Anaesthetic Considerations and Implications for Non Cardiac Surgery in a Patient Presenting with Aorto Occlusive Disease.

Patients with peripheral vascular disease continue to challenge the anesthesiologist as these patients often have associated coronary artery disease. There is always a danger of myocardial ischemia and cardiac morbidity both intraoperatively and postoperatively in this group of patients. We here report a patient presenting with aorto occlusive disease posted for emergency laparotomy for intestinal obstruction.

Anestesia regional: todavía una alternativa adecuada en la parturienta con obesidad mórbida / Regional anaesthesia: Still a comfortable choice in morbidly obese parturient

La obesidad se ha identificado como un factor importante de riesgo de morbimortalidad relacionada con anestesia en obstetricia. La obesidad acentúa la mayoría de los cambios fisiológicos del embarazo. Las parturientas obesas tienen un mayor riesgo de presentar problemas médicos concomitantes o enfermedades prenatales, entre ellas la preeclampsia y la diabetes gestacional. Estas pacientes requieren valoración preoperatoria minuciosa, una preparación meticulosa y alistamiento para una vía aérea difícil, puesto que la incidencia de intubación fallida es mucho más alta en ellas. Siempre que sea posible, la anestesia regional es la mejor alternativa en este grupo de pacientes.

Obesity has been identified as a significant risk factor for anaesthesia related morbi-dity/mortality in obstetrics. Obesity compounds most of the physiological changes in pregnancy. The obese parturients are at increased risk of having either concurrent medical problems or superimposed antenatal diseases including preeclampsia and gestational diabetes. These patients need thorough preoperative assessment, meticulous preparation and preparation for difficult airway as incidence of failed intubation is many times higher in these patients. Regional anaesthesia whenever possible is the best choice in this group of patients.