Acta anaesthesiologica Belgica
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Acta Anaesthesiol Belg · Jan 2015
ReviewAnesthesia and neurotoxicity in the developing brain: A non-systematic review.
In recent years, increasing experimental evidence has suggested an association between exposure to anesthesia in early life and subsequent poor neurodevelopmental outcome. Retrospective and follow-up studies have also suggested anesthesia-related neurotoxicity in the developing human brain. The present non-systematic review summarizes the available evidence, depicts the current knowledge on the potentially harmful effects of anesthesia and will discuss whether this knowledge urges us to implement changes in clinical practice.
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Acta Anaesthesiol Belg · Jan 2015
Case ReportsPostsurgical compartment syndrome of the forearm diagnosed in a child receiving a continuous infra-clavicular peripheral nerve block.
Opinions diverge as to whether or not regional anaesthesia delays the diagnosis of evolving acute compartment syndrome. Withholding regional anaesthesia from patients with painful orthopaedic injuries may be ethically unacceptable, however. In this report, we describe a case of acute compartment syndrome in a 4-year old child who underwent resection of a forearm osteochondroma. ⋯ Pain disappeared while motor function and sensation recovered. The child was discharged without any complications. Despite an effective peripheral nerve block and the young age of the patient, the diagnosis of acute compartment syndrome could be made thanks to a well-defined post-operative analgesia protocol, a high level of suspicion and careful clinical assessment when break-through pain occurred.
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Acta Anaesthesiol Belg · Jan 2015
Case ReportsIntermediate cervical plexus block for cervical esophagus diverticulectomy.
We report the case of a 97 year old woman suffering from a voluminous diverticle of the cervical esophagus with important comorbidities and a very poor quality of life. A diverticulectomy under general anesthesia implied a high level of risk. Regional anesthesia was chosen, i.e. an intermediate cervical plexus block, with mild sedation allowing to maintain contact with the patient. The procedure was carried out without complications and the patient's and surgical staff satisfaction were optimal.
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Acta Anaesthesiol Belg · Jan 2015
Case ReportsPhrenic nerve palsy following interscalene brachial plexus block; a long lasting serious complication.
Interscalene brachial plexus block (ISBPB) offers good analgesia for painful surgical procedures on the shoulder. We here describe two cases of long-term phrenic palsy following ISBPB that occurred in our practice in a relative short time period and both clearly illustrate the devastating impact of this complication for the patient. ⋯ When ISPBP is considered, the fact that the incidence of prolonged phrenic nerve palsy may be higher than previously expected should be taken into account carefully. A reevaluation on the indication and patient selection of ISBPB may even be warranted.