Hiperventilasyon Sendromu Gelişen Olguda Anestezi Yönetimi
Özet
Hiperventilasyon sendromu, genellikle perioperatif dönem gibi stresli koşullarda ortaya çıkan, tipik olarak iyi prognozlu olan, ancak hastanın pH'sındaki değişimlere sekonder ciddi metabolik dengesizlik durumunda tıbbi bir acil durum haline gelebilen bir semptomlar dizisi olarak tanımlanmaktadır. Madende çalışırken parmağının vagon arasına sıkışması sonrası plastik cerrahi tarafından distal falanks fraktürüne yönelik monitörize anestezi bakım altında işlem yapılırken hiperventilasyon sendromu ve buna bağlı karpal spazm ve parestezi gelişen 26 yaşında bir erkek hasta sunulmuştur. Bu olgu sunumunda hiperventilasyon sendromunun tanı ve tedavi yaklaşımı tartışılmıştır.
Hyperventilation syndrome is classified as a series with a typically good prognosis that usually occurs under stressful situations, such as the perioperative period, but can present as a medical emergency in the event of severe metabolic imbalance secondary to changes in pH. We report a 26-year-old male patient who developed hyperventilation syndrome and associated carpal spasm while undergoing a procedure under monitorized anesthesia care for distal phalanx fracture by plastic surgery after his finger was caught between the wagon while working in a mine. The approach to the diagnosis and treatment of hyperventilation syndrome is discussed in this case report.
Referanslar
Folgering H. The pathophysiology of hyperventilation syndrome. Monaldi Arch Chest Dis. 1999;54(4):365-372.
Tomioka S, Enomoto N, Momota Y. Hyperventilation syndrome after general anesthesia. J Anaesthesiol Clin Pharmacol. 2015;31(2):284-285. doi: 10.4103/0970-9185.155219.
Williams A, Liddle D, Abraham V. Tetany: a diagnostic dilemma. J Anaesthesiol Clin Pharmacol. 2011, 27:393-394. doi: 10.4103/0970-9185.83691.
Cowley DS, Roy-Byrne PP. Hyperventilation and panic disorder. Am J Med. 1987;83(5):929-937. doi:10.1016/0002-9343(87)90654-1.
Martinez JM, Kent JM, Coplan JD et al. Respiratory variability in panic disorder. Depress Anxiety. 2001. 14(4):232-237. doi:10.1002/da.1072
Meuret AE, Ritz T. Hyperventilation in panic disorder and asthma: empirical evidence and clinical strategies. Int J Psychophysiol. 2010;78(1):68-79. doi:10.1016/j.ijpsycho.2010.05.006.
Moon HS, Lee SK, Chung JH et al. Hypocalcemia and hypokalemia due to hyperventilation syndrome in spinal anesthesia -A case report-. Korean J Anesthesiol. 2011;61(6):519-23. doi: 10.4097/kjae.2011.61.6.519.
Payne RB. Albumin-Adjusted Calcium and Ionized Calcium. Clin Chem. 2019;65(5):705-706. doi:10.1373/clinchem.2018.300905.
Parasa M, Saheb SM, Vemuri NN. Cramps and tingling: A diagnostic conundrum. Anesth Essays Res. 2014;8(2):247-249. doi:10.4103/0259-1162.134524
Cowley DS, Roy-Byrne PP. Hypocalcemic crisis. Hypoparathyroidism--non-parathyroid origin--the most frequent form: hyperventilation syndrome. Fortschr Med. 1996;114(17):223-226.
Macefield G, Burke D. Paraesthesiae and tetany induced by voluntary hyperventilation. Increased excitability of human cutaneous and motor axons. Brain. 1991;114:527-540. doi:10.1093/brain/114.1.527.
Tomioka S, Nakajo N. Beta-adrenergic blocker for hyperventilation syndrome in dentistry: A report of three cases. Oral Sci Int. 2011;8:34–35. doi: 10.1016/S1348-8643(11)00006-1.
Gardner WN. The pathophysiology of hyperventilation disorders. Chest. 1996;109(2):516-534. doi:10.1378/chest.109.2.516.
Tomioka S, Takechi M, Ohshita N et al. Propofol is not effective for hyperventilation syndrome. Anesth Analg. 2001;92(3):781-782. doi:10.1097/00000539-200103000-00042.
RuDusky BM. ECG abnormalities associated with hypocalcemia. Chest. 2001;119(2):668-669. doi:10.1378/chest.119.2.668-a.
Jones M, Harvey A, Marston L et al. Breathing exercises for dysfunctional breathing/hyperventilation syndrome in adults. Cochrane Database Syst Rev. 2013 (5):CD009041. doi:10.1002/14651858.CD009041.pub2
DeGuire S, Gevirtz R, Kawahara Y et al. Hyperventilation syndrome and the assessment of treatment for functional cardiac symptoms. Am J Cardiol. 1992;70(6):673-677. doi:10.1016/0002-9149(92)90211-g
DeGuire S, Gevirtz R, Hawkinson D et al. Breathing retraining: a three-year follow-up study of treatment for hyperventilation syndrome and associated functional cardiac symptoms. Biofeedback Self Regul. 1996;21(2):191-198. doi:10.1007/BF02284695
Referanslar
Folgering H. The pathophysiology of hyperventilation syndrome. Monaldi Arch Chest Dis. 1999;54(4):365-372.
Tomioka S, Enomoto N, Momota Y. Hyperventilation syndrome after general anesthesia. J Anaesthesiol Clin Pharmacol. 2015;31(2):284-285. doi: 10.4103/0970-9185.155219.
Williams A, Liddle D, Abraham V. Tetany: a diagnostic dilemma. J Anaesthesiol Clin Pharmacol. 2011, 27:393-394. doi: 10.4103/0970-9185.83691.
Cowley DS, Roy-Byrne PP. Hyperventilation and panic disorder. Am J Med. 1987;83(5):929-937. doi:10.1016/0002-9343(87)90654-1.
Martinez JM, Kent JM, Coplan JD et al. Respiratory variability in panic disorder. Depress Anxiety. 2001. 14(4):232-237. doi:10.1002/da.1072
Meuret AE, Ritz T. Hyperventilation in panic disorder and asthma: empirical evidence and clinical strategies. Int J Psychophysiol. 2010;78(1):68-79. doi:10.1016/j.ijpsycho.2010.05.006.
Moon HS, Lee SK, Chung JH et al. Hypocalcemia and hypokalemia due to hyperventilation syndrome in spinal anesthesia -A case report-. Korean J Anesthesiol. 2011;61(6):519-23. doi: 10.4097/kjae.2011.61.6.519.
Payne RB. Albumin-Adjusted Calcium and Ionized Calcium. Clin Chem. 2019;65(5):705-706. doi:10.1373/clinchem.2018.300905.
Parasa M, Saheb SM, Vemuri NN. Cramps and tingling: A diagnostic conundrum. Anesth Essays Res. 2014;8(2):247-249. doi:10.4103/0259-1162.134524
Cowley DS, Roy-Byrne PP. Hypocalcemic crisis. Hypoparathyroidism--non-parathyroid origin--the most frequent form: hyperventilation syndrome. Fortschr Med. 1996;114(17):223-226.
Macefield G, Burke D. Paraesthesiae and tetany induced by voluntary hyperventilation. Increased excitability of human cutaneous and motor axons. Brain. 1991;114:527-540. doi:10.1093/brain/114.1.527.
Tomioka S, Nakajo N. Beta-adrenergic blocker for hyperventilation syndrome in dentistry: A report of three cases. Oral Sci Int. 2011;8:34–35. doi: 10.1016/S1348-8643(11)00006-1.
Gardner WN. The pathophysiology of hyperventilation disorders. Chest. 1996;109(2):516-534. doi:10.1378/chest.109.2.516.
Tomioka S, Takechi M, Ohshita N et al. Propofol is not effective for hyperventilation syndrome. Anesth Analg. 2001;92(3):781-782. doi:10.1097/00000539-200103000-00042.
RuDusky BM. ECG abnormalities associated with hypocalcemia. Chest. 2001;119(2):668-669. doi:10.1378/chest.119.2.668-a.
Jones M, Harvey A, Marston L et al. Breathing exercises for dysfunctional breathing/hyperventilation syndrome in adults. Cochrane Database Syst Rev. 2013 (5):CD009041. doi:10.1002/14651858.CD009041.pub2
DeGuire S, Gevirtz R, Kawahara Y et al. Hyperventilation syndrome and the assessment of treatment for functional cardiac symptoms. Am J Cardiol. 1992;70(6):673-677. doi:10.1016/0002-9149(92)90211-g
DeGuire S, Gevirtz R, Hawkinson D et al. Breathing retraining: a three-year follow-up study of treatment for hyperventilation syndrome and associated functional cardiac symptoms. Biofeedback Self Regul. 1996;21(2):191-198. doi:10.1007/BF02284695
