Harun ÖZMEN, Bahar AYDINLI, Uğur Serkan ÇİTİLCİOĞLU, Aydın YÜCEL

Preterm Eylem ile Sezaryene Alınan Akut Eroin Kullanımı Olan Hastada Anestezi Yönetimi

Madde suistimali toplumsal sorun olup, cerrahi gerektiren hastalarda anestezi uygulamasına ekrisklerle morbiditeyi arttırabilir. Konu sezaryen olduğunda hem bebek hem anne açısından iyi biranestezi tekniği seçimi ve yönetimi zorunlu hale gelir. Olgu, 30 yaşında 50 kg idi; multipar, 34haftalık gebeliği, eski sezaryen öyküsü olan ve rutin takipleri bulunmayan gebe, ani başlayan aktifservikal kanama, preterm eylemle başvurdu. Vital bulguları stabil, laboratuvar değerleri normalsınırlarda olan, 4 saat önce eroin kullandığı, tok olduğu öğrenilen hasta acil şartlarda sezaryenealındı. Genel anestezi altında 1.500 g ağırlığında bebek doğurtuldu. Yenidoğan yoksunluk sendromu gelişen bebeğe yoğun bakım ünitesinde fenobarbital tedavisi uygulandı. Annede madde kullanımına bağlı yoksunluk sendromu ve başka komplikasyon olmadı. Postoperatif 5. günde anneve bebek taburcu edildi.

Anesthetic Management in An Acute Heroin User Undergoing Emergency Cesarean Section with the Indication of Preterm Labour

Substance abuse is a social problem and may increase morbidity with additional risks to the administration of anesthesia in patients requiring surgery. When it comes to cesarean section, the choice and management of a good anesthetic technique is mandatory for both the baby and the mother. A 30-year-old multiparous patient weighing 50 kg, in her 34 gestational week with a history of cesarean section but without routine follow-up presented with a sudden onset of active cervical hemorrhage and preterm labour. The patient’s vital signs were stable, laboratory values were within normal limits. It was learnt that she used heroin 4 hours previously, and she was not hungry. She underwent caesarean section under emergency conditions. A baby weighing 1500 g was delivered under general anesthesia. The infant was diagnosed with newborn withdrawal syndrome and phenobarbital treatment was performed in the neonatal intensive care unit. Maternal withdrawal syndrome and other complications did not occur. On the postoperative 5th day, the mother and baby were discharged.

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