Anaesthetic management of a patient with glucose-6-phosphate dehydrogenase deficiency undergoing robotic-assisted laparoscopic radical prostatectomy

Authors

  • Vani Bhageria Rajiv Gandhi Cancer Institute and Research Centre, Sector 5, Rohini, Delhi 110085 http://orcid.org/0000-0002-9227-0803
  • Itee Chowdhury Rajiv Gandhi Cancer Institute and Research Centre, Sector 5, Rohini, Delhi 110085
  • Nitesh Goel Rajiv Gandhi Cancer Institute and Research Centre, Sector 5, Rohini, Delhi 110085
  • Soumi Pathak Rajiv Gandhi Cancer Institute and Research Centre, Sector 5, Rohini, Delhi 110085 http://orcid.org/0000-0003-1987-6670

DOI:

https://doi.org/10.3126/jsan.v3i2.15621

Keywords:

Bispectral index monitor, Epidural analgesia, Glucosephosphate Dehydrogenase Deficiency, oxidative stress, Robotic surgical procedure.

Abstract

Glucose-6-phosphate dehydrogenase deficient patients may develop acute haemolysis after exposure to oxidative stress of surgery, and certain anaesthethic or alnalgesic agents. The steep trendelenburg position, pneumoperitoneum, and associated extreme hemodynamic changes in robotic surgery add on to oxidative stress. Here, we present a 68 year old Glucose-6-phosphate dehydrogenase deficient patient who uneventfully underwent robotic assisted laparoscopic radical prostatectomy focussing on avoidance of drugs predisposing haemolysis, minimizing surgical stress, providing adequate anxiolysis, analgesia, stable haemodynamics and depth of anaesthesia that is unique to robotic surgery.

Author Biographies

Vani Bhageria, Rajiv Gandhi Cancer Institute and Research Centre, Sector 5, Rohini, Delhi 110085

DNB, Department of Anaesthesia

Itee Chowdhury, Rajiv Gandhi Cancer Institute and Research Centre, Sector 5, Rohini, Delhi 110085

Senior consultant,

Nitesh Goel, Rajiv Gandhi Cancer Institute and Research Centre, Sector 5, Rohini, Delhi 110085

Consultant,

Soumi Pathak, Rajiv Gandhi Cancer Institute and Research Centre, Sector 5, Rohini, Delhi 110085

Consultant,

References

<ol>
<li>Cappellini MD, Fiorelli G. Glucose-6-phosphate dehydrogenase deficiency. Lancet 2008;371:64-74. <a href="http://dx.doi.org/10.1016/S0140-6736(08)60073-2">http://dx.doi.org/10.1016/S0140-6736(08)60073-2</a> <a href="http://www.ncbi.nlm.nih.gov/pubmed/18177777">[PMid: 18177777]</a></li>
<li>Jennifer E Frank. Diagnosis and Management of G6PD Deficiency. Am Fam Physician 2005;72:1277-82. <a href="http://www.ncbi.nlm.nih.gov/pubmed/16225031">[PMid:16225031]</a></li>
<li>Glucose-6-phosphate dehydrogenase deficiency. WHO Working Group. Bulletin of the World Health Organization 1989;67:601-11. <a href="http://www.ncbi.nlm.nih.gov/pubmed/2633878">[PMid:2633878]</a> <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2491315/">[PMCid:PMC2491315]</a></li>
<li>Aran T, Unsal MA, Guven S, Kart C, Cetin EC, Alver Carbon dioxide pneumoperitoneum induces systemic oxidative stress: a clinical study. Eur J Obstet Gynecol Reprod Biol 2015;161:80-3. <a href="http://dx.doi.org/10.1016/j.ejogrb.2011.11.027">http://dx.doi.org/10.1016/j.ejogrb.2011.11.027</a> <a href="http://www.ncbi.nlm.nih.gov/pubmed/22142814">[PMid:22142814]</a></li>
<li>Valiaveedan S, Mahajan C, Rath GP, Bindra A, Marda MK. Anaesthetic management in patients with glucose-6-phosphate dehydrogenase deficiency undergoing neurosurgical procedures. Indian J Anaesth 2011;55:68-70. <a href="http://dx.doi.org/10.4103/0019-5049.76597">http://dx.doi.org/10.4103/0019-5049.76597</a> <a href="http://www.ncbi.nlm.nih.gov/pubmed/21431058">[PMid:21431058]</a> <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3057251/">[PMCid:PMC3057251]</a></li>
<li>Depta AL, Erdos G, Werner C. Anesthesia in patients with glucose-6-phosphate dehydrogenase deficiency: case report and perioperative anesthesiologic management. Anaesthesist 2006;55:550-4. <a href="http://dx.doi.org/10.1007/s00101-005-0971-6">http://dx.doi.org/10.1007/s00101-005-0971-6</a> <a href="http://www.ncbi.nlm.nih.gov/pubmed/16485110">[PMid:16485110]</a></li>
<li>Dogra N, Puri GD, Rana SS. Glucose-6-phosphate dehydrogenase deficiency and cardiac surgery. Perfusion 2010;25:417-21. <a href="http://dx.doi.org/10.1177/0267659110380770">http://dx.doi.org/10.1177/0267659110380770</a> <a href="http://www.ncbi.nlm.nih.gov/pubmed/20705643">[PMid:20705643]</a></li>
<li>Smith CL, Snowdon SL. Anaesthesia and glucose-6-phosphate dehydrogenase deficiency: A case report and review of literature. Anaesthesia 1987;42:281-8. <a href="http://dx.doi.org/10.1111/j.1365-2044.1987.tb03040.x">http://dx.doi.org/10.1111/j.1365-2044.1987.tb03040.x</a> <a href="http://www.ncbi.nlm.nih.gov/pubmed/3578727">[PMid:3578727]</a></li>
<li>Petz LD, Garratty G. Immune haemolytic anemias. 2nd ed. Philadelphia: Churchill Livingstone; 2004. p. 261-317. <a href="http://dx.doi.org/10.1016/B978-0-443-08559-8.50012-1">http://dx.doi.org/10.1016/B978-0-443-08559-8.50012-1</a></li>
<li>Habibi B, Basty R, Chodez S, Prunat Thiopentone related immune hemolytic anemia and renal failure. Specific involvement of red cell antigen 1. N Engl J Med 1985;312:353-5. <a href="http://dx.doi.org/10.1056/NEJM198502073120606">http://dx.doi.org/10.1056/NEJM198502073120606</a> <a href="http://www.ncbi.nlm.nih.gov/pubmed/3969087">[PMid:3969087]</a></li>
</ol>

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Published

2016-09-17

How to Cite

Bhageria, V., Chowdhury, I., Goel, N., & Pathak, S. (2016). Anaesthetic management of a patient with glucose-6-phosphate dehydrogenase deficiency undergoing robotic-assisted laparoscopic radical prostatectomy. Journal of Society of Anesthesiologists of Nepal, 3(2), 93-95. https://doi.org/10.3126/jsan.v3i2.15621

Issue

Vol. 3 No. 2 (2016): 2016 September Issue

Section

Case Report

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Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License (CC-BY-NC-4.0) that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.