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1.
SJA-Saudi Journal of Anaesthesia. 2015; 9 (2): 202-203
em Inglês | IMEMR | ID: emr-162339

RESUMO

Presence of intraoral pathology poses a great challenge during management of pediatric airway. We report management of big intraoral cystic swelling physically occupying the entire oral cavity restricting access to airway. Preintubation aspiration of swelling was done to decrease its size and make room for airway manipulation, followed by laryngoscopy and intubation in lateral position. Airway patency is at risk in postoperative period also, in this case, though the swelling decreased in size postoperatively but presence of significant edema required placement of tongue stitch and modified nasopharyngeal airway. Case report highlights simple maneuvers to manage a difficult case

3.
SJA-Saudi Journal of Anaesthesia. 2014; 8 (3): 399-401
em Inglês | IMEMR | ID: emr-152561

RESUMO

Apert syndrome is an autosomal dominant disease characterized by craniosynostosis, midface hypoplasia and syndactyly. In general, patients present in early childhood for craniofacial reconstruction surgery. Anesthetic implications include difficult airway, airway hyper-reactivity; however, possibility of raised intracranial pressure especially when operating for craniosynostosis and associated congenital heart disease should not be ignored. Most of the cases described in literature talk of management of syndactyly. We describe the successful anesthetic management of a patient of Aperts syndrome with craniosynostosis posted for bicornual strip craniotomy and fronto-orbital advancement in a 5-year-old child

4.
SJA-Saudi Journal of Anaesthesia. 2014; 8 (2): 276-278
em Inglês | IMEMR | ID: emr-142213

RESUMO

Aspiration of foreign bodies is common in a pediatric age group but adults can also be at risk. We describe management of two adult trauma victims with aspirated tooth. In the first case, foreign body went missing for sometime by intensive care physician and detected by radiologist while it was obvious in the second case. Both the patients were managed with the help of rigid bronchoscopy. Tooth should be removed as soon as possible or it may result in complete airway obstruction or lung collapse.


Assuntos
Humanos , Masculino , Dente , Gerenciamento Clínico , Adulto , Traumatismos Craniocerebrais , Corpos Estranhos , Broncoscopia
5.
SJA-Saudi Journal of Anaesthesia. 2013; 7 (4): 410-414
em Inglês | IMEMR | ID: emr-148637

RESUMO

Re-intubation of neurosurgical patients after a successful tracheal extubation in the operating room is not uncommon. However, no prospective study has ever addressed this concern. This study was aimed at analyzing various risk factors of re-intubation and its effect on patient outcome. Patients aged between 18-60 years and of ASA physical status 1 and 2 undergoing elective craniotomies over a period of two years were included. A standard anesthetic technique using propofol, fentanyl, rocuronium, and isoflurane/sevoflurane was followed, in all these patients. 'Re-intubation' was defined as the necessity of tracheal intubation within 72 hrs of a planned extubation. Data were collected and analyzed employing standard statistical methods. One thousand eight hundred and fifty patients underwent elective craniotomy, of which 920 were included in this study. A total of 45 [4.9%] patients required re-intubation. Mean anesthesia duration and time of re-intubation were 6.3 +/- 1.8 and 24.6 +/- 21.9 hrs, respectively. The causes of re-intubation were neurological deterioration [55.6%], respiratory distress [22.2%], unmanageable respiratory secretion [13.3%], and seizures [8.9%]. The most common post-operative radiological [CT scan] finding was residual tumor and edema [68.9%]. Seventy-three percent of the re-intubated patients had satisfactory post-operative cough-reflex. The ICU and hospital stay, and Glasgow outcome scale at discharge were not significantly affected by different causes of re-intubation. Neurological deterioration is the most common cause of re-intubation following elective craniotomies owing to residual tumor and surrounding edema. A satisfactory cough reflex may not prevent subsequent re-intubation in post-craniotomy patients


Assuntos
Humanos , Masculino , Feminino , Craniotomia , Estudos Prospectivos , Extubação , Tomografia Computadorizada por Raios X , Tosse
6.
SJA-Saudi Journal of Anaesthesia. 2011; 5 (3): 323-325
em Inglês | IMEMR | ID: emr-129933

RESUMO

Neurogenic pulmonary edema [NPE] is a well-known entity, occurs after acute severe insult to the central nervous system. It has been described in relation to different clinical scenario. However, NPE has rarely been mentioned after endovascular coiling of intracranial aneurysms. Here, we report the clinical course of a patient who developed NPE after aneurysmal rupture during endovascular surgery. There was significant cardiovascular instability possibly from stimulation of hypothalamus adjacent to the site of aneurysm. This case highlights the predisposition of minimally invasive procedures like endovascular coiling to life-threatening complications such as NPE


Assuntos
Humanos , Feminino , Adulto , Aneurisma Intracraniano/complicações , Hemorragia Subaracnóidea/complicações , Procedimentos Endovasculares/métodos , Procedimentos Endovasculares/efeitos adversos , Ruptura
7.
Middle East Journal of Anesthesiology. 2009; 20 (2): 309-312
em Inglês | IMEMR | ID: emr-92211

RESUMO

Double aortic arch with patent ductus arteriosus and atrial septal defect is an uncommon association. Such complex cardiac lesions may complicate an otherwise normal anesthetic course. We came across a case with aqueductal stenosis and hydrocephalus, scheduled for ventriculoperitoneal shunt surgery, on an emergent basis. The child was managed successfully. The anesthetic implications of resultant left-to-right shunt with increased intracranial pressure have been described


Assuntos
Humanos , Masculino , Aorta Torácica/anormalidades , Permeabilidade do Canal Arterial , Comunicação Interatrial , Anestesia , Cirurgia Geral , Lactente , Hidrocefalia/cirurgia , Pressão Intracraniana
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