RESUMO
A 20-year-old girl was diagnosed to have severe coarctation of the aorta, large patent ductus arteriosus and severe pulmonary artery hypertension. She underwent single therapeutic catheterization for the treatment of native coarctation of aorta and closure of ductus arteriosus using 39 mm long Cheatham-Platinum covered stent. The procedure was done successfully under local anesthesia without any complication. This appears to be a safe strategy while dealing with an adolescent or an adult with this combination of lesions.
Assuntos
Anormalidades Múltiplas/diagnóstico , Adulto , Angioplastia com Balão/instrumentação , Materiais Revestidos Biocompatíveis , Permeabilidade do Canal Arterial/diagnóstico por imagem , Feminino , Seguimentos , Cateterismo Cardíaco/métodos , Cardiopatias Congênitas/diagnóstico , Hemodinâmica/fisiologia , Humanos , Implantação de Prótese , Medição de Risco , Stents , Resultado do TratamentoRESUMO
We present two cases of pulmonary atresia with ventricular septal defect who were not suitable for corrective surgery due to absent or hypoplastic native pulmonary arteries and were quite symptomatic following shunt surgery. We dilated and stented stenosed aortopulmonary collaterals as palliative procedure with improvement in oxygen saturation, and significant symptomatic relief.
Assuntos
Angiografia , Estenose da Valva Aórtica/cirurgia , Procedimentos Cirúrgicos Cardiovasculares/métodos , Criança , Pré-Escolar , Circulação Colateral , Feminino , Comunicação Interventricular/complicações , Humanos , Masculino , Atresia Pulmonar/complicações , StentsRESUMO
This randomized controlled trial study evaluated the intubating conditions at 1 minute after 0.3, 0.6 and 0.9 mg/kg of rocuronium in 60 Thai elderly patients who enrolled for elective surgery under general anesthesia with fentanyl, thiopental and halothane at King Chulalongkorn Memorial Hospital. Excellent or good conditions were observed in 50 per cent (p<0.05) at rocuronium 0.3 mg/kg, compared with 95 and 85 per cent at 0.6 and 0.9 mg/kg of rocuronium, respectively but the excellent conditions were 5 (p<0.05), 30 and 45 per cent from each dose. Therefore, rocuronium 0.6 or 0.9 mg/kg should be adequate for intubation in elective, elderly patients but was inadequate for emergency case. In addition, rocuronium 0.3 mg/kg is insufficient for intubation at 1 minute in this age group. No serious side effects of the drug nor complications were found in this study.
Assuntos
Idoso , Idoso de 80 Anos ou mais , Androstanóis/administração & dosagem , Determinação da Pressão Arterial , Relação Dose-Resposta a Droga , Método Duplo-Cego , Tratamento de Emergência/métodos , Feminino , Frequência Cardíaca , Hemodinâmica/fisiologia , Humanos , Intubação Intratraqueal/métodos , Masculino , Pessoa de Meia-Idade , Relaxamento Muscular/efeitos dos fármacos , Músculo Liso/efeitos dos fármacos , Fármacos Neuromusculares não Despolarizantes/administração & dosagem , Estudos Prospectivos , Resultado do TratamentoRESUMO
Headache following lumbar puncture is a well known and well described complication. Various manoeuvres have been tried to prevent post lumbar puncture headache--the commonest being bed rest for 4 to 24 hours following lumbar puncture, though its value is questionable. Randomised controlled clinical trial was done to evaluate the effect of 24 hours bed rest on the incidence and severity of post lumbar puncture headaches. Two hundred and eight patients were randomly allocated to either the ambulant or the bed rest group. Patients were interviewed by a single investigator on days 0, 1, 2 and 7 about the presence and nature of headache. Other relevant clinical and laboratory data pertaining to the lumbar puncture was collected. The overall incidence of post lumbar puncture headache was 17%; 15% in the ambulant and 18% in the bed rest group. Of the patients who had headaches, severe headache was observed in 57% in the ambulant and 12% in the bed rest group (p = 0.02). Other variables did not alter the outcome of headaches. Bed rest does not appear to alter the incidence of post lumbar puncture headaches, but reduces the severity in those who get headaches, after a lumbar puncture.