Traumatic Diaphragmatic Hernia: Anaesthetic Consideration

Any type of trauma may lead to diaphragmatic hernia with blunt forces accounting for majority. Diaphragmatic hernias require a high level of suspicion to detect. Brain, pelvis, long bones, liver, spleen, and aorta are some other organs that can be severely damaged and need different anesthetic management. Gastric decompression, pre-oxygenation, rapid sequence induction and mechanical ventilation with low tidal volume after intubation were used in anesthetic management for thoracotomy and repair. Traumatic diaphragmatic hernia can be life threatening as it may compromise cardiorespiratory function.

Ileostomy closure in a patient with severe pulmonary hypertension and COPD - Anaesthetic consideration

<p class="abstract"><span lang="EN-US">High morbidity and mortality occur in patients with pulmonary hypertension (PH) undergoing non-cardiac surgery under any type of </span>anaesthesia<span lang="EN-US"> technique. Right heart failure occurs due to increased pressure in pulmonary artery secondary to pain, stress and ventilation. It is important to maintain preload, ventricular contractility, pulmonary vascular resistance and right ventricular afterload. It is also necessary to avoid hypoxia, hypercarbia, hypothermia and pain. A 45 year old male patient, known case of chronic obstructive pulmonary disease (COPD) with severe PH was posted for ileostomy closure. General </span>anaesthesia<span lang="EN-US"> (GA) with epidural catheter for analgesia was given.</span></p>