Spinal Anestezi Altında Antibiyotiğe Bağlı Gelişen Anafilaktik Şok: Teşhis ve Yönetim Stratejilerine Işık Tutan Bir Olgu
Özet
Anafilaksi bir alerjene karşı gelişen akut ve yaşamı tehdit edici sistemik bir hipersensitivite reaksiyonudur (1). Perioperatif dönemde en sık antibiyotikler, nöromüsküler blokörler, klorheksidin, lateks ve metilen mavisi gibi boyalar nedeniyle ortaya çıkar (2). Hızla gelişen deri döküntüleri, ürtiker, kızarıklık, eritem, anjiyoödem, bulantı, kusma, diyare gibi gastrointestinal semptomlar, rinokonjonktivit, bronkospazm gibi respiratuvar semptomlar, taşikardi ve hipotansiyon perioperatif anafilaksinin belirtilerindendir (3). Spinal anesteziye bağlı belirgin sempatik blokaj varlığında anafilaksi tedavi yönetimi güçleşebilmektedir. Bu olgu sunumunda spinal anestezi uygulanmış bir hastada antibiyotik uygulaması sonrası gelişen anafilaksinin tanı ve tedavisi tartışılmıştır.
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