1/3. Excision of a giant hydatid cyst of the lung under thoracic epidural anaesthesia.We present a patient with a large pulmonary hydatid cyst compressing underlying lung, with previous pulmonary tuberculosis, who presented in respiratory failure. After institution of thoracic epidural anaesthesia employing 0.25% bupivacaine, 1% lignocaine and fentanyl, the patient was placed in the sitting position and the hydatid cyst excised and drained after a limited rib resection. An air leak persisted until the 16th postoperative day. A marked improvement in symptoms as well as in spirometly and arterial blood gases occurred, and the patient was discharged on the 20th day. Thoracic epidural anaesthesia may be a safer method than general anaesthesia for removal of a hydatid cyst in a patient with severe respiratory compromise.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
2/3. Transmission of tuberculosis from patient to healthcare workers in the anaesthesia context.INTRODUCTION: Pulmonary tuberculosis (PTB) is prevalent in our population. We report an incident of healthcare workers (HCWs) suspected of being infected by a patient with undiagnosed active PTB in the operating theatre. CLINICAL PICTURE: A 60-year-old patient admitted for intestinal obstruction, underwent an emergency laparotomy. Preoperative chest X-ray (CXR) showed diffuse reticular-nodular shadowing and postoperative sputum was positive for acid-fast bacilli. TREATMENT: The patient was isolated and treated for active tuberculosis. The anaesthetist and her assistants in the operating theatre that day were referred to the infectious disease physician and some were started on tuberculosis prophylaxis. OUTCOME: The patient and the HCWs involved recovered. CONCLUSION: Thus, all PTB-susceptible patients with suggestive CXR should be treated as potentially infective. Adequate personnel protection should include highly efficient facemasks and shields. risk of patient-to-patient transmission of tuberculosis through the anaesthetic circuit is low if effective bacterial/viral filters are used.- - - - - - - - - - ranking = 0.57142857142857keywords = anaesthesia (Clic here for more details about this article) |
3/3. Serious sequelae of delayed diagnosis of endobronchial tuberculosis.We report three cases of pulmonary tuberculosis in whom the diagnosis of the endobronchial component was missed initially. Despite proper chemotherapy, one patient had bronchostenosis leading to acute respiratory failure and death, the second developed collapse of the left lung, while failure of endotracheal intubation for general anaesthesia was the immediate problem faced by the third patient.- - - - - - - - - - ranking = 0.14285714285714keywords = anaesthesia (Clic here for more details about this article) |