Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Case Reports
Pott's disease with unstable cervical spine, retropharyngeal cold abscess and progressive airway obstruction.
Retropharyngeal abscess formation has the potential for acute respiratory compromise from obstruction or secondarily from rupture. The initial attempt to secure the airway is of paramount importance. We describe a patient with an unstable cervical spine secondary to Pott's disease who developed progressively obstructing retropharyngeal cold abscess. ⋯ This report suggests that selected cases of tense obstructing retropharyngeal abscesses can be effectively managed with fibreoptic endoscopy for assessment and subsequent intubation before requiring surgical airway control as a first line strategy.
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Transport after surgery under spinal anesthesia is associated with cardiovascular changes. The extensively vasodilated patient may be unable to compensate for postural blood flow redistribution. This observational study investigated pre- and post-surgery sensory levels as well as hemodynamic changes during the postoperative transfer period. ⋯ These results draw attention to the persistence of extensive sympathetic block at the end of Cesarean section. Transport to the Recovery Room was associated with the development of considerable hypotension in 10% of patients and this was unaffected by position. We recommend recording the level of sensory block at the end of surgery and increased monitoring during transport to the Recovery Room.