1/9. Profound bradycardia and hypotension following spinal anaesthesia in a patient receiving an ACE inhibitor: an important 'drug' interaction?An 86-year-old man on whom a transurethral resection of prostate was performed under spinal anaesthesia developed profound bradycardia and hypotension with disturbance of consciousness during transfer to the recovery room. Initial treatment with atropine produced rapid improvement in cardiovascular and cerebral function. A further hypotensive episode (without bradycardia) occurred approximately 1 h later but responded rapidly to methoxamine. The patient made a full recovery during an overnight stay on the High Dependency Unit. Possible mechanisms for this event are discussed, with the proposal that the concomitant administration of captopril and the relative unavailability of angiotensin ii may have significantly contributed to the problem.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
2/9. Palliative surgery of acrometastases from lung cancer: a case report.A clinical case of a woman with lung cancer and a very painful bone metastases of the phalangette of the 4th finger of the right hand (acrometastases) is described. Palliative radiation on the 4th finger was not indicated due to almost complete bone destruction. Both patient and daughter refused administration of strong opioids, such as morphine, for pain management, due to fear of addiction and of opioid-related adverse effects. Phalangectomy, with palliative intent, was performed under local anaesthesia, in day surgery, resulting in complete pain relief.- - - - - - - - - - ranking = 0.2keywords = anaesthesia (Clic here for more details about this article) |
3/9. Radio-frequency ablation of hepatic metastases from colorectal cancer.BACKGROUND: The aim of our study is to present the preliminary results of an ongoing radio-frequency (RF) ablation study in patients with hepatic metastases from colorectal cancer. patients AND methods: From November 2003, two patients affected with metachronous liver metastases from colorectal cancer were treated with RF ablation. The mean age of the patients was 66 years (58 and 74 years). Tumours were unifocal right-lobe lesions in one patient and bifocal in the second patient. Under general anaesthesia, a Radionics 200-W RF generator was used to ablate lesions with H2O-cooled electrodes via laparotomy. patients' follow-up ranged from two to five months including evaluation of salient clinical, radiological and laboratory parameters. RESULTS: The patients experienced moderate-to-severe pain in the right abdomen lasting for 2-3 days and mild fever for 3-6 days after treatment. During the follow-up period no local recurrence was observed. CONCLUSIONS: RF ablation emerges to be a promising method for the treatment of hepatic metastases from colorectal cancer.- - - - - - - - - - ranking = 0.2keywords = anaesthesia (Clic here for more details about this article) |
4/9. Metachronous breast carcinoma (second malignancy), following "cure" from colorectal carcinoma.Metachronous or synchronous breast carcinoma following or co-existing with colorectal carcinoma are well recognised clinicopathological entities, and the risk of developing both possibly underlines the similarities in carcinogenesis pathways for these carcinomas. We present a 60-year-old housewife with a history of a treated primary colon carcinoma (Duke's C) 15 years previously. Six months ago, during the follow-up care a small sub-areolar lesion was determined in a mammogram. A lumpectomy was performed under local anaesthesia, which revealed an infiltrating ductal carcinoma (6 mm in greatest diameter). Immuno-histochemical assays for oestrogen and progesterone receptors and c-erb B2 ongoprotein were performed. Axillary lymphadenectomy showed 1/11 positive node. She received adjuvant radiotherapy and hormone manipulation. To date, seven months later she is disease free. The aim of this report is to emphasise the risk of metachronous second malignancy of breast or colorectal carcinoma following colorectal carcinomas. A second primary colonic malignancy following breast primary carcinoma is more frequent than inverse clinical form.- - - - - - - - - - ranking = 0.2keywords = anaesthesia (Clic here for more details about this article) |
5/9. Development of adenocarcinoma in chronic fistula in Crohn's disease.The authors report the case of a 55 yr-old woman suffering from Crohn's disease since 31 years with stricture and fistulas developed in the ileocolic junction and anorectal portion. Long-standing anorectal fistulas and stricture led to adenocarcinoma and finally fistulisation in the vagina. diagnosis was made by perineal examination with biopsies under general anaesthesia. Treatment was first posterior pelvectomy with resection of the anterior wall of vagina. Secondarily, radiochemotherapy was administrated. The authors discuss the incidence and risk factors of carcinoma in Crohn's disease with chronic fistulas.- - - - - - - - - - ranking = 0.2keywords = anaesthesia (Clic here for more details about this article) |
6/9. Metastatic breast carcinoma discovered in a dentigerous cyst - a case report.This paper reports a patient with a history of breast cancer, who presented with altered sensation to the right lower lip and chin. An orthopantomogram showed a probable dentigerous cyst associated with an unerupted lower wisdom tooth, which was closely related to the inferior dental canal. The tooth and cyst were enucleated under general anaesthesia. The subsequent histopathology report concluded that the cyst contained metastatic adenocarcinoma from a primary breast tumour.- - - - - - - - - - ranking = 0.2keywords = anaesthesia (Clic here for more details about this article) |
7/9. Anaesthetic complications of mediastinal masses and superior vena caval obstruction.Two patients with mediastinal tumour and superior vena caval obstruction who, after general anaesthesia, experienced respiratory difficulties requiring intubation or reintubation are presented. Possible aetiological mechanisms are discussed in relation to these cases.- - - - - - - - - - ranking = 0.2keywords = anaesthesia (Clic here for more details about this article) |
8/9. Mental nerve anaesthesia as a result of mandibular metastases of prostatic adenocarcinoma.Three cases of mental nerve anaesthesia as a result of metastatic deposits from prostatic carcinoma are presented. They were referred to Consultant Oral and Maxillofacial Surgeons by alert GDPs. This highlights the fact that dental surgeons must be aware that systemic illness may manifest in the mouth and appropriate referral is essential.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
9/9. Endometrial cancer thirteen years after total abdominal hysterectomy and bilateral salpingo-oophorectomy and hormone replacement therapy: a case report.We have reported a very interesting, rare case of endometrial adenocarcinoma arising from pelvic endometriosis thirteen years after hysterectomy with bilateral salpingo-oophorectomy, followed with hormone replacement therapy. Our patient presented with history of abnormal vaginal bleeding, which was investigated with abdominal scans, examination under anaesthesia (EUA), and biopsy. histology of which confirmed malignant transformation. We then proceeded to primary excision of all macroscopic tumour and palpable lymph nodes followed with radiotherapy.- - - - - - - - - - ranking = 0.2keywords = anaesthesia (Clic here for more details about this article) |