1/50. Radicular acute pain after epidural anaesthesia with the technique of loss of resistance with normal saline solution.Epidural anaesthesia using the loss of resistance to saline technique, without air, was successfully performed in a 65-year-old man scheduled for elective vascular surgery of the right leg. Epidural catheterisation was uneventful. Fifteen minutes after the initial dose of plain 0.5% bupivacaine, the patient experienced severe pain in his lower abdomen and legs which coincided with a supplementary injection of 2 ml bupivacaine and 50 microgram fentanyl, and a change from the lateral to the supine position. General anaesthesia was induced and CT and MRI scans were performed showing trapped air in the epidural space at the L4 level causing compression of the thecal sac. After excluding other causes, the spontaneous entry of air through the Tuohy needle was thought to be the most likely explanation for this complication. The patient recovered uneventfully.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
2/50. Acute angle closure glaucoma precipitated by intranasal application of cocaine.We describe a patient who developed acute angle-closure glaucoma following the application of topical intranasal cocaine. A 46-year-old woman underwent an elective antral washout under general anaesthesia and with local application of 25 per cent cocaine paste to the nasal mucosa. Twenty-four hours post-operatively the patient developed sudden painful blindness which was found to be due to acute glaucoma. cocaine with its indirect sympathomimetic activity causes mydriasis, that can precipitate acute angle-closure glaucoma in predisposed individuals with a shallow anterior chamber. Although the incidence is rare, otolaryngologists need to be aware of this potential complication.- - - - - - - - - - ranking = 0.16666666666667keywords = anaesthesia (Clic here for more details about this article) |
3/50. Pulmonary oedema after peribulbar block.Local anaesthesia is now preferred for cataract surgery. Respiratory distress caused by pulmonary oedema is a rare, if well recognized, complication of the technique of retrobulbar block. We report this complication after the increasingly favoured peribulbar approach.- - - - - - - - - - ranking = 0.16666666666667keywords = anaesthesia (Clic here for more details about this article) |
4/50. Acute horner syndrome due to thoracic epidural analgesia in a paediatric patient.A 4-year-old boy with coarctation of the aorta underwent surgical aortic arch repair with general anaesthesia and thoracic epidural analgesia. In the immediate postoperative period, the child developed a unilateral horner syndrome which appeared to be related to the epidural infusion rate. Management of this patient as well as alternate aetiologies of horner syndrome are described. horner syndrome is a rare complication of epidural catheters and is often unrecognized, especially in children.- - - - - - - - - - ranking = 0.16666666666667keywords = anaesthesia (Clic here for more details about this article) |
5/50. Acute pulmonary haemorrhage in an infant during induction of general anaesthesia.Pulmonary haemorrhage is a rare, life-threatening complication of anaesthesia. This report describes the anaesthetic management of an infant who developed laryngospasm and pulmonary haemorrhage during general anaesthesia. The infant was subsequently found to have prior exposure to a fungus, stachybotrys chartarum, which produces mycotoxins that may have produced capillary fragility in the infant's rapidly growing lungs.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
6/50. Acute complete puerperal inversion of the uterus following twin birth: case report.A twenty-year old multiparous woman was admitted to our obstetric unit on February 13th 1998, with features of acute complete puerperal uterine inversion, two hours after twin birth at home. She was resuscitated and the inverted uterus repositioned using Johnson's method under general anaesthesia. The potential of twin birth as an important aetiological factor in acute/sub-acute puerperal inversion is discussed. Formal training of traditional birth attendants (TBAs) in developing countries where trained medical personnel are scarce, is emphasised.- - - - - - - - - - ranking = 0.16666666666667keywords = anaesthesia (Clic here for more details about this article) |
7/50. Refractory amiodarone-associated thyrotoxicosis: an indication for thyroidectomy.BACKGROUND: tasmania is an area of endemic iodine deficiency. amiodarone is a class III anti-arrhythmic drug that is widely used for the management of ventricular and supraventricular tachydysrhythmias. Individuals from areas of endemic iodine deficiency appear more likely to manifest hyperthyroidism following amiodarone therapy, whereas hypothyroidism is a more frequent complication in iodine-replete communities. methods: Cases series. The clinical and biochemical response to medical and surgical management of five consecutive Tasmanian patients presenting with severe type-II amiodarone-associated thyrotoxicosis was reviewed. RESULTS: Five patients were identified. Combinations of antithyroid therapy including propylthiouracil, lithium carbonate, dexamethasone and cholestyramine were used. thyroidectomy was required in two cases (40%) due to severe unremitting thyrotoxicosis despite combined drug regimens. Anaesthesia and total thyroidectomy were undertaken without complication despite the presence of severe hyperthyroidism at the time of surgery. In both cases thyroid histopathology demonstrated degenerative and destructive follicular lesions with multinuclear cell infiltrate and focal fibrosis. CONCLUSION: amiodarone-associated thyrotoxicosis may be severe and refractory to medical therapy. Despite the potential risks of anaesthesia associated with uncontrolled thyrotoxicosis, thyroidectomy should be considered in the setting of life-threatening thyrotoxicosis.- - - - - - - - - - ranking = 0.16666666666667keywords = anaesthesia (Clic here for more details about this article) |
8/50. Acute transverse myelopathy caused by penicillin injection.A case of acute transverse myelopathy with anaesthesia and flaccid paralysis of both lower limbs, following intragluteal penicillin injection, is reported. This accident was probably due to a mistaken intra-arterial injection of the drug with retrograde progression through branches of the internal iliac artery up to the spinal cord. The treatment of such events in all the cases reported by the literature has been disappointing. Therefore, particular precautions must be taken in case of intramuscular penicillin injection, according to the present and the previous cases described, in order to avoid such accidents.- - - - - - - - - - ranking = 0.16666666666667keywords = anaesthesia (Clic here for more details about this article) |
9/50. paraplegia associated with combined spinal-epidural anaesthesia caused by preoperatively unrecognized spinal vertebral metastasis.We describe a case of paraplegia following combined spinal-epidural anaesthesia. It was postoperatively determined that a tumour of the vertebrae which was compressing the spinal cord was responsible for this complication. We suggest that the pre-existing pathology of the spine must be borne in mind as a differential diagnosis of acute postoperative paraplegia.- - - - - - - - - - ranking = 0.83333333333333keywords = anaesthesia (Clic here for more details about this article) |
10/50. Probable dystonic reaction after a single dose of cyclizine in a patient with a history of encephalitis.A patient underwent an emergency Caesarean section under general anaesthesia for an antepartum haemorrhage. Following delivery of a live infant, cyclizine was administered in accordance with departmental anti-emetic protocol. On awakening she was confused, slow to articulate and had slurred speech. A computed tomography (CT) scan, which was performed to exclude an intracranial event, was normal. Her symptoms were suggestive of a lingual-facial-buccal dyskinesia as seen with dopamine antagonists. A presumptive diagnosis of a dystonic reaction to cyclizine was made. She received two doses of procyclidine before her symptoms completely resolved. cyclizine has had a resurgence in popularity owing to the recent withdrawal of droperidol and anaesthetists should be aware that, although extremely rare, dystonic reactions may occur with this agent.- - - - - - - - - - ranking = 0.16666666666667keywords = anaesthesia (Clic here for more details about this article) |
| | Next -> |