1/10. heart block following propofol in a child.We present the case of a nine-year-old boy afflicted with Ondine's curse, who developed complete atrioventricular heart block after a single bolus of propofol for induction of anaesthesia for strabismus surgery. Ondine's curse, the other name for congenital central hypoventilation syndrome, is characterized by a generalized disorder of autonomic function. propofol has no effect on the normal atrioventricular conduction system in humans but it reduces sympathetic activity and can highly potentiate other vagal stimulation factors. heart block has been documented after propofol bolus use in adults but, to our knowledge, not in children. It would appear that propofol is not a good choice for anaesthesia in congenital central hypoventilation syndrome.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
2/10. Rectus muscle trauma complicating sub-Tenon's local anaesthesia.PURPOSE: To describe three cases of rectus muscle trauma in patients undergoing phacoemulsification cataract extraction and intraocular lens implantation under sub-Tenon's local anaesthesia via the inferonasal quadrant. methods: Retrospective review was carried out of 3 cases from 1080 patients who underwent phacoemulsification cataract extraction and intraocular lens implantation under sub-Tenon's local anaesthesia in our unit over a 3 year period up to April 2000. RESULTS: Two patients complained postoperatively of vertical diplopia and were shown to have restriction of elevation of the eye, which was found at surgical exploration to be due to inferior rectus muscle restriction. One patient had post-operative horizontal diplopia due restriction of abduction and exploration of the medial rectus muscle was planned. CONCLUSION: Rectus muscle trauma is proposed as a complication of sub-Tenon's local anaesthesia and caution is advised to operators to clearly identify the sub-Tenon's space for injection of local anaesthetic.- - - - - - - - - - ranking = 3.5keywords = anaesthesia (Clic here for more details about this article) |
3/10. Cardiac arrest during ophthalmological operations.From a total number of 822 ophthalmological operations carried out under general anaesthesia two cases of cardiac arrest were observed as a result of oculocardiac reflex. The receptor for this reflex is the eye and the retrobulbal tissue, the effector is the myocardium. Children and adults with certain diseases show a predisposition to this complication. Most frequently the results of the oculocardiac reflex require no treatment, sometimes, however, resuscitation is necessary.- - - - - - - - - - ranking = 0.5keywords = anaesthesia (Clic here for more details about this article) |
4/10. 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 = 2keywords = anaesthesia (Clic here for more details about this article) |
5/10. One stage adjustable sutures: practical aspects.strabismus surgery using one stage adjustable sutures was carried out under local anaesthesia in six patients with good results. The criteria for patient selection and the surgical technique are discussed.- - - - - - - - - - ranking = 0.5keywords = anaesthesia (Clic here for more details about this article) |
6/10. williams syndrome: masseter spasm during anaesthesia.A 4-year-old boy with williams syndrome developed masseter spasm after halothane and suxamethonium. He did not develop malignant hyperthermia; the surgery was accomplished with a nontriggering anaesthetic and no further problems.- - - - - - - - - - ranking = 2keywords = anaesthesia (Clic here for more details about this article) |
7/10. Adjustable sutures in strabismus surgery: a personal series of cases.A personal series of 77 separate primary adjustable suture procedures performed on 69 patients is analysed. Adjustable suture surgery was performed on patients over ten years of age undergoing rectus muscle surgery, and a few selected younger patients. The ages ranged from 7 to 74 years. A 24-month-old infant who had a two-stage-anaesthesia is included in the series. Thirty-eight of the 69 patients were reoperations. Of the 77 primary procedures, 48 (62.3%) required postoperative adjustment; 29 (37.7%) were tied down without adjustment. Sixty-two of the 69 patients (89.8%) achieved a "cure". A further four patients (5.8%) were initially in desired alignment, but deteriorated within the follow-up period. Three of these were successfully reoperated. Of the three primary failures (4.4%) two were reoperated with one achieving orthophoria. Apart from alignment failure in the primary procedure, complications were minimal. Current follow-up periods range from one to 24 months.- - - - - - - - - - ranking = 0.5keywords = anaesthesia (Clic here for more details about this article) |
8/10. wolff-parkinson-white syndrome. Termination of paroxysmal supraventricular tachycardia with phenylephrine.A patient with wolff-parkinson-white syndrome, susceptible to tachydysrhythmias , presented for eye surgery under general anaesthesia. He developed a supraventricular tachycardia refractory to a variety of treatments. phenylephrine consistently abolished the dysrhythmia, probably by acting directly to stimulate the arterial baroreceptors and hence vagal output. Vasopressor therapy should be considered in wolff-parkinson-white syndrome tachyarrhythmias, when circumstances permit.- - - - - - - - - - ranking = 0.5keywords = anaesthesia (Clic here for more details about this article) |
9/10. strabismus as a possible sign of subclinical muscular dystrophy predisposing to rhabdomyolysis and myoglobinuria: a study of an affected family.Administration of succinylcholine to normal individuals results in alterations in muscle membrane integrity expressed as a slight increase in the concentrations of creatine phosphokinase (CK) in serum and appearance of small amounts of myoglobin in the urine, but without clinical symptoms. Subjects with strabismus due to congenital muscular dystrophy may develop more significant rhabdomyolysis expressed as muscle stiffness and weakness, massive myoglobinuria, marked elevation of serum CK and other enzymes, metabolic acidosis, tachycardia and moderate elevation of body temperature. In some cases grave malignant hyperthermia with significant hypoxia, metabolic acidosis, tachycardia and marked abnormalities in serum electrolyte concentrations may cause irreversible damage to the central nervous system and other vital organs and death. A case of difficult anaesthesia for a six year old boy belonging to family affected with muscular dystrophy is presented. More attention must be given to preoperative examination (anamnesis, serum enzymes) or ophthalmological patients and more careful monitoring during anaesthesia and in the early postoperative period must be instituted to prevent and treat complications induced by succinylcholine and volatile anaesthetic agents.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
10/10. Acupuncture anaesthesia for squint surgery.An account of an operation for squint using acupuncture analgesia is given. This is the first ophthalmic operation carried out in australia using this form of analgesia; and is probably the first surgical operation of any type carried out in australia using acupuncture technique. The indications and possibilities of this method are discussed.- - - - - - - - - - ranking = 2keywords = anaesthesia (Clic here for more details about this article) |
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