1/3. Anaesthetic dilemma: spinal anaesthesia in an eclamptic patient with mild thrombocytopenia and an "impossible" airway.We present our anaesthetic management of a 27-year-old woman with antepartum eclampsia, mild thrombocytopenia, difficult airway and clinical evidence of impending upper airway obstruction. She required urgent delivery by caesarean section, which was conducted uneventfully under spinal anaesthesia. We discuss the management conundrums presented by this case and why we chose spinal anaesthesia over other anaesthetic options.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
2/3. Amphetamine ingestion presenting as eclampsia.A case of amphetamine abuse in late pregnancy is reported. The presenting features of convulsions, confusion, agitation with hypertension and proteinuria led to a diagnosis of eclampsia for which a caesarean section was performed. Investigations and differential diagnosis of convulsions in late pregnancy are reviewed. A general urinary drug screen gives results after 24 hr whereas, if amphetamine abuse is suspected, this can be confirmed within three hr if a specific test for urinary amphetamines is performed. The sympathomimetic effects of a single dose of amphetamine are contrasted with the depression of the sympathetic nervous system which occurs after long-term use. Implications for anaesthesia are discussed.- - - - - - - - - - ranking = 0.16666666666667keywords = anaesthesia (Clic here for more details about this article) |
3/3. Topical nasopharyngeal anaesthesia with vasoconstriction in preeclampsia-eclampsia.We report the case of a 38-year-old eclamptic patient undergoing emergency Caesarean section who required awake nasotracheal intubation because of her massively swollen and lacerated tongue. vasoconstriction, in addition to topical anaesthesia, was required due to thrombocytopaenia. The use of three per cent lidocaine with 0.125 per cent phenylephrine for anaesthesia and vasoconstriction is described with successful maternal and neonatal outcome.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |