ABSTRACT
We report the strategy of anesthesia and intraoperative neurophysiological monitoring (IONM) in a 29-year-old, 22 weeks pregnant patient posted for surgery for aggressive vertebral body hemangioma. We used propofol and fentanyl-based anesthesia for IONM. Motor-evoked potentials (MEP) and somatosensory-evoked potentials (SSEP) were used to monitor the neural tracts during surgery. Fetal heart rate monitoring was done preoperatively and postoperatively. Train of 8, 75 µs duration pulse, 250-500 Hz stimulus was used for MEP and 30 mA, 200-400 µs, 3-5 Hz was used for SSEP. No new motor or somatosensory deficits appeared. Our findings suggest that IONM can be safely done in pregnant women.
Subject(s)
Anesthetics, Intravenous , Evoked Potentials , Hemangioma , Intraoperative Neurophysiological Monitoring , Pregnancy Complications, Neoplastic , Spinal Neoplasms , Adult , Female , Humans , Pregnancy , Anesthetics, Intravenous/administration & dosage , Cardiotocography , Evoked Potentials/physiology , Evoked Potentials, Motor/physiology , Evoked Potentials, Somatosensory/physiology , Fentanyl/administration & dosage , Hemangioma/surgery , Neurosurgical Procedures , Propofol/administration & dosage , Retrospective Studies , Spinal Neoplasms/surgery , Spine/surgery , Neural Pathways/physiology , Neural Pathways/physiopathology , Pregnancy Complications, Neoplastic/surgeryABSTRACT
How to cite this article: Burman S, Sharma PB, Tyagi M, Singh GP, Chaturvedi A. Transport Circuit during COVID-19 Crisis: A Simple Modification of the Bain's Circuit for Safety of Healthcare Workers. Indian J Crit Care Med 2020;24(12):1281-1283.
ABSTRACT
A 15-year-old boy diagnosed as case of cervical kyphosis, atlantoaxial dislocation, and hypofibrinogenemia was posted for corrective surgery under general anesthesia. His preoperative plasma fibrinogen levels and other coagulation profile were deranged. He was diagnosed with type 1 congenital fibrinogen abnormality, that is, hypofibrinogenemia. Preoperative blood products including cryoprecipitates were transfused to correct fibrinogen levels and coagulation profile. Cryoprecipitate was transfused at the dose of 1 bag per 10kg body weight per day. During intraoperative period, blood products were transfused following blood loss of 1100mL. Postoperatively the repeat laboratory investigations after 20âh revealed normal PF levels (211âmg/dL) with normal coagulation profile. He was discharged five days later with the uncomplicated postoperative course.
