Masui. The Japanese journal of anesthesiology
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Case Reports
[A case of stagnation of a large amount of irrigation fluid in abdominal cavity during hysteroscopic myomectomy].
A 30-year-old woman was scheduled to undergo hysteroscopic myomectomy for uterine myoma. Spinal anesthesia was performed with 3 ml of 0.5% bupivacaine and she was sedated with intravenous propofol during the surgery. After the surgical procedure, propofol infusion was stopped. ⋯ During the laparotomy, it was revealed that 4800 ml of irrigation fluid had been accumulated in the abdominal cavity. Although hysteroscopic surgery is generally considered non-invasive, two major complications (fluid overload and uterine perforation) occurred in this case. This case suggests that anesthetists must remain alert for the signs of these complications during hysteroscopic surgery.
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Perioperative management including anesthesia may alter long-term outcome of surgical patients. We have reviewed abstracts for meeting and articles published recently concerning effects of anesthetic depth, volatile anesthetic preconditioning, beta-blockers, alpha-agonists, statins, and glucose control on long-term outcome. Although research in this area has just been started, we, anesthesiologists should recognize its importance.
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Case Reports
[Anesthetic management in a patient with Goldenhar's syndrome using a perilaryngeal airway and a videolaryngoscope].
A 5-year-old girl with Goldenhar's syndrome was scheduled for reconstruction of her left thumb. Because her preanesthetic X-p had revealed airway abnormality, difficult intubation was anticipated. After induction of anesthesia with thiamylal, the lungs were ventilated easily via a facemask. ⋯ In consideration of potential regurgitation of gastric content, endotracheal intubation was scheduled. Her vocal cord was confirmed with a videolaryngoscope, and she was intubated successfully. In conclusion, a PLA and a videolaryngoscope are useful for airway management of patients with Goldenhar's syndrome for whom difficulty in intubation is anticipated.