ABSTRACT
Myotonic dystrophy (DM) is an uncommon inherited disease. Anesthesia for DM patients is tough due to its potency of cardiogenic and pulmonary problems, but a series of studies have shown how to manage and avoid complications and situations. We describe a case of a 33-year-old male patient who was scheduled for an elective excision & biopsy on the left axillae for hidradenitis suppurativa with DM type I. Anesthesia was induced and maintained with propofol, remifentanil, and rocuronium. Sugammadex is used as a reversal agent of neuromuscular blockade. He didn’t show myotonia during surgery and emergence. He also didn’t show postoperative pulmonary complications.
ABSTRACT
Eisenmenger's syndrome describes the elevation of pulmonary arterial pressure to the systemic level caused by an increased pulmonary vascular resistance with reversed or bi-directional shunt through an intracardiac or aortopulmonary communication. We report the case of 48-year-old woman with an elective total hip replacement arthroplasty for right femur neck fracture with Eisenmenger's syndrome secondary to large atrial septal defect. Anesthesia was induced with etomidate and rocuronium, maintained with desflurane 5 vol% and O₂ 3 L/min. Mirinone and norepinephrine were infused continuously to decrease right to left shunt. The patient was extubated after spontaneous breathing recovery and transferred to the intensive care unit. She was treated with mirinone, norepinephrine, dopamine, and dobutamine for hypoxemia and hypotension. After 3 hours of admission to intensive care unit, the patient had a cardiac arrest and died 30 minutes later.
Subject(s)
Female , Humans , Middle Aged , Anesthesia , Hypoxia , Arterial Pressure , Arthroplasty , Arthroplasty, Replacement, Hip , Dobutamine , Dopamine , Eisenmenger Complex , Etomidate , Femoral Neck Fractures , Heart Arrest , Heart Septal Defects, Atrial , Hypertension, Pulmonary , Hypotension , Intensive Care Units , Norepinephrine , Respiration , Vascular ResistanceABSTRACT
A 35-year-old female complaining of a painful huge right posterior chest wall mass was admitted. Chest computed tomography showed the pleural invasion of mass and deformed ribs. Suspected diagnosis was hemangioma. Entire mass was removed carefully and pleural biopsy was performed. The operation was finished after bleeding control and chest tube insertion. The mass was diagnosed as a cavernous hemangioma histopathologically. Cavernous hemangioma of chest wall is a rare benign vascular tumor. Surgical operation of hemangioma demands meticulous bleeding control because of risk of hemorrhage.