Journal of clinical anesthesia
-
Observational Study
Factors associated with blood transfusion during intracranial aneurysm surgery.
The purpose of this study was to identify risk factors associated with intraoperative blood transfusions in patients presenting for intracranial aneurysm surgery in the current era of more restrictive transfusion guidelines. ⋯ The incidence of intraoperative red blood cell transfusion in intracranial aneurysm surgery in our patient cohort was 9.5%, and the most significant factors associated with transfusion were presenting hemoglobin level less than 11.7 g/dL and age greater than 52 years. It would seem advisable that these patients undergo routine type and cross-matching of red blood cells before intracranial aneurysm surgery.
-
Observational Study
Anesthesia and Brugada syndrome: a 12-year case series.
The aim of this 12-year case series was to review the drugs used during anesthetic management of patients with diagnosis of or risk criteria for Brugada syndrome (BrS), and to document any possible association between these drugs and arrhythmogenic activity or unexplained hemodynamic instability. ⋯ Major adverse events related to the deleterious effects of drugs recommended to be avoided were not detected in our series of patients with or at risk of BrS. Although authors cannot refute the theoretical risk of major adverse advents when using known or potential BrS triggers, the true clinical risk of these drugs is unknown, and recommendations to avoid their use should be better supported.
-
To evaluate the quality of postoperative pain relief during the first 3 days after surgery and to evaluate with the incidence of persistent pain at 6 months after surgery. ⋯ Poorly controlled acute postoperative pain correlated with persistent postsurgical pain at 6 months. In view of such a high incidence in thoracotomy patients, preventative strategies assume great significance.
-
Case Reports
Aneurysmal hemorrhage in a pregnant patient with coarctation of aorta: An anesthetic challenge.
A 25years old female patient with pregnancy of 16weeks (G2 P1), diagnosed to have distal anterior cerebral artery aneurysm (DACA) with Hunt & Hess grade I, subarachnoid hemorrhage (SAH) and coexisting atretic type of aortic coarctation posted for aneurysmal clipping under general anesthesia is a challenge to anesthesiologists in perioperative period. Hypertensive surges in a pregnant patient may result in rupture of aneurysms. Mortality in the mothers with CoA has been reported to be in the range of 0 to 9%. Anesthetic management of a pregnancy with CoA and SAH has never been reported.
-
Cases of amyotrophic lateral sclerosis with pregnancy are quite rare. The aim of this case report is to present the successful use of total intravenous anesthesia without muscle relaxant for cesarean section in a parturient with amyotrophic lateral sclerosis at 35 weeks' gestation. ⋯ During the procedure, no muscle relaxant was used. This strategy helped avoid prolonged ventilation and prevent maternal respiratory complications.