Anesthesia experience in a child affected by congenital cystic adenomatoid malformation and retinopathy of prematurity for eye laser procedure--a case report.

Congenital Cystic Adenomatoid Malformation or bronchopulmonary displasia (congenital lung cysts disease) is a rare condition. Intrauterine death affect severe cases, those infants surviving till birth lead a chronic course of respiratory illness amenable to corrective thoracic surgery or other corrective measures for non pulmonary conditions. This report describes an experience with one girl that needed anesthesia for congenital retinopathy's laser treatment.

Historical report account on the development of anesthesiology and medical services in Kingdom Saudi Arabia 1956-1987: M. I. Al-Khawashki's letter dated April 25(th) 1997.

In this historical report, a new light is spotting new details of the development of anesthesiology and medical services in Kingdom Saudi Arabia 1956-1987. The value of this letter written in Arabic language and cannot be accessible to non-Arabic speakers. The translation and verification of author publications to support its evidence would augment the current of scientific history writing. The time covered was since 1952 to the eighties. It reflects the ambition of various ministers of health in Saudi Arabia and international health body WHO that allowed many health care providers to build the services. It is first-hand experience of the writer Al Khawashki. The picture would be more complete when more research would follow this paper publication.

Conscious sedation for awake craniotomy in intra-operative magnetic resonance imaging operating theatre (IMRI OT) environment.

This technical report disrobes the first case in Intra-operative Magnatic Resonance Imaging operating theatre (iMRI OT) (BrainSuite), of Awake Craniotomy. The procedure was for frontal lobe glioma excision in 24 y. old man. He was scheduled to undergo eloquent cortex language mapping intra-operatively. He was motivated and was excited to see the operating theatre. He requested to take his photos while operated upon. The authors adapted conscious sedation technique with variable depth according to Ramsey's scale, in order to revert to awake state to perform the intended neurosurgical procedure. Patient tolerated the situation satisfactory and was cooperative till the finish without any event. We elicit in this report the special environment of iMRI OT for lengthy operation in pinned fixed patient having craniotomy. The text shows the special environment, its demands and its possible difficulties.

Historical essay: An Arabic surgeon, Ibn al Quff's (1232-1286) account on surgical pain relief.

This is a review of Ibn al Quff's account of surgical pain relief in his surgical book Al Omdah, in which he mentioned the word anesthetic (Al moukhadder) and the involvement of physician (al tabbaaee) to give mixture of drugs to prevent pain in a surgical condition to relieve the patient from pain or to make surgical management possible. Hich indicated one rare occasion to such description in Arabic medical texts. Methods of administration of these drugs were inhalation, ingestion and by rectal suppositories. The drugs used in anesthetic sponges include all the drugs that are recorded in the modern literature of anesthesia. They are as follows: opium, mandrake, Hyocymus albus, belladonna, Cannabis sativus, Cannabis indica, wild lettuce. The anesthetic sponge, mentioned in many references as an inhalation method, may be of symbolic value to surgery.

Conscious sedation for awake craniotomy in intraoperative magnetic resonance imaging operating theater.

This case report describes the first case in intraoperative magnetic resonance imaging operating theater (iMRI OT) (BrainSuite®) of awake craniotomy for frontal lobe glioma excision in a 24-year-old man undergoing eloquent cortex language mapping intraoperatively. As he was very motivated to take pictures of him while being operated upon, the authors adapted conscious sedation technique with variable depth according to Ramsey's scale, in order to revert to awake state to perform the intended neurosurgical procedure. The patient tolerated the situation satisfactorily and was cooperative till the finish, without any event. We elicit in this report the special environment of iMRI OT for lengthy operation in pinned fixed patient having craniotomy.

Failed sevoflurane induction of anesthesia in a child affected by congenital cystic adenomatoid malformation of the lungs.

A case of congenital lung cyst disease is presented here. The inhalational induction of anesthesia with sevoflurane failed to ensure satisfactory intubation condition. Then, intravenous ketamine and rocuronium were given and they facilitated the intubation.

Management of neonatal massive anterior mediastinal teratoma--a case report.

We report a challenging case of a newborn with a massive anterior mediastinal teratoma (MT), occupying nearly the right hemithorax, presenting at birth with life threatening respiratory distress (RD). Optimal approach and outcome was achieved with a coordinated, multidisciplinary approach.

Saudi patients' knowledge and attitude toward anesthesia and anesthesiologists--A prospective cross-sectional interview questionnaire.

BACKGROUND: Patients' awareness of the duties of anesthesiologists in the operating theatres may sometimes be limited. Many studies around the world proved lack of patient perception of the anesthesiologist's role in surgical practice. METHODS: One hundred and seventy operative patients were interviewed by anesthesiologists in the peri-operative period in King Khalid University Hospital at Riyadh KSA This paper reports the results of a prospective study on these patient's interviews by filling predetermined questionnaire by the interviewer. The survey was conducted on two sessions namely before anesthesia and surgery, and in the first post operative day. It included three sections exploring the demographical profile of the participant, knowledge about anesthesia procedure, assessment, anesthesiologists personnel, postoperative pain relief and the attitude toward the service given to him. RESULTS: Patients who recognized the anesthesiologists as specialized doctor consisted of 55.3%. But those who recognized anesthesia services during surgical intervention were only 16.5%. This result reflect ignorance of the public of the function of anesthesiologists, showed lack of perception regarding anesthesia procedures during surgery, and the role of the anesthesiologist in monitoring resuscitation and postoperative analgesia. Patients showed inclination to know more about the anesthesia services and choices and ranked the services from very good to excellent. The illiterate section of the studied population showed statistically significant correlation between their information on anesthesiologists and anesthesia, and their degree of education, level of income and habitat. CONCLUSIONS: Reasonable percentage of the patients knew that the anesthesiologist is a doctor who administers anesthesia. Services of anesthesiologists were highly appreciated, but their function during the operation and nature of anesthetics administered were poorly known. These results call for the necessity to educate the surgical patient by the anesthesiologists preoperative interview allow more time to establish rapport, by distributing educational material related to anesthesia and use of the media to educate illiterate section of the public on subjects pertaining to anesthesia.

Osler-Weber-Rendu disease--unexpected complication following excision of splenic aneurysm--a case report.

Osler-Weber-Rendu disease is an autosomal dominant disease, sometimes known as hereditary hemorrhagic telangiectasia (HHT) with a family history. It is a rare disease and there are no records of families with inheritance lineage in Riyadh. We experienced an anesthetic management of a 28-yr-old woman with Osler-Weber-Rendu disease. She was diagnosed to have splenic aneurysm and was scheduled for excision of splenic aneurysm. A chest X-ray revealed pulmonary arterio-venous malformation all over the lungs. The anesthesia and surgery went deliberately smooth with selective period of Intensive Care admission. In the intermediate post operative period, however, she was diagnosed as having pleural effusion. A chest drain was inserted as an emergency, but the patient developed tension pneumothorax, which necessitated resuscitation and readmission to Intensive Care Unit. Lung atelactasis was diagnosed. Attendance by qualified surgical night staff, communication, vigilance and consultations are as important as the proper management of such rare cases.