Anesthetic management with scalp nerve block and propofol/remifentanil infusion during awake craniotomy in an adolescent patient: A case report / 대한마취과학회지

Despite of various neurophysiologic monitoring methods under general anesthesia, functional mapping at awake state during brain surgery is helpful for conservation of speech and motor function. But, awake craniotomy in children or adolescents is worrisome considering their emotional friabilities. We present our experience on anesthetic management for awake craniotomy in an adolescent patient. The patient was 16 years old male who would undergo awake craniotomy for removal of brain tumor. Scalp nerve block was done with local anesthetics and we infused propofol and remifentanil with target controlled infusion. The patient endured well and was cooperative before scalp suture, but when surgeon sutured scalp, he complained of pain and was suddenly agitated. We decided change to general anesthesia. Neurosurgeon did full neurologic examinations and there was no neurologic deficit except facial palsy of right side. Facial palsy had improved with time.

Diaphragmatic paralysis following alcohol celiac plexus neurolysis and a review of literature: A case report

A 54-year-old man who had metastasis of gastric cancer was referred to pain clinic to control his severe epigastric pain.After the confirmation of the effect of the diagnostic celiac plexus block, c-arm-guided neurolysis of celiac plexus using alcohol was performed without any sensory or motor change.Five days after the chemical neurolysis, elevated hemidiaphragm and basal atelectasis of right lung were noted at routine chest X-ray follow-up without any respiratory symptoms such as dyspnea.There was no evidence of diaphragmatic metastasis. Two months after the neurolysis, the radiographic finding did not show any change.