MAO-B İnhibitörü Kullanan Progresif Supranükleer Palsi’li Hastada Spinal Anestezi Deneyimi

Year 2021, Volume: 3 Issue: 3, 267 - 269, 01.09.2021

Erol Toy , Kenan Kart , Duygu Taşkın

https://doi.org/10.37990/medr.939389

Abstract

Progresif supranükleer palsi (PSP), postural instabilite ve hafif demans ile karakterize nadir bir klinik sendromdur. PSP’nin klasik klinik tablosunda şiddetli yürüme ve denge bozukluğu, genel bradikinezi, frontal demans, görme bozuklukları, dizartri ve disfaji vardır. Bu hastalarda disfajinin neden olduğu aspirasyon pnömonisi başlıca ölüm nedenidir.
MAO-B inhibitörü kullanan 72 yaşındaki PSP hastasındaki spinal anestezi deneyimlerimizi sunmayı amaçladık. PSP’li hastalarda disfaji nedeniyle aspirasyon riskinin yüksek olması, ilaç etkileşimi yüksek olan çeşitli medikal tedaviler kullanıyor olmalarının göz önünde bulundurulmasını ve anestezi tercihinin rejyonel anesteziden yana yapılmasını önermekteyiz. Aynı zamanda MAO-B inhibitörü kullanan hastalarda eğer ilaç kesilemiyor ise genel ve rejyonel anestezi sırasında opioidlerin dikkatli kullanılmasını önermekteyiz.

Keywords

progresif supranükleer palsi, MAO-B inhibitörü, anestezi

Spinal anaesthesia experience in a patient with progressive supranuclear palsy using MAO-B inhibitor

Abstract

Progressive supranuclear palsy (PSP) is a rare clinical syndrome characterized by postural instability and mild dementia. The classical clinical picture of PSP includes severe gait and balance disorder, general bradykinesia, frontal dementia, visual disorders, dysarthria and dysphagia. Aspiration pneumonia is the leading cause of death in advanced PSP. We aimed to present our experiences in a 72-year-old patient with PSP using MAO-B inhibitor as an update for anaesthesiologists. We recommend that it should be taken into consideration that patients with PSP have a high risk of aspiration due to dysphagia and use of various medical treatments with high drug interaction and regional anaesthesia should be preferred. At the same time, we recommend the careful use of opioids during general or regional anaesthesia if the drug cannot be discontinued in patients using MAO-B inhibitor.

Keywords

progressive supranuclear palsy, MAO-B inhibitor, anaesthesia

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