ABSTRACT
Anesthesiologists are occasionally faced with a dilemma in managing Jehovah's witness patients who refuse transfusion of blood or blood products in life threatening situations. We report a case in which a 28-year old Jehovah's witness parturient underwent an emergency cesarean section due to complex problems of fetal distress, twin pregnancy and preeclampsia. Despite the severe anemia, she had a good postoperative recovery without any complications. We suggest that it is necessary to know the religious background, ethical issues and conflicts in caring for Jehovah's Witness patients, and be familliar with perioperative management without transfusion for these cases.
Subject(s)
Adult , Female , Humans , Pregnancy , Anemia , Cesarean Section , Emergencies , Ethics , Fetal Distress , Pre-Eclampsia , Pregnancy, TwinABSTRACT
Epileptic patients, who may be deprived of antiepileptic medication, are subject to stimuli that can result in seizures in the postoperative period. Status epilepticus is defined as a continuous seizure that lasts more than 30 minutes or serial seizures in which the patient does not regain a premorbid level of consciousness. Status epilepticus is considered a serious neurologic emergency that requires immediate recognition and prompt treatment to avoid life-threatening complications. We report a case in which status epilepticus developed unexpectedly after several recurrences of generalized convulsions on a 39 year old man who underwent the emergency repair of a bladder perforation. We should consider the influence of poor antiepileptic drug compliance on the precipitation of epileptic seizures when planning anesthesia for epileptic patients.