Anesthetic management and outcomes of patients with Steven-Johnson Syndrome—A retrospective review study

Autor:	Sitaram P Maganti, Surender Pasupuleti, Dilipkumar Kulkarni, Sarada Devi Vankaylapatti, Manjula V Ramsali, Koshy G Puduchira
Rok vydání:	2021
Předmět:	Butorphanol medicine.medical_treatment airway problems ophthalmic surgery Sevoflurane Fentanyl 03 medical and health sciences Pharmacy and materia medica 0302 clinical medicine Anesthesiology 030202 anesthesiology Medicine RD78.3-87.3 Pharmacology (medical) General Pharmacology Toxicology and Pharmaceutics business.industry Medical record drugs and sensitivity 030208 emergency & critical care medicine general anesthesia RS1-441 Anesthesiology and Pain Medicine Isoflurane Anesthesia Anesthetic steven-johnson syndrome (sjs) Original Article Airway management sequel of sjs business Propofol medicine.drug
Zdroj:	Journal of Anaesthesiology Clinical Pharmacology, Vol 37, Iss 1, Pp 119-123 (2021) Journal of Anaesthesiology, Clinical Pharmacology
ISSN:	0970-9185
DOI:	10.4103/joacp.joacp_46_19
Popis:	Background and Aims: Steven-Johnson Syndrome (SJS) is a rare and severe form of erythema exudative multiforme. Multisystem involvement in SJS and the suspicion of precipitation of the disease with exposure to anesthetic drugs makes anesthesia a challenging task. The concerns during anesthesia are the mucosal lesions and special care that is required to prevent injury to the oropharynx and larynx during airway management and also the drugs used for anesthesia. In the literature, very few isolated case reports or case series are available. Here, we have analyzed the cases of SJS coming for ophthalmic anesthesia, taking into consideration factors like mode of presentation, precipitating factors, associated diseases, types of anesthesia, anesthetic modifications, and various drugs used during anesthesia. Material and Methods: The electronic medical records of 497 cases of SJS who required interventions like ophthalmic examination or surgery (either under local or general anesthesia) over a period of 18 months were analyzed retrospectively. The records were reviewed to obtain the concerned details like anesthesia-inducing agents, muscle relaxants, inhalational agents, and analgesics. The problems concerned with monitoring and intubation were also noted. The data were analyzed and presented as frequency and percentage. Results: Patient age ranged between 9 months and 72 years. Many surgeries were conducted under general anesthesia (441) although a few required local (peribulbar block) anesthesia (56). The drugs administered for general anesthesia were sevoflurane, isoflurane, propofol, thiopentone, vecuronium, and atracurium and those administered for pain management were fentanyl, tramadol, butorphanol, and paracetamol. The patients who were sensitive to nonsteroidal anti-inflammatory drugs (NSAIDs) and paracetamol were not administered the same. None of the patients reacted adversely to the different drugs used for anesthesia. Conclusion: Identifying the precipitating factors, understanding the pathophysiology and its implications for anesthesia will help in successfully managing anesthesia in the rare cases of SJS.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::bb5e5259b1b92b9e5dbe892c072a44af https://doi.org/10.4103/joacp.joacp_46_19 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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