Anestezi indüksiyonu sonrası gabapentine bağlı atriyoventriküler tam blok gelişen bir hasta: Çok nadir bir olgu

Relationship Between Serum Asymmetric Dimethylarginine (ADMA) Level And Obstructive Sleep Apnea Syndrome (OSAS) Severity

Özet

Nonkardiyak cerrahilerde, genel anestezi sırasında atriyoventriküler tam blok gelişmesi çok nadir görülen bir durumdur. Kardiyak patoloji veya kardiyak iletiyi etkileyen ilaç ya da metabolik predispozan faktörlerin varlığı ile atriyoventriküler blok gelişme olasılığında artış görülebilir. Bu durumda, kullanılan anestezik ajanlar da blok gelişimine katkıda bulunabilir. Biz de bu olguda, sol dal bloğu olan ve gabapentin kullanan bir hastada genel anestezi indüksiyonu sırasında atriyoventriküler tam blok gelişen hastayı sunmayı amaçladık.

Abstract

Introduction: The repetitive hypoxemia can induce oxidative stress mechanisms. Oxidative stress increases serum ADMA levels in patients with OSAS. Aim: To investigate the relationship between serum levels of ADMA and OSAS severity. Methods: 330 patient’s records, who underwent overnight polysomnography (PSG) were retrospectively examined. The patients who had a abnormal serum glucose, lipid, thyroid, renal and liver function tests levels, had excluded. 72 patients had participating criteria. Patients were categorized into five groups according to apnea/hipopnea index (AHI). Measurement of ADMA levels was performed by ELISA kit. Results: The mean age was 44,19 ± 14,24 years. 31,9 % of the patients were female. Patients in normal group, severe, medium, mild and positional–REM dependent OSAS group were 26,4%, 25%, 6,9 %, 16,7% and 25%; respectively. A significant positive correlation was found between AHI and ADMA (r= 0,483; p 10) and the negative likelihood ratio was (LR-) 0,28 (R-