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Yıl:2003; Cilt: 13; Sayı: 4>> Özet
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Klinik Psikofarmakoloji Bülteni; 2003;13(4):188-190
Organofosfat içeren tarım ilacıyla intihar girişiminde bulunan hastada anestezili elektrokonvulsif tedavi sonrası uzamış apne: bir olgu sunumu
M Yanık, M Cengiz, S Ganidağlı, M Katı
Harran Ü. Tıp Fak. Psikiyatri ABD, ŞanlıUrfa, Turkey
Organofosfat içeren tarım ilaçlarıyla intihar girişimi ülkemizde sık rastlanan intihar yöntemlerinden birisidir. Organofosfatlar asetilkolinesteraz enzimine dönü.ümsüz bağlanarak onu inaktif hale getirirler. Plazma asetilkolinesterazının inhibe edilmesi ile, bu enzim tarafından yıkılan süksinilkolin ve mivaküryum gibi kas gev.eticilerin etkileri artmaktadır. Bu kas gevşeticilerin etkileri sonlandırılamazsa tüm kaslarda paralizi gelişir. Bu olgu sunumunda on gün öncesinde intihar amacıyla organofosfat almış, iki uçlu duygudurum bozukluğu-mikst epizod tanısı konulan bir olgunun, genel anestezi altında yapılan kas gevşeticili elektrokonvulsif tedavi sonrasında 6 saat devam eden apne tablosu sunularak; organofosfat zehirlenmesi olan kişilerde elektrokonvulsif tedavi uygulaması tartışılmıştır
Prolonged apnea following electroconvulsive therapy in a patient with attempted organophosphate suicide: a case report
Organophosphate poisoning is a frequent used method of suicide attempt in Turkey. Organophosphates are irreversibly bound to cholinesterase enzyme, causing deactivation of the enzyme. As a result the of inhibition of plasma cholinesterase, increased sensitivity to drugs hydrolyzed by this enzyme can occur, e.g. neuromuscular blockers such as succinylcholine and mivacurium may be affected. Muscle paralysis continues if the action of these neuromuscular drugs is not terminated. In this case report we present a case of a 6-hour period of apnea and paralysis following anesthesia with a muscle relaxant for electroconvulsive therapy in a bipolar disorder patient with mixed episode who attempted suicide with organophosphate ten days prior.(

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