Methylene Tetrahydrofolate Reductase Deficiency: the Hidden Risk in Paediatric Anaesthesia.

Autor: Orhon ZN; Department of Anaesthesiology and Reanimation, Medeniyet University Göztepe Training and Research Hospital, İstanbul, Turkey., Koltka EN; Department of Anaesthesiology and Reanimation, Medeniyet University Göztepe Training and Research Hospital, İstanbul, Turkey., Tüfekçi S; Department of Anaesthesiology and Reanimation, Medeniyet University Göztepe Training and Research Hospital, İstanbul, Turkey., Buldağ Ç; Department of Anaesthesiology and Reanimation, Medeniyet University Göztepe Training and Research Hospital, İstanbul, Turkey., Kısa A; Department of Anaesthesiology and Reanimation, Medeniyet University Göztepe Training and Research Hospital, İstanbul, Turkey., Durakbaşa ÇU; Department of Pediatric Surgery, Medeniyet University Göztepe Training and Research Hospital, İstanbul, Turkey., Çelik M; Department of Anaesthesiology and Reanimation, Medeniyet University Göztepe Training and Research Hospital, İstanbul, Turkey.
Jazyk: angličtina
Zdroj: Turkish journal of anaesthesiology and reanimation [Turk J Anaesthesiol Reanim] 2017 Oct; Vol. 45 (5), pp. 277-281. Date of Electronic Publication: 2017 Apr 27.
DOI: 10.5152/TJAR.2017.68366
Abstrakt: Objective: Methylene tetrahydrofolate reductase (MTHFR) deficiency is an autosomal recessive disorder that results in increased homocysteine levels in the body. Hyperhomocysteinemia causes a predisposition to venous and arterial thrombosis and ischaemic insults. The incidence of the deficiency is around 40% in some countries. In this study, we aimed to evaluate the effects of anaesthetic agents in children with MTHFR deficiency.
Methods: Twelve paediatric patients with an MTHFR enzyme deficiency who underwent surgery in a ten-month period in a single centre were retrospectively evaluated. Demographic data, homocysteine levels before and after surgery, anaesthesia management and postoperative complications were recorded.
Results: In four patients, propofol was used both for anaesthesia induction and total intravenous anaesthesia (TIVA). Eight patients received sevoflurane for both induction and maintenance of anaesthesia. Nitrous oxide (N 2 O) was not used in any patients. There was not a significant difference between the preoperative and postoperative homocysteine levels (p>0.05). Twenty-four hours after the surgery, the homocysteine levels were within normal limits. No complications were observed.
Conclusion: Sevoflurane and propofol have no deleterious effects on homocysteine levels in patients with MTHFR deficiency. Avoidance of N 2 O is the key point for anaesthetic consideration regarding these patients.
Competing Interests: Conflict of Interest: No conflict of interest was declared by the authors.
Databáze: MEDLINE
Externí odkaz: