Journal of clinical anesthesia
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A case is presented of a 34-month-old child who developed hyperthermia with a temperature of 40 degrees C while undergoing a suboccipital craniotomy for resection of a medulloblastoma. The presentation is followed by a discussion of the differential diagnosis of hyperthermia during anesthesia. Malignant hyperthermia, septicemia, thyroid storm, neuroleptic malignant syndrome, transfusion reaction, and exogenous causes of fever are discussed. The case serves as an illustration of the association between neurosurgical manipulation, intraventricular hemorrhage, and fever that may result from hypothalamic irritation.
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Comment Letter
Television as an aid to induction of anesthesia in children.
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To examine and compare the mechanism of injury, diagnostic findings, initial methods of airway management, and outcome of patients who had upper airway injuries. ⋯ In any patient with possible upper airway injury, plain radiographs of the chest and neck should be obtained to aid in the diagnosis. Elective intubation should be attempted only with a surgical team present and prepared for emergency tracheotomy. Fiber-optic bronchoscopy could be a valuable aid for both intubation and evaluation in such cases.