An unexpected intraoperative airway obstruction due to betadine solution.

Intraoperative airway obstruction is a nightmare for anesthesiologists, especially in head and neck surgeries. Due to the proximity of airway and surgical area, it will be difficult for anesthesiologists for the airway access. There are many causes of intraoperative airway obstruction. To the best of our literature search, there is no case report of airway obstruction due to betadine solution. Here we present a case of airway obstruction due to endotracheal tube blockade by the use of betadine solution in the surgery of cervical region in a child posted for posterior C1-C2 fusion in prone position on skull pins.

Anesthetic Management of Pregnant Patient With Undiagnosed Neurofibromatosis for Emergency Cesarean Section.

Neurofibromatosis type I is a genetic autosomal dominant disorder with multisystem involvement and is particularly challenging for the anesthesiologist in emergency surgery. The presence of neurofibromas can cause airway difficulty, make delivery of gases difficult, and blood pressure variations during general anesthesia. Regional anesthesia becomes challenging due to the presence of spinal and intracranial tumors, and in undiagnosed situations, it becomes tricky. This is a case report of anesthesia management in a pregnant patient with undiagnosed neurofibromatosis for an emergency cesarean section.

Post-Operative Low Cerebrospinal Fluid Pressure Headache in Giant Tarlov Cysts.

Giant Tarlov cysts are described as fluid-filled sacs located in the spine. They are mostly found in the sacral region, but are usually asymptomatic. The symptomatic Tarlov cysts are planned for surgical treatment in the form of laminectomy and marsupilisation of cysts. These surgical procedures can have complications like cerebrospinal fluid (CSF) leak, bacterial meningitis, and radiculopathic pain. We report a case of a 30-year-old male who presented with complaints of pain in his left leg for one and half years, urinary incontinence off and on for six months, and scrotal pain for two months. He was diagnosed with two giant Tarlov cysts on contrast-enhanced magnetic resonance imaging and planned for surgery. Intraoperatively, approximately 1000 ml of CSF was drained. The patient complained of severe headache in the immediate postoperative period, which was confirmed to be a low-CSF pressure headache. Prompt diagnosis and management with collaborative teamwork of neuroanesthetists and neurosurgeons helped treat the patient and prevent long-term morbidity.

Acute Transverse Myelitis in Pregnancy: The Use of ProSeal Laryngeal Mask Airway Without Curarization for Emergency Cesarean Section.

Transverse myelitis is a rare inflammatory neurological disorder of the spinal cord that damages the myelin covering the spinal cord and thus produces sensory, motor, and autonomic symptoms. A 26-year-old primigravida of 40 weeks gestation presented to the obstetric emergency of our hospital with complaints of weakness in both lower limbs and inability to walk for four days. A diagnosis of acute transverse myelitis was made, and due to fetal distress and arrest of labor in the second stage, an emergency cesarean section was planned. Considering the risks associated with the neuraxial technique and muscle relaxants, cesarean section was planned under general anesthesia and was successfully done with ProSeal laryngeal mask airway (LMA) using propofol and sevoflurane without muscle relaxant.