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Inicio Revista Española de Anestesiología y Reanimación (English Edition) Anesthetic management of glucose 6-phosphate dehydrogenase deficiency
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Vol. 70. Issue 4.
Pages 235-239 (April 2023)
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Vol. 70. Issue 4.
Pages 235-239 (April 2023)
Case report
Anesthetic management of glucose 6-phosphate dehydrogenase deficiency
Manejo anestésico del déficit de glucosa 6-fosfato deshidrogenasa
S. Gómez Gómez
Corresponding author
soledad732@hotmail.com

Corresponding author.
, M. Ruano Santiago, A. Rodríguez Morillo, A.M. Pérez Muñoz, M. Echevarría Moreno
Servicio de Anestesiología, Reanimación y Terapéutica del dolor, Hospital Universitario de Valme, Sevilla, Spain
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Table 1. Drugs associated with haemolysis in glucose 6-phosphate dehydrogenase deficiency.
Table 2. Drugs used in anaesthesia with involvement in glucose 6-phosphate dehydrogenase deficiency.
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Abstract

Glucose 6-phosphate dehydrogenase deficiency is the most common enzyme disease of red blood cells, with around 400 million people suffering from it throughout the world and linked to the X chromosome inheritance, thus it predominantly affects men. Glucose 6-phosphate-dehydrogenase participates in the pentose-phosphate pathway, being responsible for cellular metabolism and the production of antioxidants. A deficiency of this enzyme alters its ability to protect red blood cells from oxidative stress caused by certain drugs, metabolic conditions, infections and food. Specific anesthetic considerations are required to reduce the morbidity and mortality associated with medical-surgical interventions in patients with this disease. This article presents the case of a 45-year-old man with glucose 6-phosphate dehydrogenase deficiency who underwent combined general anaesthesia for programmed low anterior resection of the rectum.

Keywords:
Glucose 6-phosphate dehydrogenase deficiency
Anaesthesia
Hemolytic anemia
Methaemoglobinaemia
Favism
Resumen

El déficit de Glucosa 6-Fosfato Deshidrogenasa es la enzimopatía más frecuente de los glóbulos rojos, contando con una prevalencia de 400 millones de personas en el mundo, y una herencia ligada al cromosoma X, afectando sobre todo a varones. La Glucosa 6-Fosfato-Deshidrogenasa participa en la vía de las pentosas-fosfato, encargada del metabolismo celular, y produciendo antioxidantes. Un déficit de esta enzima altera su capacidad de proteger a los hematíes del estrés oxidativo que producen ciertos medicamentos, condiciones metabólicas, infecciones y alimentos. Se requieren consideraciones anestésicas específicas para disminuir la morbimortalidad asociada a intervenciones medico-quirúrgicas en pacientes con esta enfermedad. En este artículo se expone el caso de un varón de 45 años con este déficit enzimático sometido a anestesia general combinada para resección anterior baja de recto programada.

Palabras clave:
Déficit de Glucosa-6-Fosfato-Deshidrogenasa
Anestesia
Anemia hemolítica
Metahemoglobina
Favismo

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