Journal of clinical anesthesia
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A 43-year-old man with neurofibromatosis and tracheal neurofibroma of the mid-trachea and respiratory difficulty was brought to the operating room for tracheostomy. After talking to the surgeons and viewing the computerized axial tomography, tracheal intubation was done under local anesthesia. Then, general anesthesia was provided for biopsy and debulking of the tumor, followed by tracheostomy. The patient had a number of surgeries later and the trachea was decannulated.
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Case Reports
Exacerbation of preexisting neurological deficits by neuraxial anesthesia: report of 7 cases.
We undertook this case series to determine if preexisting neurological disease is exacerbated by either spinal or epidural anesthesia. In the website of the Arachnoiditis Foundation, we posted an offer to advise anesthesiologists in cases of neurological problems after either of these techniques was used. Contacts were made first by way of the Internet, confirmed by telephone, and maintained by fax, e-mail, or by special mail. ⋯ Two patients had continuous lumbar epidural anesthesia, 3 had spinals; in 2 more, attempted epidural blocks led to accidental dural puncture and were converted to subarachnoid anesthetics. All patients accepted neuraxial anesthesia without informing the anesthesiologists that they had mild neurological symptoms before surgery. Because anesthesiologists did not specifically inquire about subclinical neurological symptoms or prior neurological disease, anesthesiologists are advised to carefully inquire about prior neurological disease whether neuraxial anesthesia techniques are considered.