scholarly journals Anesthesia management of patient with achondroplasia for abdominal hysterectomy

Author(s):  
Asmita P. Karnalkar ◽  
Ashok Deshpande

<p class="abstract">Achondroplasia is the commonest form of dwarfism. These patients present several problems for both general and regional anesthesia. There are reports describing regional anesthesia in such patients but there are scarce reports of general anesthesia. The aim of this report is to discuss anesthetic considerations in such patients and to emphasize the difficulties encountered. A 34 year old patient with achondroplasia underwent abdominal hysterectomy under general anesthesia supplemented with regional analgesia. Since preoperative assessment suggested difficult airway, regional anesthesia was planned which was not successful due to spinal abnormality. Subsequently general anesthesia was established with Laryngeal Mask Airway (LMA) with controlled ventilation without any complication.</p>

2020 ◽  
Vol 3 (1) ◽  
pp. 35-46
Author(s):  
Isngadi Isngadi ◽  
Rafidya Indah Septica ◽  
Susilo Chandra

Coronavirus Disease 2019 (COVID-19) merupakan masalah utama kesehatan dunia. Kasus COVID-19 terus meningkat secara ekponensial di berbagai belahan dunia. Wanita hamil juga mengalami peningkatan kejadian infeksi COVID-19. Manifestasi klinis COVID-19 bervariasi, dengan sebagian besar pasien memiliki gejala saluran pernapasan. Pasien terinfeksi covid-19 yang asimpomatis atau pasien yang terinfeksi sebelum munculnya manifestasi klinis mampu menularkan penyakit. Sehingga perlu dilakukan deteksi dini kepada semua maternal yang akan dilakukan tindakan operasi, terutama di daerah dengan kejadian inveksi COVID-19 yang tinggi. Tatalaksana anestesi pada operasi obstetri dengan COVID-19 harus memperhatikan beberapa hal dengan tujuan pengendalian infeksi untuk mencegah penularan COVID-19, kepada petugas kesehatan, anak yang baru dilahirkan serta orang lain lingkungan sekitar. Tenaga kesehatan yang terpapar COVID-19 berisiko terinfeksi apabila tidak menggunakan alat pelindung diri (APD) sesuai standar, sehingga penggunaan APD sesuai standart secara benar sangat penting,untuk mencegah tertularnya COVID-19 pada petugas. Tehnik anestesi yang menjadi pilihan utama untuk operasi obstetri dengan COVID-19, adalah dengan tehnik anestesi regional (epidural dan atau spinal), karena dengan tehnik tersebut mengindari timbulnya aerosol. Tehnik anestesi umum hanya digunakan apabila : gagal dengan tehnik anestesi regional, ada kontraindikasi dengan tehnik anestesi regional atau maternal mengalami desaturasi(saturasi <93%). Apabila menggunakan tehnik anestesi umum maka dalam pelaksanaanya harus dengan prinsip pencegahan terjadinya penyebaran infeksi. Anesthesia Management for obstetric surgery with COVID-19 infected Abstract The coronavirus disease 19 (COVID-19) is a global health problem. The number of cases of COVID-19 continue to rise exponentially in many parts of the world. Pregnant women have also increasing COVID-19 infection. The clinical manifestations of COVID-19 are varied, with most patients having respiratory symptom. The asymptomatic covid-19 infected patients or infected patients before clinical manifestations can transmit the disease. So early detection should be done for all mothers who will perform surgery, especially in areas with a high incidence of COVID-19 infection. Anesthesia management in obstetric surgery with COVID-19 must pay attention to several things with the aim of controlling infection to prevent transmission of COVID-19, for health workers, newborn babies and other people in the surrounding environment. Health workers who are exposed to COVID-19 are at risk of infection if they do not use personal protective equipment (PPE) according to the standard, so the use of PPE according to proper standards is very important, to prevent the transmission of COVID-19 to the officerExpected health workers, COVID-19, the risk of coverage, do not use personal protective equipment (PPE) according to standards, so the use of PPE according to the standard, is very important. The first choice of Anesthesia techniques for obstetric surgery in maternal COVID-19 infection are regional anesthesia techniques (epidural and or spinal), because with these techniques avoid the emergence of aerosols. General anesthesia techniques are only used if: fail with regional anesthesia techniques, there are contraindications to regional anesthesia or maternal desaturation (saturation <93). If using general anesthesia techniques, the prevention of infection is a major concern.


Author(s):  
RTh Supraptomo ◽  
Muhammad Ridho Aditya

<p>Postpartum hemorrhage remains the leading cause of maternal mortality and morbidity worldwide, happens more in developing countries with an estimated mortality rate of 140,000 per year or one maternal death every four minutes</p><p>To understand anesthesia management at postpartum et causa atonic uteri bleeding outside Dr. Moewardi hospital</p><p>In this case reported 25 years old patient was admitted to the emergency room at Dr. Moewardi Hospital Surakarta, on the 28/11/2019 at 15.30 WIB, sent by Waras Hospital Wiris Boyolali. On examination found the patient in a state of weakness, apathy awareness and blood pressure 90/60, heart rate 130, respiration rate 22, conjunctival anemic and palpable contractions of soft uterine contractions. The patient's condition is in accordance with the manifestation of grade III blood loss. The anesthesiology diagnosis is a 25-year-old woman with Postpartum hemorrhage et causa Atonic Bleeding of Uterine on P3A0H3 post SCTP Outside Dr. Moewardi Hospital + Hypovolemic Shock pro Emergency Laparotomy until Total Abdominal Hysterectomy with Physical Status ASA IVE Plan with RSI general anesthesia Control.</p><p>Intraoperative Management of anesthesia uses RSI's general anesthesia technique to control hemodynamics and uses anesthesia drugs that do not worsen the patient's condition. At the time of surgery, we did the transfusion because there was a significant amount of bleeding during the procedure and was categorized as Class IV bleeding.</p><p>Anesthesia care of patients with postpartum hemorrhage extends from the antenatal period to the postpartum period. Optimal postpartum hemorrhage management occurs when nurses, obstetricians and anesthesiologists recognize early the potential for excessive bleeding and trigger a 'major obstetric hemorrhage protocol' that describes specific tasks for each team player and the algorithm that must be followed according to etiology, circumstances and time during labor.</p>


1990 ◽  
Vol 64 (04) ◽  
pp. 497-500 ◽  
Author(s):  
Martin H Prins ◽  
Jack Hirsh

SummaryWe evaluated the evidence in support of the suggestion that the risk of deep vein thrombosis after hip surgery is lower with regional than with general anesthesia. A literature search was performed to retrieve all articles which reported on the incidence of postoperative thrombosis in both fractured and elective hip surgery. Articles were included if the method of anesthesia used was reported and if they used mandatory venography. Based upon the quality of study design the level of evidence provided by a study was graded.In patients who did not receive prophylaxis there were high level studies in elective and fractured hip surgery. All studies showed a statistically significantly lower incidence of postoperative deep vein thrombosis with regional anesthesia (relative risk reductions of 46-55%). There were no direct comparative studies in patients who received prophylaxis. However, between study comparisons did not show even a trend towards to lower incidence of postoperative thrombosis with regional anesthesia.


2020 ◽  
Vol 24 (1) ◽  
pp. 105-107
Author(s):  
Sedighe Shahhosseini ◽  
Reza Aminnejad ◽  
Amir Shafa ◽  
Mehrdad Memarzade

Carvajal syndrome is a rare genetic disorder. Patients reporting for surgery pose some difficulties in anesthesia management. In this case report we present the case of a 12-year-old boy, who was a known case of Carvajal syndrome, referred for surgical resection of perianal condyloma. Close monitoring of hemodynamic status is the mainstay of anesthetic considerations in such patients. As in any other challenging scenario, it should be kept in mind that ‘there is no safest anesthetic agent, nor the safest anesthetic technique; there is only the safest anesthesiologist’. Citation: Shahhosseini S, Aminnejad R, Shafa A, Memarzadeh M. Anesthesia in Carvajal syndrome; the first case report. Anaesth pain intensive care 2020;24(1):___ DOI: https://doi.org/10.35975/apic.v24i1.


2021 ◽  
pp. 102595
Author(s):  
kourosh Farazmehr ◽  
Mohamad Aryafar ◽  
Farshid Gholami ◽  
Giti Dehghanmanshadi ◽  
Seyed Sepideh Hosseini

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