Mitochondrial diseases represent a wide range of disorders caused by impairment of mitochondrial metabolism and energy production. We report a case of an uneventful perioperative management of a pregnant patient with early childhood-onset mitochondrial encephalopathy, attributed to a novel AIFM1 (Apoptosis-Inducing Factor, Mitochondrion-associated 1) mutation. After a multidisciplinary team consultation, it was decided to be posted for elective caesarean delivery at 36+2 weeks of gestation, under titrated combined spinal-epidural anaesthesia and multimodal analgesia. Unique anaesthetic challenges were to ensure normoglycaemia, normothermia and adequate hydration while avoiding perioperative stress and acidosis. Continue reading

Intrathecal drug administration extends beyond the purposes of anaesthesia, to therapeutic applications. Here, we describe the case of a patient with severe Systemic Lupus Erythematosus having affected multiple organs and had a meningococcal infection. She was treated with intrathecal antibiotic therapy resulting in a successful outcome.

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The scope of this study was to investigate if changing the direction of the Whitacre 26G needle aperture in regional anaesthesia during planned caesarean section produces a difference in the dose-response curves of the level of subdural blockade achieved by ropivacaine 0.75% and a standard dose of opioid. One hundred and twenty healthy parturients were blindly randomised in two groups, with 5 subgroups of 12 women each.

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We have assessed intubating conditions and haemodynamic changes in three groups of 30 ASA I or II patients after induction of anaesthesia with propofol 2 mg*kg-1, remifentanil 0.5 μg*Kgr-1 and rocuronium 0,6 mg*kg-1 (group R), propofol 2 mg*kg-1 and remifentanil 1.5 μg*Kgr-1 (group F) and propofol 2 mg*kg-1, remifentanil 1.5 μg*Kgr-1 and midazolam 0.015 mg*kg-1 (group M).

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