nickl S, Neiger FX et al. Augmentation of the rocuronium-induced neuromuscular block by the acutely administered phenytoin. Anesthesiology.1999;90:1551-1555.
Maranhão MV, Gomes EA, de Carvalho PE. Epilepsi ve anestezi. Rahip Bras Anestesiol. 2011;61:232-241.
Türk anesteziyoloji ve Reanimasyon Derneği, Preoperatif Muayene Klavuzu. 2005.
Ni R.Vagus nerve stimulation therapy for seizures. J NeurosurgAnesthesiol.2008;20:29-35.
Voss LJ, Sleigh JW, Barnard JP et al. The howling cortex: seizures and general anesthetic drugs. Anesth Analg.2008;107:1689-1703.
Nolan J, Chalkiadis GA, Low J, Olesch CA, Brown TC. Anaesthesia and pain management in cerebral palsy. Anaesthesia. 2000;55:32e41.
Wass CT, Warner ME, Worrell GA, Castagno JA, Howe M, Kerber KA, et al. Effect of general anesthesia in patients with cerebral palsy at the turn of the new millennium: a population-based study evaluating perioperative outcome and brief overview of anesthetic implications of this coexisting disease. J Child Neurol.2012;27:859e66.
Theroux MC, Akins RE. Surgery and anesthesia for children who have cerebral palsy. Anesthesiol Clin North America. 2005;23:733-743.
Wass CT, Warner ME, Worrell GA, Castagno JA, Howe M, Kerber KA, et al. Effect of general anesthesia in patients with cerebral palsy at the turn of the new millennium: a population-based study evaluating perioperative outcome and brief overview of anesthetic implications of this coexisting disease. J Child Neurol. 2012;27(7):859-66.
Friedlander AH, Yagiela JA, Paterno VI, Mahler ME. The pathophysiology, medical management, and dental implications of autism. J CalifDentAssoc.2003;31:681e2. 684, 686-91.
Dodson ME, Fryer JM. Postoperative effects of methylphenidate. Br J Anaesth. 1980;52(12):1265-1270.
Romero A, Joshi GP. Neuromuscular disease and anesthesia. Muscle Nerve. 2013;48(3):451-60.
Practice advisory for preanesthesia evaluation. An update dreport by the American Society of Anesthesiologists task force on preanesthesia evaluation. Anesthesiology.2012;116:522–538.
Irsch JR. Perioperative care of patients with neuromuscular disease and dysfunction. Anesthesiol Clin.2007;25:483–509.
Klingler W, Lehmann-Horn F, Jurkat-Rott K. Complications of anaesthesia in neuromuscular disorders. NeuromusculDisord.2005;15:195–206.
Lerman J. Perioperative management of the paediatric patient with coexisting neuromuscular disease. Br J Anaesth. 2011;107(Suppl 1):i79–i89.
Sakai T, Miki S, Ueda Y, Nomoto T, Hashimoto S, Takahashi K. Warm heart operation in a patient with myotonic dystrophy. Ann Thorac Surg.1996;62:1203–1205.
Benca, J, Hogan K. Malignant hyperthermia, coexisting disorders, andenyzmopathies: risk and managementoptions. Anesth Analg.2009;109:1049–1053.
Blichfeldt-Lauridsen L, Hansens BD. Anesthesia and myasthenia gravis. Acta Anaesthesiol Scand.2012;56:17–22.
Sejvar JJ, Baughman AL, Wise M, Morgan OW. Population incidence of Guillain‐Barré syndrome: a systematic review and meta‐analysis. Neuroepidemiology. 2011;36:123‐33.
Willison HJ, Jacobs BC, vanDoorn PA. Guillain‐Barrésyndrome. Lancet (London, England). 2016;388:717‐27.
Sinner B, Graf BM. Ketamine. Handb Exp Pharmacol. 2008;(182):313-33