1/6. Continuous spinal anaesthesia/analgesia for abdominal aortic aneurysm repair and post-operative pain management.The intra-operative management of two patients with chronic obstructive pulmonary disease and cardiovascular pathology, who underwent peripheral reconstructive vascular surgery under continuous spinal anaesthesia, is described. Furthermore, continuous intrathecal analgesia was also continued in the post-operative period and provided effective pain relief that was reflected by the favourable surgical outcome.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
2/6. Case report: difficult spinal anaesthesia for caesarian section in two obese pregnant patients.Two obese patients presented for Caesarean Section for poor progress in labour. Spinal anaesthesia was chosen because of obesity, gravidity and worry about possible related airway problems in both patients. In both cases the needle seemed to be short. In case 1, no cerebrospinal fluid (CSF) was obtained, and she was subsequently done under General Anaesthesia (GA); in case 2, CSF was obtained when the needle was pressed firmly into the patients back but flow stopped if the pressure was released. These case reports serve to illustrate that although spinal anaesthesia for obese pregnant patients may seem the safer alternative, mechanical difficulty may be considerable and eventually a GA may be considered in spite of possible risk of difficult intubation.- - - - - - - - - - ranking = 1.2keywords = anaesthesia (Clic here for more details about this article) |
3/6. Monopharmacologic general anaesthesia with sevoflurane in paediatric patient with prader-willi syndrome.prader-willi syndrome (PWS) is a genetic disease caused by a loss of paternal genes located in chromosome 15. Children affected by this syndrome often have preterm delivery; during childhood the hallmarks are: severe infantile hypotonia and feeding problems. Afterward, neurologic manifestations, endocrine signs and dysmetabolic abnormalities are usually seen together with craniofacial manifestations and musculoskeletal abnormalities. obesity causes sleep abnormalities including sleep apnea. The case we present is of a 5 year old child (CA) scheduled for strabismus surgery. The child has a lot of typical (PWS) signs. A number of anaesthesiologic problems are associated with (PWS). Some of them relate to obesity, others to facial dysmorphism. Moreover, the syndrome may give a prolonged and exaggerated response to every sedative drug. P.W.S. is also characterized by thermoregulatory disorders. sleep apnea occurs often. Considering all these problems, we planned a monopharmacologic anaesthesiologic procedure using sevoflurane.- - - - - - - - - - ranking = 0.8keywords = anaesthesia (Clic here for more details about this article) |
4/6. "Failed intubation" in obstetric anaesthesia. An indication for use of the "Esophageal Gastric Tube Airway".The management of failure to intubate the trachea during emergency Caesarean section in a 116.7-kg woman is described. General anaesthesia was continued with the aid of a Gordon and Don Michael Esophageal Gastric Tube Airway. The forward displacement of the larynx caused by the tube in the oesophagus improved the patency of the airway.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
5/6. Caesarean section associated with gross obesity.The anaesthetic and surgical problems associated with Caesarean section in eight grossly obese patients (weight 150-204 kg) are described. In addition to an increase in the frequency and severity of the complications of obesity, those weighing more than 150 kg present a panniculus which may weigh 70 kg. Extradural analgesia was used for three patients and general anaesthesia for five (two because of fetal distress). One fetus died in utero after serious and prolonged arterial hypotension in the mother caused by powerful cephalad retraction of the panniculus (extradural analgesia). General anaesthesia was associated with severe episodes of hypertension in two patients.- - - - - - - - - - ranking = 0.4keywords = anaesthesia (Clic here for more details about this article) |
6/6. Peripartum management of a patient with Isaacs' syndrome.PURPOSE: To describe the peripartum management of a patient with Isaacs' syndrome with specific reference to the anaesthetic implications of the disease process. Associated medical problems included obesity, pregnancy induced hypertension and a difficult airway. CLINICAL FEATURES: This 30-yr-old gravida V para 0 woman presented to the anaesthesia consultation clinic at 37-wk gestation to discuss pain relief options for labour and delivery. She had a history of Isaacs' syndrome (a peripheral motor neuron disorder), congenital heart disease (ASD and VSD), treated Hashimotos thyroiditis, obesity and a family history of haemachromatosis. On the day of consultation, she was hypertensive and peripheral oedema was noted. Her urine showed trace protein. Four days later, she presented to the labour suite and her cervix was 9 cm dilated. An epidural anaesthetic was given without difficulty and she had an uneventful labour and delivery course. There were no subsequent neurological complications. CONCLUSION: Isaacs' syndrome is an extremely rare peripheral motor neuron disorder. This patient was successfully managed with epidural analgesia for labour and delivered a healthy child with no congenital anomalies.- - - - - - - - - - ranking = 0.2keywords = anaesthesia (Clic here for more details about this article) |