Résumé
Rett syndrome is a neurodevelopmental disease that almost always affects female patients. It is caused by mutations in MeCP2 in the majority of cases. Patients diagnosed with Rett syndrome may experience serious adverse events even with smaller amounts of medication for sedation and anesthesia. The major anesthetic concerns associated with Rett syndrome are lack of cooperation, abnormal continuous limb movements, abnormal respiratory control, difficult positioning secondary to scoliosis, and altered sensitivity to painful stimuli. Because of the risks caused by these problems, anesthesiologists should be aware of the specific anesthetic concerns of patients with Rett syndrome in order to safely administer anesthesia. Here, we describe the management of a pediatric patient diagnosed with Rett syndrome.
Sujets)
Femelle , Humains , Anesthésie , Dyskinésies , Membres , Syndrome de Rett , ScolioseRésumé
Hiccups are an involuntary contraction of the diaphragm that may repeat several times per minute. In general, hiccups are very common, transient, and self-limited. However, if the condition persists longer than days or months, it impacts a patient's quality of life. Pharmacologic and non-pharmacologic methods are used for the treatment of persistent or intractable hiccups. Nerve block and stimulation have been shown to be effective through neural pathway interruption or stimulation of the hiccup reflex arc. Stellate ganglion block (SGB) is an injection of local anesthetic adjacent to a group of nerves in the neck known as the stellate ganglion. The authors report a case of SGB as an effective treatment for a patient with intractable hiccups resulting from right lateral medullary syndrome.
Sujets)
Humains , Muscle diaphragme , Hoquet , Syndrome de Wallenberg , Cou , Bloc nerveux , Voies nerveuses , Qualité de vie , Réflexe , Ganglion cervicothoracique , Système nerveux sympathiqueRésumé
Syncope is defined as a transient loss of consciousness and postural tone, characterized by rapid onset, short duration, and spontaneous recovery. Stellate ganglion block (SGB) is a nerve block method that is used for treatment of neuropathic pain in the head, neck and upper extremities, especially trigeminal neuralgia, postherpetic neuralgia and complex regional pain syndrome. SGB can modulate and stabilize the sympathetic nervous system, which prevents it from overexcitation and improves symptoms of syncope. The authors report a patient who was treated for pain and edema of both upper extremities with SGB, then showed improvement in recurrent syncope followed by chest pain and overall quality of life.
Sujets)
Humains , Douleur thoracique , Oedème , Tête , Méthodes , Cou , Bloc nerveux , Névralgie , Algie post-zona , Qualité de vie , Ganglion cervicothoracique , Système nerveux sympathique , Syncope , Thorax , Névralgie essentielle du trijumeau , Perte de conscience , Membre supérieurRésumé
Syncope is defined as a transient loss of consciousness and postural tone, characterized by rapid onset, short duration, and spontaneous recovery. Stellate ganglion block (SGB) is a nerve block method that is used for treatment of neuropathic pain in the head, neck and upper extremities, especially trigeminal neuralgia, postherpetic neuralgia and complex regional pain syndrome. SGB can modulate and stabilize the sympathetic nervous system, which prevents it from overexcitation and improves symptoms of syncope. The authors report a patient who was treated for pain and edema of both upper extremities with SGB, then showed improvement in recurrent syncope followed by chest pain and overall quality of life.