1/8. General anaesthesia in a patient with brugada syndrome.The successful administration of a combined general and epidural anaesthetic to a patient with brugada syndrome is reported. A review of the literature is presented.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
2/8. Spinal anaesthesia in a child with hypoplastic left heart syndrome.hypoplastic left heart syndrome (HLHS), a complex congenital heart disease, is the most common lethal cardiac defect in neonates. Its treatment includes cardiac transplantation and/or surgical palliation. Associated extracardiac congenital abnormalities are exceptional. We report the case of a neonate with HLHS and anorectal atresia who required urgent surgical management to relieve intestinal obstruction. The surgery was successfully performed under spinal anaesthesia.- - - - - - - - - - ranking = 1.25keywords = anaesthesia (Clic here for more details about this article) |
3/8. Management of the pelvic recurrence of rectal cancer with radiofrequency thermoablation: a case report and review of the literature.INTRODUCTION: The results of rectal cancer surgery are limited by the development of local recurrence (LR) that represents a great challenge to the surgeon. In the presence of unfavourable conditions for performing a curative operation, various forms of palliative treatment are indicated to control the patient's symptoms and the disease's complications. Recently, radiofrequency thermoablation (RFTA) has become a complimentary alternative therapy for malignant inoperable liver tumours. The present paper reports the use of RFTA in the management of pelvic recurrence of rectal adenocarcinoma. CASE REPORT: Fourteen months after abdominoperineal resection, a 32-year-old woman began to complain of progressive pelvic and lumbar pain. A large pelvic mass was found and serum CEA was elevated (66.4 ng/ml) at that time. Due to the dimensions of the presacral tumour (8 x 5 x 4 cm3) and the associated refractory pain, the patient underwent RFTA of the recurrent disease. Under epidural anaesthesia, a computed tomography-guided percutaneous needle electrode was introduced into the tumour. Although the procedure provided immediate pain control, the patient developed an intestinal obstruction 3 months later. This complication required surgical treatment to release adherences from the necrosed tumour. CONCLUSION: Apart from this complication, RFTA allowed prolonged relief of the pelvic pain and improved quality of life. Faced with an unresectable pelvic recurrence, RFTA proved to be a viable option for controlling pain, although a relatively high cost and eventual complications may limit its use.- - - - - - - - - - ranking = 0.25keywords = anaesthesia (Clic here for more details about this article) |
4/8. Spinal anaesthesia in a child with Job's syndrome, pneumatoceles and empyema.We present a case of acute bowel obstruction in an immunocompromised child, who also had lobar pneumonia and a giant unilateral pneumatocele. She was successfully managed with subarachnoid anaesthesia for exploratory laparotomy to relieve a colonic obstruction. This proved to be a safe alternative to general anaesthesia with tracheal intubation in this patient and should be considered in infants and children in selected cases whenever a contraindication to general anaesthesia exists.- - - - - - - - - - ranking = 1.75keywords = anaesthesia (Clic here for more details about this article) |
5/8. Intrathecal diamorphine during laparotomy in a patient with advanced multiple sclerosis.A patient with advanced multiple sclerosis was successfully managed for a sigmoid colectomy using spinal anaesthesia. Effective postoperative analgesia was achieved with intrathecal diamorphine administered through an indwelling intrathecal catheter, and wound infiltration with 0.25% bupivacaine.- - - - - - - - - - ranking = 0.25keywords = anaesthesia (Clic here for more details about this article) |
6/8. shy-drager syndrome. A review and a description of the anaesthetic management.Autonomic failure in patients with the shy-drager syndrome may produce cardiovascular instability during anaesthesia and surgery. The syndrome is reviewed and the anaesthetic management of a case is described. The choice between general and regional anaesthesia seems to be less important than adequate cardiovascular monitoring and the maintenance of blood pressure with intravenous fluids. Sympathomimetic drugs, if used at all, should be administered in very dilute solutions to avoid hypertension from denervation hypersensitivity. In the postoperative period, symptoms from orthostatic hypotension may be severe and their control requires prolonged postural training, by elevation of the head of the bed, and therapy with 9-alpha-fludrocortisone.- - - - - - - - - - ranking = 0.5keywords = anaesthesia (Clic here for more details about this article) |
7/8. The anaesthetic management of a patient with a broncho-pleural fistula and intestinal obstruction.A patient with a broncho-pleural fistula presented for emergency laparotomy for intestinal obstruction. Anaesthesia was managed with neuroleptanalgesia, and with endobronchial intubation before induction of anaesthesia.- - - - - - - - - - ranking = 0.25keywords = anaesthesia (Clic here for more details about this article) |
8/8. Anaesthetists and Dutch Elm disease.Undiagnosed tetanus can be a rare cause of acute intestinal obstruction followed by respiratory failure after surgery and general anaesthesia. The anaesthetist should always read the general practitioner's referring letter (so should the surgeon). Equally, the general practitioner's letter should record normal physiological values for that patient, such as pulse rate and blood pressure. The current shortage of anaesthetists might partly be related to inadequate exposure of medical students to the specialty. The anaesthetist's prime task is the relief of a pain during surgery: but his contract might allow sufficient time outside the operating theatre for the nurture of diagnostic skills basic to clinical competence and survival of the patient inside the operating theatre.- - - - - - - - - - ranking = 0.25keywords = anaesthesia (Clic here for more details about this article) |