ABSTRACT
INTRODUCTION: Usually presenting in infancy, Leigh's syndrome is an inherited condition often manifesting with seizures, ataxia, developmental delay, and dysarthria. The disorder is rare, appearing in approximately 1 in 40,000 live births. Consequently, providing these patients with a suitable plan by which to administer anesthetics remains problematic. CASE PRESENTATION: We report a male patient with Leigh's syndrome and a family history suggestive of unknown hypotonia and malignant hyperthermia presenting for dental rehabilitation. CONCLUSIONS: Dexmedetomidine with remifentanil can be used with no complication in this senerio.
ABSTRACT
There are many causes for stridor in a pediatric patient. We present an interesting case of a pediatric patient who had stridor due to an innominate artery compression and posterior mediastinal mass. We discuss the anesthetic complication and management of patients with stridor.
Subject(s)
Brachiocephalic Trunk , Esophagus , Foreign Bodies/complications , Mediastinal Diseases/complications , Respiratory Sounds/etiology , Tracheal Stenosis/complications , Humans , Infant , MaleABSTRACT
Resection of large sacrococcygeal teratomas (SCT) in neonates can pose many anesthetic challenges. The pathophysiology of the SCT determines the varying management. We present a case report of a 34-week newborn with a massive Altman type 3 SCT. The surgery was delayed 2 days because of hyperkalemia; however, as a result of continued tumor lysis the patient's condition had worsened with little improvement of the potassium level. During the surgery, the patient had issues of bleeding needing massive transfusion. Ventilation was also difficult at times because of the massive tumor resting on the chest, resulting in respiratory acidosis. We also had difficulty in maintaining the temperature. This patient did well after the surgery and was discharged home. We address here the anesthetic issues involved in the perioperative care management of a premature infant with a massive SCT.
