Canadian journal of anaesthesia = Journal canadien d'anesthésie
-
Case Reports
Unilateral trigeminal and facial nerve palsies associated with epidural analgesia in labour.
To report a rare complication related to epidural analgesia for obstetrics: the association of unilateral trigeminal and facial nerve palsies in a patient with the clinical syndrome of intracranial hypotension. ⋯ Post delivery trigeminal and facial nerve palsy in a 38 yr old woman recovered spontaneously with conservative therapy.
-
To present two successful cases of labour analgesia in patients who had been treated with radiation to the lumbar spine for neuroblastomas and to discuss the considerations when planning the anaesthetic management of these patients. ⋯ Craniospinal irradiation is known to have long-term effects on exposed nervous tissue, bone, and blood vessels. While a larger experience is necessary to demonstrate safety of regional anaesthesia in parturients following previous spinal irradiation, we provide reports of two successful cases.
-
To describe the management problems presented by a case of acute massive pulmonary embolism in a labouring woman. ⋯ In cases of acute massive pulmonary embolism presenting in late pregnancy and in labour, the risks and benefits of surgical embolectomy, pharmacological thrombolysis, or attempts at mechanical clot disruption have to be weighed on an individual basis. Management at the referral centre was facilitated by having cardiothoracic and obstetric facilities on the same site.
-
Case Reports
Respiratory arrest following intrathecal injection of sufentanil and bupivacaine in a parturient.
To present a case of respiratory arrest following the use of intrathecal sufentanil and bupivacaine for combined spinal-epidural anaesthesia in a healthy labouring parturient. ⋯ Respiratory arrest is a rare but potentially life-threatening complication associated with the use of intrathecal opioids for labour analgesia. Vigilance in post-procedure patient monitoring is imperative.
-
To evaluate the cerebral oxygenation effects of hypotension induced by prostaglandin E1 (PGE1) during fentanyl-oxygen anaesthesia. ⋯ These results suggest that PGE1 is a suitable drug for induced hypotension because flow/metabolism coupling of brain and regional cerebral oxygenation were well maintained during hypotension.