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Baş-Boyun Mukormikozisli Hastalarda Anestezi

Year 2019, Volume: 2 Issue: 3, 199 - 203, 26.12.2019

Ebru Biricik Demet Laflı Tunay

https://doi.org/10.36516/jocass.2019.23

Abstract

Amaç: Mukormikozis özellikle immunsuprese veya diyabetik hastalarda görülen fırsatçı bir mantar enfeksiyonudur. Tedavisi antifungal tedavi ve cerrahi debridman olan bu mantar enfeksiyonunda, hastaların çoğunluğu hemodinamik olarak anstabildir ve çoklu organ yetmezliği bulunabilir. Bu derlemede mukormikozis tanılı cerrahi girişim planlanan hastalarda anestezi ile ilgili zorluklara dikkat çekmek istedik.

Tartışma: Mukormikozisli hastalar komorbiditelerinin fazlalığına bağlı olarak %95’lere varan oranda mortaliteye sahiptirler. Sepsis, multi organ yetmezliği, kötü hematolojik profil (örn. pansitopeni) bu hastalarda sıklıkla eşlik etmektedir. Yine bu hastalarda anestezi uygulaması kadar preoperatif değerlendirme de önem kazanmaktadır. İntravenöz erişim ve hava yolu yönetiminde zorluklar yaşanabileceği gibi hastalar ciddi kan kan transfüzyonuna ve hemodinamik desteğe ihtiyaç duyabilir. Hastaların bir kısmında ise diyabetes mellitus ve hatta diyabetik ketoasidoz vardır. Bu nedenle, bu hastalarda kan şekerinin yakın takibi ve regülasyonu gerekir. Enfeksiyonlar, organ yetmezlikleri, kan transfüzyonları ve medikal antifungal tedavi nedeniyle bu hastalarda multidisipliner yaklaşım gereklidir. Cerrahinin yeri ve büyüklüğü de cerrahi öncesi hazırlık açısından göz önünde bulundurulmalıdır.

Sonuç: Mukormikozisli hastalar, gerek immün suprese olmaları gerekse eşlik eden komorbiditeleri nedeniyle anestezi uzmanları için dikkat gerektiren hasta grubudur. 

Anahtar kelimeler: Anestezi, baş-boyun mukormikozisi, preoperatif değerlendirme.

Keywords

Anestezi baş-boyun mukormikozisi preoperatif değerlendirme

References

  • 1. Chen CY, Sheng WH, Cheng A. Invasive fungal sinusitis in patients with hematological malignancy: 15 years experience in a single university hospital in Taiwan. BMC Infect Dis. 2011;11:250. doi: 10.1186/1471-2334-11-250.
  • 2. Akagün F, Şekercan Ö, Batmaz T, et al. Rinoorbital Mukormikoz: Palatal Nekroz. İstanbul Tıp Derg - Istanbul Med J. 2011;12(2):96-100.
  • 3. Ramadorai A, Ravi P, Narayanan V. Rhinocerebral Mucormycosis: A Prospective Analysis of an Effective Treatment Protocol. Ann Maxillofac Surg. 2019;9(1):192-6. doi: 10.4103/ams.ams_231_18.
  • 4. Sağıt M, Hıra İ, Polat H et al. Rinoorbital Mukormikozisli Hastalarda Tedavi Yaklaşımımız. KBB Forum. 2017;16(1): 35-42.
  • 5. Shanbag R, Rajan NR, Kumar A. Acute invasive fungal rhinosinusitis: our 2 year experience and outcome analysis. Eur Arch Otorhinolaryngol. Epub 2019;276(4):1081-7. doi: 10.1007/s00405-019-05288-w.
  • 6. Roden MM, Zaoutis TE, Buchanan WL, et al. Epidemiology and outcome of zygomycosis: a review of 929 reported cases. Clin Infect Dis. 2005;41(5):634-53.
  • 7. Zafar S, Prabhu A. Rhino-orbito-cerebral mucormycosis: recovery against the odds. Pract Neurol. Epub 2017;17(6):485-8. doi: 10.1136/practneurol-2017-001671.
  • 8. Çelebi N, Canbay Ö, Su M, et al. Mukormikozis’li Hastada Anestezik Yaklasım. Turkiye Klinikleri J Anest Reanim. 2008;6(1):38-40.
  • 9. Karaaslan E. Anesthetic management of rhinoorbitocerebral mucormycosis; Focus on challenges. J Mycol Med. 2019;S1156-5233(18):30276-2. doi: 10.1016/j.mycmed.2019.07.001. [Epub ahead of print]
  • 10. Kulkarni PK, Reddy NB, Shrinivas B et al. Anesthetic considerations in the management of mucormycosis. Int J Med Public Health. 2015;5:387–90.
  • 11. Eckmann DM, Seligman I, Coté CJ et al. Mucormycosis supraglottitis on induction of anesthesia in an immunocompromised host. Anesth Analg. 1998;86(4):729-30.
  • 12. Vahabzadeh-Hagh AM, Chao KY, Blackwell KE. Invasive Oral Tongue Mucormycosis Rapidly Presenting After Orthotopic Liver Transplant. Ear Nose Throat J. Epub 2019;98(5):268-70. doi: 10.1177/0145561319840535.
  • 13. Baiu I, Knowlton LM. Mucormycosis emboli: a rare cause of segmental bowel ischemia. Trauma Surg Acute Care Open. 2019;14:4.
  • 14. Eckmann DM, Seligman I, Cote´ CJ, et al. Mucormycosis supraglottitis on induction of anesthesia in an immunocompromised host. Anesth Analg. 1998;86:729–30.
  • 15. Bhat MT, Hegde HV, Santhosh MC, et al. Orbital exenteration under trigeminal block: An innovative method of regional anesthesia. Saudi J Anaesth. 2013;7(4):470-3.

Year 2019, Volume: 2 Issue: 3, 199 - 203, 26.12.2019

Ebru Biricik Demet Laflı Tunay

https://doi.org/10.36516/jocass.2019.23

Abstract

References

  • 1. Chen CY, Sheng WH, Cheng A. Invasive fungal sinusitis in patients with hematological malignancy: 15 years experience in a single university hospital in Taiwan. BMC Infect Dis. 2011;11:250. doi: 10.1186/1471-2334-11-250.
  • 2. Akagün F, Şekercan Ö, Batmaz T, et al. Rinoorbital Mukormikoz: Palatal Nekroz. İstanbul Tıp Derg - Istanbul Med J. 2011;12(2):96-100.
  • 3. Ramadorai A, Ravi P, Narayanan V. Rhinocerebral Mucormycosis: A Prospective Analysis of an Effective Treatment Protocol. Ann Maxillofac Surg. 2019;9(1):192-6. doi: 10.4103/ams.ams_231_18.
  • 4. Sağıt M, Hıra İ, Polat H et al. Rinoorbital Mukormikozisli Hastalarda Tedavi Yaklaşımımız. KBB Forum. 2017;16(1): 35-42.
  • 5. Shanbag R, Rajan NR, Kumar A. Acute invasive fungal rhinosinusitis: our 2 year experience and outcome analysis. Eur Arch Otorhinolaryngol. Epub 2019;276(4):1081-7. doi: 10.1007/s00405-019-05288-w.
  • 6. Roden MM, Zaoutis TE, Buchanan WL, et al. Epidemiology and outcome of zygomycosis: a review of 929 reported cases. Clin Infect Dis. 2005;41(5):634-53.
  • 7. Zafar S, Prabhu A. Rhino-orbito-cerebral mucormycosis: recovery against the odds. Pract Neurol. Epub 2017;17(6):485-8. doi: 10.1136/practneurol-2017-001671.
  • 8. Çelebi N, Canbay Ö, Su M, et al. Mukormikozis’li Hastada Anestezik Yaklasım. Turkiye Klinikleri J Anest Reanim. 2008;6(1):38-40.
  • 9. Karaaslan E. Anesthetic management of rhinoorbitocerebral mucormycosis; Focus on challenges. J Mycol Med. 2019;S1156-5233(18):30276-2. doi: 10.1016/j.mycmed.2019.07.001. [Epub ahead of print]
  • 10. Kulkarni PK, Reddy NB, Shrinivas B et al. Anesthetic considerations in the management of mucormycosis. Int J Med Public Health. 2015;5:387–90.
  • 11. Eckmann DM, Seligman I, Coté CJ et al. Mucormycosis supraglottitis on induction of anesthesia in an immunocompromised host. Anesth Analg. 1998;86(4):729-30.
  • 12. Vahabzadeh-Hagh AM, Chao KY, Blackwell KE. Invasive Oral Tongue Mucormycosis Rapidly Presenting After Orthotopic Liver Transplant. Ear Nose Throat J. Epub 2019;98(5):268-70. doi: 10.1177/0145561319840535.
  • 13. Baiu I, Knowlton LM. Mucormycosis emboli: a rare cause of segmental bowel ischemia. Trauma Surg Acute Care Open. 2019;14:4.
  • 14. Eckmann DM, Seligman I, Cote´ CJ, et al. Mucormycosis supraglottitis on induction of anesthesia in an immunocompromised host. Anesth Analg. 1998;86:729–30.
  • 15. Bhat MT, Hegde HV, Santhosh MC, et al. Orbital exenteration under trigeminal block: An innovative method of regional anesthesia. Saudi J Anaesth. 2013;7(4):470-3.
There are 15 citations in total.

Details

Primary Language Turkish
Subjects Anaesthesiology
Journal Section Reviews
Authors

Ebru Biricik 0000-0002-3355-198X

Demet Laflı Tunay 0000-0002-7984-1800

Publication Date December 26, 2019
Acceptance Date October 24, 2019
Published in Issue Year 2019 Volume: 2 Issue: 3

Cite

APA Biricik, E., & Laflı Tunay, D. (2019). Baş-Boyun Mukormikozisli Hastalarda Anestezi. Journal of Cukurova Anesthesia and Surgical Sciences, 2(3), 199-203. https://doi.org/10.36516/jocass.2019.23
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