Metakromatik Lökodistrofi (Mld) (Juvenil Tip) Tanılı Çocuk Hastada Genel Anestezi Altında Çoklu Dental Girişim
Özet
Metakromatik Lökodistrofi (MLD) (Juvenil tip) tanısı ile takip edilmekte olan 10 yaşında erkek hasta genel anestezi altında yapılması planlanan diş tedavisi nedeniyle anestezi polikliniğinde preoperatif değerlendirildi. Fizik muayenesi yapıldı, tahlil ve tetkikleri istendi, Çocuk Hastalıkları Uzmanı konsültasyonu ile preoperatif değerlendirme süreci tamamlandı. Spastisiteye bağlı anormal kas tonusu, azalmış faringeal kas gücü ve aşırı kilodan kaynaklanan artmış aspirasyon riski nedeniyle serviste premedikasyon uygulamasından kaçınıldı. Ameliyathaneye alınan hastaya modifiye hızlı-seri indüksiyon (modified rapid sequence induction: mRSI) ile 6 L dk-1 %4 sevofluran ve oksijen(O2) karışımı ile preoksijenasyon sonrası nazal entübasyon yapıldı. Sevofluran inhalasyonu ve intravenöz (İV) remifentanil infüzyonu ile dengeli anestezi idamesi sağlandı. 1 saat 40 dakika süren operasyon sonrasında yeterli düzeyde uyanıklık ve spontan solunumu olan hasta ekstübe edildi. Postoperatif derlenme ünitesinde bir saat takip edilen hasta, oral veya nazal kanamasının olmaması ve hemodinamik açıdan stabil olması üzerine servise transfer edildi.
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TARD. Günübirlik Anestezi Kılavuzu 2022. (25/08/2025 tarihinde https://akademi.tard.org.tr/?p=kilavuz-detay&bID=43&session=115147480u345442440s575737401 adresinden ulaşılmıştır).
