ABSTRACT
Posterior reversible encephalopathy syndrome is a rare and serious condition that presents with acute neurological symptoms with characteristic changes on imaging. It can lead to substantial morbidity and mortality, but can be reversible if recognised and treated. Here, we report a case of posterior reversible encephalopathy syndrome in a child post-splenectomy under general anaesthesia with spinal anaesthesia. As far as we are aware, this condition has not previously been described in relation to spinal anaesthesia in the paediatric population. This case demonstrates the importance of recognising blood pressure changes in children, which can be challenging due to age-, sex- and height-related centiles for blood pressure measurements. Posterior reversible encephalopathy syndrome should be considered as a differential diagnosis for headache in a patient that has had a spinal anaesthesia.
Subject(s)
Cesarean Section/adverse effects , Multiple Organ Failure/etiology , Subphrenic Abscess/complications , Disseminated Intravascular Coagulation/therapy , Drainage/methods , Female , Humans , Multiple Organ Failure/therapy , Subphrenic Abscess/diagnostic imaging , Subphrenic Abscess/etiology , Subphrenic Abscess/surgery , Tomography, X-Ray Computed , Young AdultSubject(s)
Bacteremia/diagnosis , Capnocytophaga/isolation & purification , Electrocardiography , Gram-Negative Bacterial Infections/diagnosis , Myocardial Infarction/diagnosis , Spleen/surgery , Splenectomy/adverse effects , Bacteremia/complications , Blood Chemical Analysis , Echocardiography , Emergency Service, Hospital , Follow-Up Studies , Gram-Negative Bacterial Infections/complications , Humans , Male , Middle Aged , Myocardial Infarction/etiology , Spleen/injuries , Splenectomy/methodsABSTRACT
BACKGROUND AND OBJECTIVE: The intubating laryngeal mask (intubating laryngeal mask airway) was designed to facilitate blind intubation. Its value as an adjunct to fibreoptic laryngoscopy has not been evaluated. This study compares the intubating laryngeal mask airway with the standard laryngeal mask airway as conduits for fibreoptic laryngoscopy. METHODS: The fibreoptic view of the laryngeal inlet was graded via both devices in 60 anaesthetized patients. The fibreoptic view through the intubating laryngeal mask airway was assessed after the central epiglottic elevator bar had been lifted out of the field of vision by an 8-mm Euromedical tracheal tube, which was inserted to a depth of 18 cm. The fibreoptic view from the aperture bars of the laryngeal mask was recorded. RESULTS: The vocal cords were viewed less frequently through the intubating laryngeal mask airway (52%) than through the laryngeal mask airway (92%) [difference = 40% (95% CI = 26% to 54%), P < 0.0001]. CONCLUSION: The view of the laryngeal inlet is better through the laryngeal mask airway than through a tracheal tube inserted to 18 cm in the intubating laryngeal mask.
