ABSTRACT
Meningoencephalocele is herniation of cerebrospinal fluid, brain tissue and meninges through the skull defect. The anaesthetic management of occipital meningoencephalocele is challenging because of the difficulty in securing airway, prone position, blood loss and, perioperative care. The two major aims of the anaesthesiologists while caring for children with occipital encephalocoele intraoperatively are to avoid premature rupture of the encephalocoele and to manage a possible difficult airway due to restricted neck movement and inability to achieve optimal position for intubation of the trachea. We report a case of giant occipital meningoencephalocele presented for surgical excision. Perioperative management of patients with giant meningoencephalocele may be challenging for both anaesthesiologist and neurosurgeon. These patients must be managed closely with an interdisciplinary approach.
ABSTRACT
Meningoencephalocele is herniation of cerebrospinal fluid, brain tissue and meninges through the skull defect. The anaesthetic management of occipital meningoencephalocele is challenging because of the difficulty in securing airway, prone position, blood loss and, perioperative care. The two major aims of the anaesthesiologists while caring for children with occipital encephalocoele intraoperatively are to avoid premature rupture of the encephalocoele and to manage a possible difficult airway due to restricted neck movement and inability to achieve optimal position for intubation of the trachea. We report a case of giant occipital meningoencephalocele presented for surgical excision. Perioperative management of patients with giant meningoencephalocele may be challenging for both anaesthesiologist and neurosurgeon. These patients must be managed closely with an interdisciplinary approach.
ABSTRACT
Children are not small adults. They have certain anatomical & physiological differences as compared to adults. Paediatric patients have limited body reserve and so they deteriorate very fast. Anaesthetising paediatric patient requires good clinical judgment and thorough knowledge of paediatric anatomy and physiology. Anaesthetising an infant who has respiratory distress preoperatively increases risk several folds. Also the cause of respiratory distress is vital and that can have an important anaesthetic implications. Here we report a case of a gasping infant operated for emergency neck exploration under anaesthesia, where the cause of respiratory distress was unknown, making the case further interesting and challenging.
ABSTRACT
Sinus tachycardia in a patient undergoing surgery under general anaesthesia is not an uncommon experience in anaesthesia practice. Causes of intraoperative sinus tachycardia can be multi-factorial. Operative causes are pain, surgical stimulation and light depth of anaesthesia. Pharmacological factors include administration of catecholamines, atropine, or ketamine. Medical factors such as sepsis, hypovolaemia, heart failure, anaemia, and thyrotoxicosis should also be considered. We report a case of inadequately controlled hyperthyroidism undergoing surgery for a spinal cord tumour under general anaesthesia who developed unexplained tachycardia intraoperatively.