1/2. Coexisting harlequin and Horner syndromes after high thoracic paravertebral anaesthesia.A patient undergoing left mastectomy and immediate latissimus dorsi breast reconstruction under combined paravertebral block and general anaesthesia developed transient, well-demarcated, right-sided hemifacial erythema and sweating, and left-sided horner syndrome postoperatively. This "harlequin" appearance occurs because of a normal or excessive vasodilatory, thermoregulatory response to heat or emotion mediated by an intact sympathetic pathway on the erythematous side, together with relative pallor of the pharmacologically blocked side.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
2/2. Anaphylactoid reaction to maltose 5% solution during spinal anaesthesia.PURPOSE: A rare case of an anaphylactoid reaction to maltose solution is presented. CLINICAL FEATURES: A 28-yr-old man underwent repair of bilateral inguinal hernia under spinal anaesthesia with dibucaine. At the end of operation, he developed generalized flush and circulatory collapse immediately after receiving Na acetate solution containing maltose, 5%, i.v. The reactions were treated with 32 mg ephedrine and 250 mg methylprednisolone i.v., and rapid infusion of 1,000 ml acetated Ringer's solution. The skin tests provoked positive responses to maltose solutions. CONCLUSION: The clinical features and skin tests suggested that the episode was an anaphylactoid reaction to maltose. maltose is one of the dissacharides (MW: 342) produced from starch and glycogen. maltose solutions are used frequently in japan as a carbohydrate source. Further study is required to confirm whether maltose has an immunological antigen-eliciting activity.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |