Combined Spinal and TAP Blocks for Laparoscopic Cholecystectomy for a Patient with Crigler-Najjar Type 2: A Case Report.

Crigler-Najjar syndrome is a rare disease which is associated with congenital deficiency of uridine-diphosphate-gulukronyltransferase (UDP-glucuronosyltransferase, UGT) enzyme. In the surgery of these patients, it is necessary to use an anesthetic method that causes less damage to the liver. Spinal anesthesia is a good alternative to general anesthesia in these patients. Transversus abdominis plane block is a new method for ultrasound guided abdominal wall block. It is less invasive and relatively safer than conventional regional anesthetic techniques. Our case is a 30-year-old male patient with the diagnosis of Crigler-Najjar type 2 (Arias syndrome). There was a history of gallbladder edema, multiple stones and thickened gallbladder wall. We applied Transversus abdominis plane block in addition to spinal anesthesia as primary anesthesia for our patient who underwent laparoscopic surgery. We didn't experience any postoperative complications in our patient. In conclusion, laparoscopic surgery performed under combined spinal anesthesia and transvesus abdominis plane block in a Criggler Najjar type 2 (Arias syndrome) patient may be a simple and effective technique.

Postoperative cognitive dysfunction developed in donor nephrectomy- Case report.

With the effects of anesthetic drugs on all organs and systems, it is known it affects the central nervous system functions at different grades and durations beyond acute unconsciousness. This causes cognitive functions of upper brain activities to be affected at varying degrees after anesthesia. After exposure to anesthetic agents, psychomotor and cognitive functions are deteriorated for 10--12 h, with sensitive tests it was showed that this deterioration lasted for 1--2 days. It has also been reported that this process can last till 3 months. Rapid recovery and mental readiness of patients, applied general anesthesia, are important objects for anesthesiologists. Postoperative cognitive functions are assessed in order to investigate mental changes caused by anesthesia and surgery or determine the level of recovery by determining the effects of anesthetics. In this case report, postoperative cognitive dysfunction (POCD) after donor nephrectomy was aimed.

Pyrethroid intoxication: A rare case report and literature review.

Synthetic pyrethroid cypermethrin is commonly used in agriculture, veterinary, and household insects management. It has been found to be a newer insectiside poisoning reported in Turkey. Acute severe poisoning of cypermethrin is a rare event. Here we report a case of a 25-year-old woman presented with features of cypermethrin poisoning in intensive care unit. Management of acute rare poisoning is discussed in this case with literature review.