Epidural anesthesia for pediatric surgery in a university hospital in Saudi Arabia

To present the safety and efficacy of epidural blockade in children. A respective review was carried out at the King Khalid University Hospital [KKUH], Riyadh, Saudi Arabia from April to December 2007. The patient age, type of surgery, epidural level block, technique, local anesthetic dose, and quality of epidural block were analyzed. Thirty-eight epidural blockades in children with a mean age of 3 years +/- 7 months were performed under general anesthesia for different procedures. All patients had minimal, or no intravenous narcotic and exhibited hemodynamic stability. There were no intraoperative or postoperative complications. Epidural anesthesia in children is safe and effective intraoperatively, as well as, for postoperative pain control

Severe hepatic dysfunction after sevoflurane exposure

Sevoflurane is thought to have a potential for hepatotoxicity. A few cases of hepatotoxicity have been reported since it was introduced in 1990 into clinical practice in Japan. The underlying pathophysiology of hepatotoxicity is nonspecific. We report a case of severe hepatic dysfunction after uneventful sevoflurane anesthesia in a child with posterior fossa resection of medulloblastoma. The case of sevoflurane being incriminated is unclear due to various confounding factors that is worthy of discussion

effect of prone position on respiratory mechanics during spinal surgery

To study the effect of prone position on respiratory mechanics during spine surgery. Prospective study. Elective spine surgery at a university hospital. 12 ASA physical I and II with no coexisting cardiorespiratory disease undergoing cervical or lumbar laminectomy under general anesthesia in prone position. Ten min after induction of general anesthesia and endotracheal intubation, while patients were in supine position, the following measurements were taken using anesthesia delivery unit [Datex Ohmeda type A_Elec, Promma, Sweden]: peak airway pressure [Ppeak], peak plataeu pressure [Pplat], peak mean pressure [Pmean] and dynamic lung compliance [DLC]. The same measurements were recorded 10 min after placing patients into prone position. At the end of surgery and 5 min after turning the patients supine and before tracheal extubation, the same measurements were again recorded. The results expressed as means +/- sd. One way ANOVA was used for analysis of differences in the data before, during prone position and after turning patients supine at the end of the procedure. For all comparisons p<0.05 was considered significant. During prone position there was significant reduction in DLC and significant increase in airway pressures. We conclude that turning the patients from supine to prone position during anesthesia for spine surgery caused significant decrease of DLC and significant increase of airway pressure