RESUMO
Thyroid diseases have an anesthetic implication that includes difficult airway management, uncontrolled hyperthyroidism, hypothyroidism and postthyroidectomy complications. Securing airway: Intubation and extubation both require skillful management and timely decision to reduce morbidity and mortality in the case of large goiter with retrosternal extension that leads to tracheal compression and deviation. We present the anesthetic management in a patient with a large goiter with retrosternal extension leading to tracheal compression and deviation. We managed the case with an awake fiberoptic intubation and guided extubation.
RESUMO
Brugada syndrome is a myocardial transmembrane conduction of sodium abnormality and a common cause of sudden cardiac death. It is characterized by a distinctive electrocardiograph pattern with right bundle branch block and ST segment elevation in precordial leads V1-V3. Many factors during general anesthetic management could precipitate malignant dysrhythmia. We report the anesthetic management of a patient with Brugada syndrome for emergency appendectomy uneventfully.
RESUMO
Ankylosing spondylitis (AS) patients are most challenging. These patient present the most serious array of intubation and difficult airway imaginable, secondary to decrease or no cervical spine mobility, fixed flexion deformity of thoracolumbar spine and possible temporomandibular joint disease. Sound clinical judgment is critical for timing and selecting the method for airway intervention. The retrograde intubation technique is an important option when fiberoptic bronchoscope is not available, and other method is not applicable for gaining airway access for surgery in prone position. We report a case of AS with fixed flexion deformity of thoracic and thoracolumbar spine, fusion of posterior elements of cervical spine posted for lumbar spinal osteotomy with anticipated difficult intubation. An awake retrograde oral intubation with light sedation and local block is performed.
