RESUMO
Hemodynamic instability as a result of altered baroreflex mechanism is common in surgeries involving manipulation around the carotid sheath. We report a case in which hypertensive crisis was associated with laryngectomy during general anesthesia. Perioperative use of vasoactive agents such as alpha(2) agonists may help in maintaining hemodynamic stability in such procedures.
Assuntos
Barorreflexo/fisiologia , Hipertensão/fisiopatologia , Laringectomia , Complicações Pós-Operatórias/fisiopatologia , Anestesia Geral , Endarterectomia das Carótidas , Humanos , Hipertensão/etiologia , Intubação Intratraqueal , Neoplasias Laríngeas/cirurgia , Masculino , Pessoa de Meia-Idade , Esvaziamento Cervical , Complicações Pós-Operatórias/etiologiaRESUMO
A prospective, randomized double-blind trial was performed to compare the effects of 4% endotracheal tube cuff lignocaine and 1.5 mg/kg intravenous (IV) lignocaine on coughing and hemodynamics during extubation in patients undergoing elective craniotomies in supine position. Forty-one patients received 4% lignocaine into the endotracheal tube cuff after intubation (ETT group) and 41 patients received IV lignocaine at 1.5 mg/kg before extubation (IV group). Coughing was assessed by a scale of 3 at the time of extubation. Hemodynamic parameters recorded at 1-minute interval after extubation for 5 minutes were compared with the baseline values recorded before skin closure. Results showed that there was no significant difference between the groups in terms of coughing or the hemodynamic response to tracheal extubation. In conclusion, 4% endotracheal tube cuff lignocaine was not superior to 1.5 mg/kg IV lignocaine in attenuating coughing and hemodynamic changes during extubation.
Assuntos
Anestésicos Locais/administração & dosagem , Anestésicos Locais/uso terapêutico , Tosse/prevenção & controle , Hemodinâmica/efeitos dos fármacos , Intubação Intratraqueal , Lidocaína/administração & dosagem , Lidocaína/uso terapêutico , Administração Tópica , Adulto , Método Duplo-Cego , Feminino , Humanos , Injeções Intravenosas , Masculino , Pessoa de Meia-Idade , Monitorização Intraoperatória , Respiração ArtificialRESUMO
Fanconi anemia (FA) is the most frequently reported of the rare inherited bone marrow failure syndromes. It is an autosomal recessive chromosomal instability disorder, which is characterized by congenital abnormalities, defective hemopoiesis and a high risk of developing acute myeloid leukemia and certain solid tumors (1). We report the anesthetic management for a Hickman catheter insertion in a 4.5-year-old girl with this condition. Possible anesthetic implications in the presence of FA are discussed.
