Peripartum cardiomyopathy is referred to as unanticipated heart failure with no determinable cause between the last trimester of pregnancy and six months post-delivery. The perioperative management of pregnant women with heart failure is challenging. Continue reading
Pulmonary embolism is linked with a remarkable rate of mortality, particularly when it is associated with hemodynamic instability, right atrial thrombus and related right ventricular dysfunction. Intraoperative use of transesophageal echocardiography can lead to the diagnosis of massive thrombi, entrapped in patent foramen ovale. Continue reading
X-linked adrenoleukodystrophy is rarely encountered in the operating room. The clinical presentation is highly variable and creates unique challenges for the anesthesiologist. Case: We hereby present a successful anesthetic management of patient with X-linked adrenoleukodystrophy and related Addison’s disease and Brugada syndrome for an orthopedic surgery and review the available literature about the topic. Continue reading
Acquired hemophilia A (AHA) is a rare bleeding disorder caused by autoantibodies to coagulation factor VIII (FVIII) leading to potentially severe bleeding diathesis that carries a high rate of morbidity and mortality. It should be suspected in patients with unexplained prolonged aPTT, normal PT and acute abnormal bleedings without personal or familiar history of congenital bleeding disorders. Continue reading
Myasthenia Gravis (MG) is an autoimmune disorder affecting the neuromuscular junction function and causing muscle weakness that gets worse during the day and after physical activity. The most common medication prescribed for MG treatment is pyridostigmine. Continue reading
Depth of anesthesia is a dynamic balance between effect-site concentration of hypnotic and analgesic drugs, and intensity of surgical stimulation. The bispectral monitor is the best described monitor of the depth of hypnosis component of anesthesia. Continue reading
Hypothyroidism is relatively common comorbidity in elderly patients, due to structural and hormonal changes in the aging thyroid. Diagnosis of hypothyroidism, in this population, is considered challenging, since many symptoms are nonspecific and may be attributed to other common medical conditions. Continue reading
Aortic aneurysms occur mainly due to atherosclerotic disease, and their conventional surgical repair is reserved for patients with anatomy unfavorable to endovascular repair. In this context, one of the challenges for the anesthesiologist is perioperative anesthetic-analgesic control. Continue reading
Nitrous oxide, also known as “laughing gas”, has been used for more than 150 years in medical practice, autonomously or in combination with other inhalation anesthetics, for pain relief, in various surgical interventions. In modern medicine, its use has declined, due to its side effects and also because of the advent of newer, shorter-acting agents and newer inhaled anesthetics. Continue reading
Orthotopic liver transplantation (OLT) has become a relatively safe procedure over the last decades, with reported 5-year survival rate of over 80%. Increasing numbers of patients will be transplated at a younger age and they will seek obstetric anaesthesia services, as their fertility is restored after succesful transplantation. In 1978, the first succesful pregnancy was reported. Continue reading
