Gebelerde Sugammadeks Uygulamasinin Retrospektif Olarak İncelenmesi

Abstract

OZ Giris: Geleneksel olarak, non depolarizan kas gevsetici etkilerinin geri dondurulmesinde asetil kolinesteraz inhi- bitorleri kullanilmaktadir. Ancak, bu ajanlarin bazi yan etkileri mevcuttur. Sugammadeks, steroid yapidaki kas gev- seticilerin etkisini geri dondurmek icin hazirlanmis olan ilk ve tek selektif ajandir ve asetil kolinesteraz inhibitorlerinin istenmeyen kolinerjik ve muskarinik yan etkilerine sahip degildir. Gebelerde sugammadeks kullanimi ile ilgili yeter- li veri mevcut degildir. Bu retrospektif calismada sezaryen uygulanan gebelerde 1 yillik surede sugammadeks ile ilgili deneyimlerimizin sunulmasi amaclandi. ABSTRACT Retrospective Analysis of Sugammadex Administration in Pregnants Background: Usually acetylcholinesterase inhibitors are used for the reversal of non depolarising agents induced neuromuscular blockade. However, these agents have some side effects. Sugammadex is the first and only selective agent for reversing the effect of steroidal neuromuscular blockers and has not any unwanted cholinergic and musca- rinic effects unlike acetylcholinesterase inhibitors. There is not sufficient data for sugammadex usage in pregnant pati - ents. In this retrospective study we would like to present our data for sugammadex usage after cesarean sections. Material and Methods: During this retrospective study we looked through intraoperative anesthesiology data and patient dossiers of all patients, who had been undergo- ne cesarean section between 01/09/2011 and 01/09/2012 in our clinic. We have recorded patients' age, ASA score, body weight, pre-pregnancy body weight, duration of the operation, allergic reactions, intraoperative and postope- rative complications, previous aneesthesis, comorbide di- seases, whether the operation was performed in emergency or elective conditions and the indication of sugammadex administration. Results: Sugammedex was used for 16 (1 %) patients from total 1681 cesarean sections. The average operation dura- tion was 52.81±16.83 minutes. 37.5 % of the patients were operated in elective condition and 62.5 % in emergency condition. Sugammadex indication was difficult entubati - on for 4 patients (25 %), inadequate decurarisation for 7 patients (43.7 %), morbid obesity for 2 patients (12.5 %), HELLP (hemolysis, elevated liver functions and low pla- telet count) syndrome for 2 patients (12.5 %) and severe hemodynamic instability for 1 patient (6.2 %). We have not experienced any allergic reactions, intraoperative and pos- toperative complications in Sugammadex used patients. Sonuc: Sugammadex was used for 1 % of patients operated for cesarean section. The indication of Sugammadex admi- nistration was difficult intubation, morbid obesity, inadequa - te decurarisation and hemodynamic instability. We have not experienced any compliction due to Sugammadex usage.