ABSTRACT
Paraganglioma is an uncommon neuroendocrine tumor of cells that originate in the autonomic nervous system. Some paragangliomas have the ability to secrete catecholamines, similar to secretions in pheochromocytoma. For this reason, paragangliomas may cause malignant hypertension in patient, upon being administered anesthesia, or during surgery, this may lead to a life-threatening condition, despite the tumor having been diagnosed before conducting the procedure. Therefore, it is important to take adequate actions for reducing the occurrence of morbidity and mortality during surgery. Here, we describe a successful anesthetic management in a patient diagnosed with retroperitoneal paraganglioma invading the iliac bone.
Subject(s)
Humans , Anesthesia , Autonomic Nervous System , Catecholamines , Hypertension, Malignant , Mortality , Neuroendocrine Tumors , Paraganglioma , PheochromocytomaABSTRACT
Neurofibromatosis type 2 (NF2) is a rare form of neurofibromatosis. Because the central nervous system involvement is predominant feature of NF2, the presence of intracranial and intraspinal neurofibroma make regional anesthesia difficult in patients with NF2.When diagnostic imaging study was not performed in NF2 parturient with CNS tumor involvement, general anesthesia is a better choice for delivery and not associated with the aggravation of neurofibromatosis.We report a case of parturient with NF2 whose emergency cesarean section was successfully managed with general anesthesia.Her neurological status was not worsened and her baby had no problem.
Subject(s)
Female , Humans , Pregnancy , Anesthesia, Conduction , Anesthesia, General , Central Nervous System , Cesarean Section , Diagnostic Imaging , Emergencies , Neurofibroma , NeurofibromatosesABSTRACT
BACKGROUND: In pediatric anesthesia, a method using deliberate endobronchial intubation and auscultation has been used for proper endotracheal tube depth. Tube size, however, may influence on auscultation for air leak between the tube and main bronchus. We attempted to ascertain whether the uncuffed tracheal tube (TT) size affects verifying tube placement by auscultation in children. METHODS: In 23 children, we measured the distance from the carina to the tip of a tube when the first auscultatory sound could be detected on the left chest and when the breathing sound of both chests equalized during withdrawal from right main bronchus. Then, we compared them with those of either a one-size larger or a one-size smaller tube. RESULTS: The distance from the carina to the tip at the first sound was significantly longer in the smaller tracheal tube (1.8 cm vs 1.5 cm, P = 0.01). The tube tip at the equalized breath sounds was 0.6 cm below the carina in both tubes. CONCLUSIONS: These results suggest that detecting endobronchial intubation may be more difficult when using uncuffed tracheal tubes with one-size smaller tube and that auscultation with deliberate bronchial intubation can place the uncuffed TT deeper than an intended depth.