1/8. Transthoracic echocardiography for perioperative haemodynamic monitoring.Transoesophageal echocardiography (TOE) is valuable for perioperative monitoring in patients at risk from haemodynamic disturbance. However, its use is not practicable in patients undergoing surgical procedures under regional anaesthesia. We describe two cases showing that transthoracic echocardiography (TTE) has the same advantages as TOE and thus may be valuable for monitoring awake patients. TTE should be considered when extended perioperative haemodynamic monitoring is needed but TOE is not possible.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
2/8. survivors of childhood cancers: implications for obstetric anaesthesia.Treatment of many childhood malignancies involves surgery, radiotherapy and chemotherapy. If the child survives, normal physical development can be impaired and abnormalities with anaesthetic implications may be present. We discuss two women with a range of problems who presented for obstetric anaesthesia, having survived childhood malignancies. Common features included anthracycline cardiotoxicity and short stature. Both patients received incremental spinal anaesthesia in order to titrate the dose of local anaesthetic required to produce an adequate block height and to minimize cardiovascular instability.- - - - - - - - - - ranking = 6keywords = anaesthesia (Clic here for more details about this article) |
3/8. Renal transplantation and diabetic autonomic neuropathy.This report describes six episodes of cardiovascular collapse in the perioperative period of a young diabetic woman undergoing general anaesthesia for renal transplantation and a similar episode after a second anaesthetic. She was subsequently found to have an autonomic neuropathy. Recommendations for the management of similar patients are made.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
4/8. Profound reversible myocardial depression after anaphylaxis.Profound myocardial depression developed in 2 patients after severe anaphylactic reactions following the induction of anaesthesia in 1 case and a bee-sting in the other. Neither patient had pre-existent cardiac disease. In both patients haemodynamic assessment, radionuclide ventriculography, and two-dimensional echocardiography confirmed the clinical impression of profound systolic myocardial dysfunction. Haemodynamic stability was attained by intra-aortic balloon counterpulsation, which was probably life-saving in both cases. Cardiac function improved rapidly although some contractile depression persisted for several days. At follow-up both patients had normal cardiac function with no evidence of underlying heart disease.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
5/8. Epidural opioids as anaesthesia for extracorporeal shock wave lithotripsy in two patients with cardiac disease.Two patients with cardiac disease underwent Extracorporeal shock Wave lithotripsy (ESWL) in the Dornier HM3 machine. In order to minimize cardiovascular changes, epidural opioids (fentanyl 100 micrograms in 10 ml saline was used in one patient and meperidine 50 mg in 10 ml saline in the other patient) were used as an alternative to either general anaesthesia or epidural local anaesthesia. Both patients displayed haemodynamic stability, remained pain-free and experienced no complications. Epidural opioids proved a suitable form of anaesthesia for ESWL in these patients.- - - - - - - - - - ranking = 7keywords = anaesthesia (Clic here for more details about this article) |
6/8. Prolongation of the Q-T interval (romano-ward syndrome): anaesthetic management.The anaesthetic management is described of a patient with prolonged Q-T interval which had been complicated by ventricular fibrillation at induction of general anaesthesia for a previous operation. This complication was prevented by effective premedication with i.v. propranolol and block of the left stellate ganglion.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
7/8. Anaesthetic implications of long term diabetic complications.A case history in which a patient suffering from long-term diabetes mellitus underwent vascular surgery of a lower extremity is presented. Anaesthesia was commenced with an epidural anaesthesia, but due to insufficient analgesia combined with a high thoracal block general anaesthesia was added. The course was complicated because of cardiomyopathy, autonomic neuropathy, difficult laryngoscopy, aspiration of gastric content, and acute renal failure. Anaesthetic implications of long-term diabetes mellitus are discussed.- - - - - - - - - - ranking = 2keywords = anaesthesia (Clic here for more details about this article) |
8/8. Upper limb compartment syndromes: a complication of malignant hyperthermia in a patient with ill-defined myopathy.We report a case of compartment syndrome complicating malignant hyperthermia (MH) in a 12-yr-old girl with a history of myopathy and multiple skeletal deformities; she underwent bilateral achilles tendon surgery. Marked oedema of both forearms became evident in the immediate postoperative period and resolved after conservative treatment. Compartment syndrome is a rare complication of MH. Early recognition and therapy may prevent the onset of muscle ischaemia and distal neurovascular deficit. The need for urgent surgery and repeated anaesthesia in the early phase of recovery from an acute episode of MH may thus be reduced.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |