Articles: general-anesthesia.
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A 38-yr-old woman who was 35 weeks pregnant presented with a subarachnoid haemorrhage, secondary to a ruptured anterior communicating artery aneurysm. Following initial recovery, she subsequently underwent simultaneous elective Caesarean section and clipping of the aneurysm. The anaesthetic management of the case is described and discussed.
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Rev Esp Anestesiol Reanim · May 1990
Case Reports[Mediastinal tumors in children: apropos of 2 cases].
General anesthesia in patients with mediastinal tumors has specific problems that need careful evaluation before surgery. Sometimes, mediastinal masses may result in life threatening complications, such as upper airway obstruction, superior vena cava syndrome, cardiac or pulmonary artery compression and acute pulmonary edema. After a review of the literature related to death during general anesthesia in children with mediastinal tumors, we emphasize the importance of the agreement between oncologists, surgeons and anesthesiologists for a sound diagnosis of these patients. ⋯ The second patient was a 2-year-old female with anterior mediastinal and paratracheal masses and severe respiratory compromise, who was operated under general inhalation anesthesia and spontaneous breathing for biopsy of supraclavicular lymphadenopathy, after a meticulous preanesthetic evaluation. In these patients, the anesthetic procedure is a challenge to the anesthesiologist. Inhalation induction in a half seated position is recommended, maintaining the patient with spontaneous ventilation with halogenated agents and avoiding muscle relaxants.
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Neuroleptic malignant syndrome is an uncommon, idiosyncratic, and sometimes life-threatening disorder associated with the use of neuroleptic drugs. The pathogenesis of neuroleptic malignant syndrome is uncertain, but it may be similar to that of malignant hyperthermia (MH). ⋯ We anesthetized a 17-year-old man with this syndrome multiple times for electroconvulsive therapy (ECT) using a variety of anesthetic techniques. In this patient, dantrolene pretreatment and the use of nondepolarizing muscle relaxants did not relieve symptoms of the syndrome, including fever and creatine phosphokinase (CPK) increases.