1/3. Removal of catecholamine-secreting chemodectoma. The use of neuroleptanaesthesia, adrenergic blockade and sodium nitroprusside.A case of catecholamine-secreting chemodectoma of the neck in a 47-year-old male who also had temporal lobe epilepsy is described. Details of presentation, diagnosis and successful treatment are given. He was fully alpha blocked with phenoxybenzamine and given neuroleptic drugs but his blood pressure rose to dangerous levels when the tumour was handled and did not respond to intravenous phentolamine. sodium nitroprusside was successfully used to achieve blood pressure control.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
2/3. Anaesthesia for carotid body tumour resection in a patient with the Eisenmenger syndrome. A case report.A patient with the Eisenmenger syndrome presented for removal of a carotid body tumour under general anaesthesia. The presentation and management of the case are described and some of the anaesthetic problems associated with these two uncommon conditions are discussed. The case is reported because of its rarity and because some of the complications of carotid body surgery may be particularly hazardous in the presence of the Eisenmenger syndrome. The importance of monitoring, of maintaining a stable heart rate and blood volume, and the danger of paradoxical systemic air embolism are stressed.- - - - - - - - - - ranking = 0.25keywords = anaesthesia (Clic here for more details about this article) |
3/3. Postoperative respiratory depression following excision of carotid body tumours.This report is of two adult patients who were scheduled for excision of carotid body tumours. One of the patients had bilateral tumours, while the second had a unilateral tumour. In the first, anaesthesia was maintained by nitrous oxide:oxygen and halothane 1-2%. Postoperatively, the intramuscular injection of meperidine 75 mg resulted in apnoea, cyanosis, and loss of consciousness. In the second, anaesthesia was maintained by nitrous oxide:oxygen, supplemented by fentanyl 2 micrograms.kg-1 and incremental doses of vecuronium. Following complete reversal of neuromuscular block, the patient became wide awake but spontaneous breathing was resumed at a rate of only two to three breaths per minute, and the oxygen saturation as monitored by pulse oximetry decreased to 50%. naloxone 0.4 mg iv increased the respiratory rate to 14 per minute and the oxygen saturation to 98%. The report suggests that surgical excision of carotid body tumours, whether unilateral or bilateral, can be followed by severe postoperative respiratory depression. The complication may be attributed to opioid administration in the absence of peripheral chemoreceptor drive.- - - - - - - - - - ranking = 0.5keywords = anaesthesia (Clic here for more details about this article) |