Anaesthetic Management of Turner's Syndrome posted for Modified Radical Mastoidectomy

A 25 year old female, known case of Turner's syndrome was posted for elective Radical Modified Mastoidectomy. Patient had tachycardia, high BP and ECG changes along with all signs and symptoms of Turner's syndrome. During surgery, the aims of anaesthetist were: 1.) To maintain hemodynamic stability, 2.) To provide optimum analgesia intraoperatively and post operatively and 3.) To maintain Peak Airway Pressure within normal limits. Patient was managed intra-operatively by monitoring vitals and maintaining airway pressures. Also airway was secured with blockbuster LMA in order to minimize haemodynamic fluctuations. Surgery was well managed and lasted for 3.5 hours. Patient was managed well intraoperatively with newer supraglottic device and all parameters were served. Patient was smoothly extubated and shifted to recovery with Aldrete score 8 out of 10. Thus, surgery was managed well both intraoperatively and postoperatively and also throughout surgery, patient remained stable. Use of LMA blockbuster was found to be useful and effective in such case for securing airway.

Anaesthetic Management of a Complicated Bilateral Tubo-Ovarian Abscess Posted for Diagnostic Laparoscopy followed by Laparotomy

A middle aged female presented with abdominal distension due to tubo ovarian abscess compressing both ureters leading to Acute Kidney Injury and reactive pleural effusion posted for diagnostic laproscopy and laparotomy done under general anaesthesia with Rapid Sequence Induction. The aims of anaesthetist during surgery were 1) To maintain hemodynamic stability and prevent regurgitation. 2) To provide optimum analgesia intraoperatively and post operatively and 3) To maintain Peak Airway Pressure within normal limits to prevent the basal lung atelectasis. Intra-operatively hemodynamic vitals were monitored and airway pressures were maintained within normal limits. Intra operatively laryngospasm occurred that was treated with i.v. succinylcholine and regurgitated contents were suctioned immediately. Patient was uneventfully managed and underlying pathology was corrected. Post-operatively; patient was shifted to ICU with endotracheal tube in situ that was weaned off eventually and successfully. Thus finally meticulous and collaborative efforts of Anesthesiologist, Gynecologist and para-medical staff, such critical patient can be well managed pre, intra and postoperatively uneventfully.