1/3. Anaesthetic management of a patient with myotonic dystrophy.A 13-year-old boy with myotonic dystrophy underwent insertion of a percutaneous gastrostomy feeding tube under general anaesthesia. We used a laryngeal mask airway and a spontaneously breathing technique with propofol total intravenous anaesthesia. Postoperative vomiting and aspiration, 12 h after the procedure, subsequently required intubation and ventilation. We discuss the anaesthetic management of this case and review the features of the disease to be considered when contemplating anaesthesia in such patients.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
2/3. Excruciating perineal pain after intravenous dexamethasone.We describe two cases of unexpected perineal pain immediately after intravenous injection of fentanyl and dexamethasone (100 microg and 8 mg respectively) during induction of general anaesthesia. In both cases the pain was immediate (onset within 30 seconds), severe, localized to the genital region and of shooting and burning character No other clinical signs or symptoms were observed in either case and both patients made an uneventful recovery without neurological sequelae. We review the existing literature on perineal pain as an adverse effect of intravenous corticosteroid esters and recommend their administration either in diluted form or after induction of general anaesthesia.- - - - - - - - - - ranking = 0.66666666666667keywords = anaesthesia (Clic here for more details about this article) |
3/3. acupuncture for acute postoperative pain relief in a patient with pregnancy-induced thrombocytopenia--a case report.A 39 year old woman, scheduled for elective caesarean section in her second pregnancy, developed thrombocytopenia. Therefore, at the time of surgery, spinal anaesthesia and non-steroidal analgesic drugs were avoided and she was given a standard general anaesthetic procedure including fentanyl 100 microg and morphine 10 mg. In the early postoperative period she received tramadol 100 mg and a further 10 mg of morphine. These drugs did not control her pain, but caused side effects--in particular nausea and retching. acupuncture to LI4 and PC6 on the right side produced dramatic pain relief within minutes.- - - - - - - - - - ranking = 0.33333333333333keywords = anaesthesia (Clic here for more details about this article) |