1/5. Use of nitrous oxide causing severe visual loss 37 days after retinal surgery.A case of severe visual loss following nitrous oxide anaesthesia in the presence of an intraocular perfluoropropane (C3F8) gas bubble is described. The diabetic patient had previously undergone vitreoretinal surgery at which time the gas had been inserted. The case highlights the use of long-acting intraocular gases in modern vitreoretinal surgery, and the measures that can be taken to prevent further such episodes.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
2/5. Intravitreal triamcinolone acetonide as an adjuvant therapy to panretinal photocoagulation for proliferative retinopathy with high risk characteristics in type 1 diabetes: case report with 22 weeks follow-up.PURPOSE: To describe a new treatment protocol to deliver panretinal photocoagulation that may avoid further deterioration of vision in patients with type 1 diabetes mellitus with proliferative retinopathy with high risk characteristics for severe visual loss and cystoid macular oedema. methods: Fundus photography, measurement of foveal thickness with optical coherence tomography and best corrected visual acuity (BCVA) determined by Snellen and ETDRS charts were measured before and after treatment in a 28-year-old man. RESULTS: Over 9 weeks, BCVA improved from 0.05 to 0.25 and the number of letters read at 2 metres from four to 39 after panretinal photocoagulation and adjuvant intravitreal triamcinolone injection under intraconal anaesthesia. Foveal thickness decreased from 691 microm to 239 microm and cysts disappeared by 15 weeks. By 22 weeks, foveal thickness had increased to 282 microm and small cysts had reappeared, but BCVA remained at 0.2 and the number of letters read at 30. CONCLUSION: Proliferative retinopathy regressed, cystoid macular oedema disappeared and vision improved after panretinal photocoagulation and adjuvant intravitreal triamcinolone acetonide injection under intraconal anaesthesia. This represents a feasible option in cases where pain during laser treatment and impairment of vision afterwards due to cystoid macular oedema result in poor compliance with standard laser treatment under topical anaesthesia.- - - - - - - - - - ranking = 3keywords = anaesthesia (Clic here for more details about this article) |
3/5. Congenital corneal anaesthesia and the MURCS association: a case report.Bilateral corneal anaesthesia and reduced sensation in the distribution of the ophthalmic division of the fifth cranial nerve associated with neuroparalytic keratitis and reduced vision is described in a 26-year-old woman with absence of the fallopian tubes, uterus, and upper vagina, a single pelvic kidney, and cervico-thoracic vertebral anomalies (the MURCS association). Other features of the disorder also present were short stature, facial asymmetry, micrognathia, and cleft palate. The neuroparalytic keratitis did not respond to tear substitutes and bilateral lateral tarsorrhaphies were eventually needed. This is the first report of congenital corneal anaesthesia in a case of MURCS.- - - - - - - - - - ranking = 6keywords = anaesthesia (Clic here for more details about this article) |
4/5. Anaesthesia and mitochondrial disease.mitochondrial diseases, or encephalomyopathies, are an uncommon, heterogeneous group of disorders with variable clinical course and presentation. Many of these patients present for surgery, or undergo anaesthesia in the course of investigation of their illness. Unfortunately, little information exists on their management in anaesthetic texts and the literature. We report on the anaesthetic management of a paediatric patient with mitochondrial disease, and briefly discuss the pathophysiology and anaesthetic implications of these disorders.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
5/5. hemiplegia following general anaesthesia: an unusual presentation of migraine.We report the case of a 33-year-old woman who developed a dense hemiplegia immediately after an uncomplicated general anaesthetic for diagnostic laparoscopy. She had a history of recurrent hemiplegic migraine with a strong family history. Her migraine was normally associated with visual disturbances and a unilateral headache followed by a left-sided weakness such that she was unable to walk. Symptoms would last up to 24 h. Her post-operative state was atypical of her normal migraine, in that she had no headache or visual disturbance and initially all four limbs were affected.- - - - - - - - - - ranking = 4keywords = anaesthesia (Clic here for more details about this article) |