scholarly journals Persistent ventricular dysrhythmia follow in general anesthesia for tonsillectomy

2021 ◽  
pp. 131-134
Keyword(s):  
Ventricular Tachycardia ◽  
General Anesthesia ◽  
Medical Therapy ◽  
Surgical Procedures ◽  
Cardiovascular Complications ◽  
Premature Ventricular Complex ◽  
Ventricular Dysrhythmia ◽  
Usual Treatment ◽  
Benign Course

Arrhythmia is one of the most common cardiovascular complications during anesthesia. Its occurrence has been reported in 70% of patients undergoing general anesthesia for various surgical procedures. Premature ventricular complex usually follows a benign course and shows a good response to medical therapy. In this study, a case was reported that did not respond to the usual treatment of ventricular tachycardia and frequent premature ventricular complex.

General anesthesia and hepatic circulation

1987 ◽  
Vol 65 (8) ◽  
pp. 1762-1779 ◽  
Author(s):  
Simon Gelman
Keyword(s):  
Blood Flow ◽  
General Anesthesia ◽  
Surgical Procedures ◽  
Hepatic Blood Flow ◽  
Portal Blood Flow ◽  
Arterial Blood Flow ◽  
Hepatic Circulation ◽  
Arterial Blood ◽  
Total Hepatic Blood Flow ◽  
Circulatory Disturbances

This article describes hepatic circulatory disturbances associated with anesthesia and surgical intervention. The material is presented in three parts: part 1 describes the effects of general anesthetics on the hepatic circulation; part 2 deals with different factors related to surgical procedures and anesthesia; and part 3 analyzes the role of hepatic circulatory disturbances and hepatic oxygen deprivation in anesthesia-induced hepatotoxicity. The analysis of available data suggests that general anesthesia affects the splanchnic and hepatic circulation in various directions and to different degrees. The majority of anesthetics decreases portal blood flow in association with a decrease in cardiac output. However, hepatic arterial blood flow can be preserved, decreased, or increased. The increase in hepatic arterial blood flow, when it occurs, is usually not enough to compensate for a decrease in portal blood flow and therefore total hepatic blood flow is usually decreased during anesthesia. This decrease in total hepatic blood flow-has certain pharmacokinetic implications, namely a decrease in clearance of endogenous and exogenous substances with a high hepatic extraction ratio. On the other hand, a reduction in the hepatic oxygen supply might play a certain role in liver dysfunction occurring perioperatively. Surgical procedures–preparations combined with anesthesia have a very complex effect on the splanchnic and hepatic circulation. Within this complex, the surgical procedure–preparation plays the main role in developing circulatory disturbances, while anesthesia plays only a modifying role. Hepatic oxygen deprivation may play an important role in anesthesia-induced hepatotoxicity in different experimental models.

scholarly journals Bidirectional Ventricular Tachycardia in a Young Female: A Case of Andersen-Tawil Syndrome

2021 ◽  
Author(s):  
Jacob L Ransom ◽  
Ka C Wong ◽  
Jacqueline Kircher ◽  
Courtney Usry ◽  
Christopher Larson
Keyword(s):  
Differential Diagnosis ◽  
Ventricular Tachycardia ◽  
Beta Blocker ◽  
Genetic Disorder ◽  
Symptom Burden ◽  
Young Female ◽  
Ventricular Ectopy ◽  
Digitalis Toxicity ◽  
Ventricular Dysrhythmia ◽  
Mandibular Hypoplasia

ABSTRACT Bidirectional ventricular tachycardia (VT) is a rare ventricular dysrhythmia with a limited differential diagnosis that includes digitalis toxicity, catecholaminergic polymorphic VT, aconite poisoning, and genetic channelopathy syndromes, specifically, Andersen–Tawil syndrome (ATS). We present a case of a young female with palpitations found to have bidirectional VT on cardiac event monitor and strong family history of cardiac dysrhythmias. Her physical examination findings included minor dysmorphic features of mandibular hypoplasia, hypertelorism, and clinodactyly. The patient was clinically diagnosed with ATS and started on a beta-blocker for control of ectopy. A second Holter review demonstrated markedly decreased burden of ventricular ectopy compared to the initial monitoring. She was referred for genetic testing, which revealed a KCNJ2 mutation. Bidirectional VT is an uncommon ventricular dysrhythmia that has a limited differential diagnosis, one of which is ATS—a rare genetic disorder that results from mutations in the KCNJ2 gene. The condition is frequently associated with developmental, skeletal, and cardiac abnormalities. Although there are no strong recommendations that exist for treatment of ventricular dysrhythmias associated with this genetic disorder, we demonstrate a case of clinical improvement in a patient with ATS by using the beta-blocker metoprolol succinate. Furthermore, we propose that ATS patients may not need exercise restrictions as overall ventricular ectopy burden decreased with exercise and there was no prolongation of the QT interval. This patient will continue to follow up in our clinic to reassess symptom burden and for continued monitoring for the development of any new features.

Down Syndrome

2013 ◽  
Author(s):  
Erica P Lin ◽  
James P Spaeth
Keyword(s):  
Down Syndrome ◽  
General Anesthesia ◽  
Surgical Procedures ◽  
Perioperative Care ◽  
Congenital Anomalies ◽  
Trisomy 21 ◽  
Live Births

Trisomy 21, or Down syndrome, is the most common human chromosomal syndrome, with an overall incidence of 1:700 live births. Because of its association with other congenital anomalies, children with this syndrome often present for surgical procedures that require general anesthesia. Anesthesiologists caring for these patients must be familiar with the implications of Down syndrome on perioperative care.

scholarly journals Surgery and anesthesia in sickle cell disease. Cooperative Study of Sickle Cell Diseases

Blood ◽  
1995 ◽  
Vol 86 (10) ◽  
pp. 3676-3684 ◽  
Author(s):  
M Koshy ◽  
SJ Weiner ◽  
ST Miller ◽  
LA Sleeper ◽  
E Vichinsky ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Sickle Cell Disease ◽  
General Anesthesia ◽  
Sickle Cell ◽  
Surgical Procedures ◽  
Surgical Procedure ◽  
Complication Rates ◽  
Cooperative Study ◽  
Cell Disease

From 1978 to 1988, The Cooperative Study of Sickle Cell Disease observed 3,765 patients with a mean follow-up of 5.3 +/- 2.0 years. One thousand seventy-nine surgical procedures were conducted on 717 patients (77% sickle cell anemia [SS], 14% sickle hemoglobin C disease [SC], 5.7% S beta zero thalassemia, 3% S beta zero + thalassemia). Sixty-nine percent had a single procedure, 21% had two procedures, and the remaining 11% had more than two procedures during the study follow- up. The most frequent procedure was abdominal surgery for cholecystectomy or splenectomy (24% of all surgical procedures, N = 258). Of these, 93% received blood transfusion, and there was no association between preoperative hemoglobin A level and complication rates (except reduction in pain crisis). Overall mortality within 30 days of a surgical procedure was 1.1% (12 deaths after 1,079 surgical procedures). Three deaths were considered to be related to the surgical procedure and/or anesthesia (0.3%). No deaths were reported in patients younger than 14 years of age. Sickle cell diseases (SCD)-related complications after surgery were more frequent in SS patients who received regional compared with general anesthesia (adjusted for risk level of the surgical procedure, patient age, and preoperative transfusion status, P = .058). Non-SCD-related postoperative complications were higher in both SS and SC patients who received regional compared with those who received general anesthesia (P =.095). Perioperative transfusion was associated with a lower rate of SCD- related postoperative complications for SS patients undergoing low-risk procedures (P = .006, adjusted for age and type of anesthesia), with crude rated of 12.9% without transfusion compared with 4.8% with transfusion. In SC patients, preoperative transfusion was beneficial for all surgical risk levels (P = .009). Thus, surgical procedures can be performed safely in patients with SCD.

Minor elective surgical procedures using general anesthesia in children with sickle cell anemia without pre-operative blood transfusion

2005 ◽  
Vol 45 (1) ◽  
pp. 43-47 ◽  
Author(s):  
Teresa Fu ◽  
Nicole J. Corrigan ◽  
Charles T. Quinn ◽  
Zora R. Rogers ◽  
George R. Buchanan
Keyword(s):  
Blood Transfusion ◽  
General Anesthesia ◽  
Sickle Cell ◽  
Surgical Procedures ◽  
Sickle Cell Anemia ◽  
Elective Surgical Procedures
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