Unexplained cardiac arrest during closure of craniotomy: case report and review of literature

Hypotension and bradycardia after application of suction to a subgaleal drain, or stimulus inside or outside the skull, have been reported in the medical literature. The commonly reported occurrence is stimulation of the Trigeminal nerve along its distribution and is the main factor that sets off the whole reflex arc through the Vagus nerve ending in a series of serious hemodynamic changes that institute severe bradycardia, asystole and severe hypotension. Another less common but possible pathology caused by a suction drain is Pseudo-Hypoxic Brain Swelling [PHBS]. We report a case of transient cardiac arrest after the application of theatre suction to a subgaleal drain at the closure of an uneventful craniotomy and discuss the possibilities as well as review the literature

Hypothermia in infants: the important factors

A prospective consecutive observational study over a period of six months was conducted in thepediatric surgical theatre of Hamad General Hospital, Qatar, on infants aged one day to one year who required general anesthesia with or without regional anesthesia. It was found that neonates [aged 1-29 days] had difficulty in maintaining a stable body temperature despite various methods of promoting warmth. Infants [aged 1-12 months] undergoing major surgery were more exposed to hypothermia than those in minor surgery. Causes of hypothermia were multifactorial