RESUMO
We observed a patient who had central retinal artery occlusion with severely reduced visual acuity and characteristic retinal changes after cervical spine surgery under general anesthesia. In acute stage, visual acuity was slightly improved. But over course of several months, there was no improvement in visual acuity and central scotoma was remained. There were no evidences of hypotension or anemia during operation. The only presumptive cause was direct external ocular compression by horseshoe headrest. It is necessary to pay attention to eyes when prone positioning in the patients of cervical spine surgery.
Assuntos
Humanos , Anemia , Anestesia Geral , Cegueira , Hipotensão , Decúbito Ventral , Oclusão da Artéria Retiniana , Retinaldeído , Escotoma , Coluna Vertebral , Acuidade VisualRESUMO
Congenital tracheal stenosis is a rare life-threatening obstruction in infancy and childhood. Symptoms are ranged from recurrent stridor and wheezing to severe respiratory compromise and hypercarbia. If the patient with tracheal stenosis, who has hypercarbia, is hyperventilated to maintain normocarbia, air is trapped in the lung and the risk of pulmonary barotrauma is increased. Cardiopulmonary-bypass is recommended for this patient to have corrective surgery. Permissive hypercapnia is proposed for the mechanical ventilation of patients with severe tracheal stenosis before cardiopulmonary-bypass.