Anaesthesia and intensive care
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Anaesth Intensive Care · Mar 2012
Case ReportsPostpartum seizure and ischaemic stroke following dural puncture and epidural blood patch.
A 33-year-old parturient experienced seizures, then an ischaemic stroke after caesarean section, while undergoing an epidural blood patch for dural puncture. A diagnosis of normotensive late postpartum eclampsia, with either a posterior reversible encephalopathy syndrome or postpartum vasculopathy, leading to stroke, was made - based primarily on a temporal relationship to the postpartum period and consistent findings on magnetic resonance imaging and angiography scans and an electroencephalogram. The difficulties in definitively elucidating the cause of seizures and cerebral infarction in the postpartum period and the impact of anaesthetic interventions in this case are discussed.
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In order to review anaesthetic morbidity in our remote rural hospital, a retrospective audit of all anaesthetic records was undertaken for a five-year period between 2006 and 2010. Eight hundred and eighty-nine anaesthetic records were reviewed. The patients were all American Society of Anaesthesiologists physical status I to III. ⋯ It is our opinion that the case selection, prior experience of anaesthetic and theatre staff, stable nursing workforce and the use of protocols were important factors in determining the low rate of adverse events. However, we caution against over-interpretation of the data, given its retrospective nature, relatively small sample size, reliance on case records and the absence of agreed definitions for adverse events. We would also like to encourage all anaesthetic services, however remote, to audit their results as part of ongoing quality assurance.
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Anaesth Intensive Care · Mar 2012
Letter Case ReportsTransilluminated ProSeal™ laryngeal mask airway insertion.
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Anaesth Intensive Care · Mar 2012
Letter Case ReportsAmitraz poisoning -- familiar presentation, unfamiliar diagnosis.