Anesthesia management of pregnant patient with behçet’s disease: a case report

Objective: Behcet’s Disease is a chronic inflammatory with multiorgan involvements that it develope relapses. This disease is characterized with recurrent oral and genital ulcers, skin signs and uveitis. In this case report we discussed the anesthetic management of a pregnant patient with Behçet’s disease who underwent an emergency cesarean section.
Case: Nineteen year old pregnant patient with Behcet’s disease was scheduled for emergency caesarean delivery when fetal distress developed. She was diagnosed a year before and she did not use drugs during pregnancy. Cesarean section was performed under general anesthesia. Patient’s trackea was entubated with 7.0 endotracheal tube at the first attempt without any problems. Anesthesia was maintained with oxygen, air, sevoflurane and remifentanil. Hemodynamic parameters remained stable and there was no any complication. Apgar scores of the neonate were 8 and 10 at 1 and 5 minute respectively.
Conclusion: The main perioperative anaesthetic concerns are scarring of airway leading to difficult intubation and involvement of other organ systems. Due to the chronic drug therapy changes occur in organ systems causing more difficulty for the anaesthetic approach. The anesthetic technique for pregnant women with Behcet’s Disease requiring cesarean section remains at the discretion of the anesthesiologist, who should be guided by the clinical conditions of each patient.

Behçet hastalýðýna sahip gebe hastada anestezik yaklaþým: Olgu sunumu

Amaç: Behçet Hastalýðý alevlenmelerle seyreden, çoklu organ tutulumu gösteren, kronik enflamatuvar bir hastalýktýr. Hastalýk, tekrarlayan aðýz ve genital bölge ülserleri, deri bulgularý ve üveit ile karakterizedir. Bu olgu sunumunda acil sezaryen operasyonu planlanan Behçet hastalýðýna sahip gebede anestezi yönetimini tartýþtýk.
Olgu: On dokuz yaþýnda Behçet hastalýðý tanýlý gebe hasta fetal distres geliþmesi üzerine acil sezaryen planlandý. Hastamýz bir yýl önce Behçet Hastalýðý tanýsý almýþ. Gebelik boyunca ilaçlarýný kullanmayý býrakmýþ. Sezaryen operasyonu genel anestezi altýnda gerçekleþtirildi. Hasta herhangi bir problem yaþanmadan 7.0 endotrakeal tüp ile ilk seferde entübe edildi. Anestezi oksijen, hava, sevofluran ve remifentanil ile idamesi saðlandý. Hemodinamik parametreler stabil seyretti ve herhangi bir komplikasyon yaþanmadý. Yenidoðanýn 1. ve 5. dk Apgar skoru 8 ve 10 idi.
Sonuç: Perioperatif anestezik yaklaþýmda temel problemleri, organ tutulumlarý ve havayolundaki skarlaþmaya baðlý zor entübasyon oluþturur. Kronik ilaç tedavisine baðlý olarak organ ve sistemlerde birtakým deðiþiklikler meydana gelmekte ve bu durum anestezi yönetimini daha da karmaþýk hale getirmektedir. Sezaryen gerektiren Behçet hastalýðýna sahip gebe hastalar için anestezi tekniði her hastanýn klinik durumuna göre deðerlendirilip en son anestezistin takdirine kalýr.