Recent advances in techniques such as iontophoresis represent a promising approach to pain management. Iontophoresis involves the use of low-voltage electrical currents to improve transdermal delivery of medications, including local anesthetics. 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
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
Despite the vast progress in contemporary medicine, the burden of spinal cord injury has increased over the last decades. Thus, more and more often patients with paraplegia appear for an emergency or elective surgery below the level of the injury. Anesthetic management of those patients can be turn out to be a challenge. Continue reading
Ankylosing spondylitis (AS) is a chronic inflammatory arthritis characterized by progressive ossification of the spinal column with resultant stiffness. Patients, with AS, have a suppressed immune function due to proinflammatory cytokines and chemokines which are responsible for the inflammation of the joint. Continue reading
Prader-Willi syndrome (PWS) is a rare genetic disorder characterized by various abnormalities, such as hypotonia, high body mass index (BMI), craniofacial anomalies, and obstructive sleep apnea. Anesthetic management of these patients requires special perioperative planning and care due to multisystem involvement. Continue reading
Friedreich’s ataxia is an autosomal recessive inherited neurodegenerative ataxic condition that is often accompanied with multiple comorbidities like scoliosis, cardiac myopathies, diabetes mellitus, abnormal reflexes, dysarthria and it is a challenging task for the anesthesia providers in regards to the pharmacologic, physiologic, and pathologic effects that would occur with this disorder. We present a case report of a 10-year-old male child who was scheduled for a Galeazzi fracture surgery. Continue reading
Noonan syndrome (NS) is an autosomal dominant disorder characterized by anatomic and pathophysiologic abnormalities.Anesthetic management in these cases has many challenges regarding airway management and cardiovascular stability.We present a case report of a 11-year-old male child who was scheduled for maxillofacial surgery under general anesthesia.
Continue readingWe report a case of persistent bronchospasm after anesthesia induction. The case refers to an elective surgery of an ulcerous formation in the intergluteal cleft. Bronchospasm is not an unusual event in the immediate intubation period, especially in patients with respiratory disease, but in most cases resolves uneventfully. In this patient, despite thorough treatment in the operation room, ausculatory findings remained unchanged, with progressive worsening of arterial blood gases. After this event, the surgery was postponed and the patient was transferred to the ICU for further management. In this article we describe the steps that were taken in order to manage this adverse event and ensure patient’s safety and successful outcome.
Continue readingManagement of epileptic patients in the perioperative period is an anesthetic challenge. New drugs and surgical procedures are being used to treat epilepsy. Various anaesthetics exhibit both proconvulsant and anticonvulsant properties at different doses and under different physiologic conditions. Continue reading
