[Late postpartum eclampsia. Apropos of a case]. / Eclampsia tardía posparto. A propósito de un caso.

We report the case of a 32-year-old multipara who presented preeclampsia on the fourth day after childbirth without receiving proper treatment that progressed to eclampsia 4 days later. Pregnancy and delivery had been uneventful. The patient presented proteinuria (30 mg/dl), serum total proteins 5.3 g/dl and serum albumin 3.3 g/dl. Blood pressure was controlled with methyldopa, 500 mg at six-hour intervals by intravenous route. The patient presented hypoxemia secondary to bilateral pleural effusion and aspirative pneumonia requiring mechanical ventilation and invasive hemodynamic monitoring. Treatment with cefotaxime, 1 g at six-hour intervals by intravenous route and clindamycin, 600 mg at six-hour intervals by intravenous route was initiated. Sedation was maintained with thiopental sodium, 3 mg/kg/hour in continuous infusion. At dismission, the patient was completely recovered from her clinical picture and needed no antihypertensive therapy. Physiopathologic features and the aforementioned complications are discussed with particular reference to differential diagnosis.

[Effect of succinylcholine on serum levels of potassium in patients treated for intracranial aneurysm]. / Efecto de la succinilcolina sobre los niveles séricos de potasio en pacientes intervenidos de aneurisma intracraneal.

A prospective study was carried out on 10 patients who were submitted to intracranial aneurysm clipping and who had bled some days before the operation. All patients received a precurarization dose of pancuronium (0.01 mg/kg) and lidocaine (1.5 mg/kg) during the preinduction and succinylcholine (1 mg/kg) to facilitate orotracheal intubation. The operation took place between the days 5 and 27 following the subarachnoid hemorrhage. Basal potassium plasma levels were determined at 1, 3, 5 and 10 minutes after succinylcholine had been administered. The levels (media +/- SD), expressed in mEq/l, were: basal 3.77 +/- 0.31; at first minute 3.64 +/- 0.38: 3 minutes 3.69 +/- 0.35; 5 minutes 3.78 +/- 0.31, and 10 minutes 3.82 +/- 0.39. Using the analysis of variance, no significant differences (p = 0.11) were observed among the average levels of potassium in the intervals of time studied. There is no significant correlations either between the potassium figures and the time elapsed since the subarachnoid hemorrhage occurred.