Pre-anesthesia evaluation leading to a diagnosis of long QT syndrome - a case study

Long QT Syndrome is a rare disorder characterized by prolongation of QT interval on an ECG. Patients with this disorder have an increased risk of developing life-threatening arrhythmias such as torsades de pointes, and occasionally sudden cardiac arrest. We present this case of undiagnosed Long QT Syndrome in a 7 years old boy, who presented to our service for incision and drainage of an abscess in the left axilla under general anesthesia. This case highlights the importance of proper and meticulous preanesthesia evaluation, even in low risk patients, so that potentially harmful medical conditions are diagnosed well in time and managed accordingly

Suxamethonium apnoea: the forgotten episode in current practice

We present the first case in Bahrain of suxamethonium apnea in a parturient for an emergency Cesarian section. Immediate onset of action, optimal intubating conditions and rapid recovery are the key features that promote the use of suxamethonium. Suxamethonium apnea is critical and occurs in patients with pseudocholinesterase [PChE] deficiency either inherited or due to an acquired cause. Early suspicion of suxamethonium apnea and appropriate management with adequate sedation and mechanical ventilation whilst waiting for spontaneous recovery are all essential for a successful outcome

Negative pressure pulmonary edema

Negative Pressure Pulmonary Edema [NPPE] or Post-Obstructive Pulmonary Edema [POPE] is one of the most life-threatening emergencies in anesthesia

Immediate diagnosis with NPPE leads to better outcome. Usually, it affects healthy young patients. It occurs after upper airway obstruction, such as laryngeal spasms, tumor, and infection; it follows strong inspiratory effort leading to low negative pressure in the lungs which results into fluid infiltration and precipitates interstitial and alveolar edema

We report a case of unusual presentation of Negative Pressure Pulmonary Edema during and after extubation, which highlights the importance of early recognition and timely intervention to prevent further deterioration

Anaphylaxis: a life threatening but treatable condition

We present a case of perioperative anaphylaxis associated with the administration of intraoperative antibiotics. Perioperative anaphylaxis remains an important preventable cause of morbidity and mortality during anesthesia particularly if diagnosed early. Diagnosis can be challenging because multiple drugs are administered simultaneously during anaesthesia and surgery and any of these agents can potentially cause anaphylaxis. Early suspicion, immediate diagnosis and prompt management are vital as early specific management of anaphylaxis improves the outcome

Cerebral venous thrombosis and cerebral infarction: a rare disease with a rare cause

We present a case of cerebral venous thrombosis and cerebral infarction associated with diabetic ketoacidosis. The patient presented with vomiting, headache, lethargy and altered sensorium. CT venography provided the final diagnosis; therefore, anticoagulant was used, which resulted in the improvement of neurological outcome. Neurological deterioration during an episode of diabetic ketoacidosis is usually assumed to be caused by cerebral edema. Neuroimaging should always be performed in suspected cerebral edema associated with diabetic ketoacidosis in order to exclude other pathologies.