Panhipopitüitarizmli Olguda Perioperatif Yönetim
Özet
Hipopituitarizm, steroid ve tiroid hormonları gibi hayati endokrinolojik hormonların kısmi veya tam eksikliği ile karakterizedir. Genel olarak normal bir bireyin stresli döneminde serum kortizol düzeylerinde 2 ila 10 kat artış görülebilir. Ancak panhipopituitarizmi olan hastalarda özellikle stresli perioperatif dönemde metabolik ve hemodinamik instabilite gelişmeye daha yatkındır. Bu potansiyel olarak ciddi morbidite ve mortaliteyi artırabilir. Biz de trafik kazası nedeniyle intertrokanterik femur kırığı olan panhipopitüitarizmli hastamızda anestezi yönetimimizi sunmayı amaçladık.
Referanslar
Siminelakis S, Kotsanti A, Baikoussis NG, et al. Congenital hypopituitarism: monitoring after coronary artery bypass grafting. Annals of cardiac anaesthesia. 2010;13:257–259. doi: 10.4103/0971-9784.69051
Abdu TA, Elhadd T, Pfeifer M, et al. Endothelial dysfunction in endocrine disease. Trends Endocrinology Metabolism. 2001;12:257–265. doi: 10.1016/s1043-2760(01)00425-8
Capaldo B, Guardasole V, Pardo F, et al. Abnormal vascular reactivity in growth hormone deficiency. Circulation 2001;103:520–524. doi: 10.1161/01.cir.103.4.520
Yasuda T, Kawasuji M, Ishida Y, et al. Coronary artery bypass grafting in patients with hypopituitarism. Japanese Circulation Journal. 2000;64:207–208. doi: 10.1253/jcj.64.207
Ladenson PW, Levin AA, Ridgway EC, et al. Complications of surgery in hypothyroid patients. American Journal of Medicine. 1984;77:261–266. doi : 10.1016/0002-9343(84)90701-0
Syed AU, Al Fagih MR, Fouda M.. Coronary bypass surgery in patients with Sheehan's syndrome. European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery. 2001;20:1264–1266. doi: 10.1016/s1010-7940(01)01006-5
Fleseriu M, Hashim IA, Karavitaki N, et al. Hormonal replacement in hypopituitarism in adults: an endocrine society clinical practice guideline. The Journal Clinical Endocrinology and Metabolism. 2016;101:3888–3921.doi: 10.1210/jc.2016-2118
Patil N, Rehman A, Anastasopoulou C et al. Hypothyroidism. Treasure Island (FL): StatPearls Publishing; 2024 Jan.
Elshimy G, Chippa V, Correa R. Myxedema. Treasure Island (FL): StatPearls Publishing; 2024 Jan.
Butterworth J.F., Mackey D.C., Wasnick J.D. Morgan and Mikhail Clinical Anesthesiology 6.th ed. (F. Handan Cuhruk ed.). NewYork :Mcgraw-Hill Medical publishing. 2018
Matsumoto S, Shingu C, Hidaka S, et al. Anesthetic management of a patient with hyperthyroidism due to hydatidiform mole. Journal of anesthesia. 2009;23:594–6. doi : 10.1007/s00540-009-0809-5
Liao Z, Xiong Y, Luo L. Low-dose spinal-epidural anesthesia for Cesarean section in a parturient with uncontrolled hyperthyroidism and thyrotoxic heart disease. Journal of anesthesia. 2016 Aug;30(4):731-4. doi: 10.1007/s00540-016-2186-1
Hirvonen EA, Niskanen LK, Niskanen MM. Thyroid storm prior to induction of anaesthesia. Anaesthesia. 2004 Oct;59(10):1020-2. doi: 10.1111/j.1365-2044.2004.03838.x.
Weinberg AD, Brennan MD, Gorman CA, et al. Outcome of anesthesia and surgery in hypothyroid patients. Archives of Internal Medicine. 1983;143: 893–7.
Van Boxstael S, Peene L, Dylst D, et al. The effect of spinal versus general anaesthesia on perioperative muscle weakness in patients having bilateral total hip arthroplasty: a single center randomized clinical trial. European Journal Medical Resesarch. 2023; 28(1): 450. doi: 10.1186/s40001-023-01435-6.
Vrbanović Mijatović V, Gatin L, Tonković D, et al. The effect of regıonal vs. General anesthesıa on the ımmune response ın breast cancer surgery: a narratıve revıew of the lıterature. Acta Clinica Croatica. 2022 ;61 (2):115-120. doi: 10.20471/acc.2022.61.s2.15.
Abu Elyazed MM, Mostafa SF, Abdullah MA, et al. The effect of ultrasound-guided transversus abdominis plane (TAP) block on postoperative analgesia and neuroendocrine stress response in pediatric patients undergoing elective open inguinal hernia repair. Paediatric Anaesthesia. 2016; 26(12):1165-1171. doi: 10.1111/pan.12999.
Rathod PR, Bhoi D, Kumar A, et al. Effect of ultrasound-guided quadratus lumborum block on neuroendocrine stress response and postoperative analgesia in paediatric patients undergoing elective open pyeloplasty - A randomised clinical trial. Indian Journal of Anaesthesia. 2024 ;68(5):467-472. doi: 10.4103/ija.ija_608_23.
Lai HY, Foo LL, Lim SM, et al. The hemodynamic and pain impact of peripheral nerve block versus spinal anesthesia in diabetic patients undergoing diabetic foot surgery. Clinical autonomic research : official journal of the Clinical Autonomic Research Society. 2020 ;30(1):53-60. doi: 10.1007/s10286-017-0485-8.
Barends CR, Absalom A, van Minnen B, et al. Dexmedetomidine versus Midazolam in Procedural Sedation. A Systematic Review of Efficacy and Safety. PLoS One. 2017 Jan 20;12(1):e0169525. doi: 10.1371/journal.pone.0169525.
Wang XW, Cao JB, Lv BS, et al. Effect of perioperative dexmedetomidine on the endocrine modulators of stress response: a meta-analysis. Clinical and experimental pharmacology & physiology. 2015; 42(8):828-36. doi: 10.1111/1440-1681.12431.
Paola A, Carlo L, Cinzia DR et al. Stress Response to Surgery, Anesthetics Role and Impact on Cognition. Journal of Anesthesia & Clinical Research. 2015; July 6;7. doi: 10.4172/2155-6148.1000539
Referanslar
Siminelakis S, Kotsanti A, Baikoussis NG, et al. Congenital hypopituitarism: monitoring after coronary artery bypass grafting. Annals of cardiac anaesthesia. 2010;13:257–259. doi: 10.4103/0971-9784.69051
Abdu TA, Elhadd T, Pfeifer M, et al. Endothelial dysfunction in endocrine disease. Trends Endocrinology Metabolism. 2001;12:257–265. doi: 10.1016/s1043-2760(01)00425-8
Capaldo B, Guardasole V, Pardo F, et al. Abnormal vascular reactivity in growth hormone deficiency. Circulation 2001;103:520–524. doi: 10.1161/01.cir.103.4.520
Yasuda T, Kawasuji M, Ishida Y, et al. Coronary artery bypass grafting in patients with hypopituitarism. Japanese Circulation Journal. 2000;64:207–208. doi: 10.1253/jcj.64.207
Ladenson PW, Levin AA, Ridgway EC, et al. Complications of surgery in hypothyroid patients. American Journal of Medicine. 1984;77:261–266. doi : 10.1016/0002-9343(84)90701-0
Syed AU, Al Fagih MR, Fouda M.. Coronary bypass surgery in patients with Sheehan's syndrome. European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery. 2001;20:1264–1266. doi: 10.1016/s1010-7940(01)01006-5
Fleseriu M, Hashim IA, Karavitaki N, et al. Hormonal replacement in hypopituitarism in adults: an endocrine society clinical practice guideline. The Journal Clinical Endocrinology and Metabolism. 2016;101:3888–3921.doi: 10.1210/jc.2016-2118
Patil N, Rehman A, Anastasopoulou C et al. Hypothyroidism. Treasure Island (FL): StatPearls Publishing; 2024 Jan.
Elshimy G, Chippa V, Correa R. Myxedema. Treasure Island (FL): StatPearls Publishing; 2024 Jan.
Butterworth J.F., Mackey D.C., Wasnick J.D. Morgan and Mikhail Clinical Anesthesiology 6.th ed. (F. Handan Cuhruk ed.). NewYork :Mcgraw-Hill Medical publishing. 2018
Matsumoto S, Shingu C, Hidaka S, et al. Anesthetic management of a patient with hyperthyroidism due to hydatidiform mole. Journal of anesthesia. 2009;23:594–6. doi : 10.1007/s00540-009-0809-5
Liao Z, Xiong Y, Luo L. Low-dose spinal-epidural anesthesia for Cesarean section in a parturient with uncontrolled hyperthyroidism and thyrotoxic heart disease. Journal of anesthesia. 2016 Aug;30(4):731-4. doi: 10.1007/s00540-016-2186-1
Hirvonen EA, Niskanen LK, Niskanen MM. Thyroid storm prior to induction of anaesthesia. Anaesthesia. 2004 Oct;59(10):1020-2. doi: 10.1111/j.1365-2044.2004.03838.x.
Weinberg AD, Brennan MD, Gorman CA, et al. Outcome of anesthesia and surgery in hypothyroid patients. Archives of Internal Medicine. 1983;143: 893–7.
Van Boxstael S, Peene L, Dylst D, et al. The effect of spinal versus general anaesthesia on perioperative muscle weakness in patients having bilateral total hip arthroplasty: a single center randomized clinical trial. European Journal Medical Resesarch. 2023; 28(1): 450. doi: 10.1186/s40001-023-01435-6.
Vrbanović Mijatović V, Gatin L, Tonković D, et al. The effect of regıonal vs. General anesthesıa on the ımmune response ın breast cancer surgery: a narratıve revıew of the lıterature. Acta Clinica Croatica. 2022 ;61 (2):115-120. doi: 10.20471/acc.2022.61.s2.15.
Abu Elyazed MM, Mostafa SF, Abdullah MA, et al. The effect of ultrasound-guided transversus abdominis plane (TAP) block on postoperative analgesia and neuroendocrine stress response in pediatric patients undergoing elective open inguinal hernia repair. Paediatric Anaesthesia. 2016; 26(12):1165-1171. doi: 10.1111/pan.12999.
Rathod PR, Bhoi D, Kumar A, et al. Effect of ultrasound-guided quadratus lumborum block on neuroendocrine stress response and postoperative analgesia in paediatric patients undergoing elective open pyeloplasty - A randomised clinical trial. Indian Journal of Anaesthesia. 2024 ;68(5):467-472. doi: 10.4103/ija.ija_608_23.
Lai HY, Foo LL, Lim SM, et al. The hemodynamic and pain impact of peripheral nerve block versus spinal anesthesia in diabetic patients undergoing diabetic foot surgery. Clinical autonomic research : official journal of the Clinical Autonomic Research Society. 2020 ;30(1):53-60. doi: 10.1007/s10286-017-0485-8.
Barends CR, Absalom A, van Minnen B, et al. Dexmedetomidine versus Midazolam in Procedural Sedation. A Systematic Review of Efficacy and Safety. PLoS One. 2017 Jan 20;12(1):e0169525. doi: 10.1371/journal.pone.0169525.
Wang XW, Cao JB, Lv BS, et al. Effect of perioperative dexmedetomidine on the endocrine modulators of stress response: a meta-analysis. Clinical and experimental pharmacology & physiology. 2015; 42(8):828-36. doi: 10.1111/1440-1681.12431.
Paola A, Carlo L, Cinzia DR et al. Stress Response to Surgery, Anesthetics Role and Impact on Cognition. Journal of Anesthesia & Clinical Research. 2015; July 6;7. doi: 10.4172/2155-6148.1000539
