Journal of clinical anesthesia
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During palatoplasty on a 9-year-old girl with no personal or familial history of malignant hyperthermia, the temperature monitor reported an increase in temperature. Additionally, the surgeon thought the patient's jaw muscle was in spasm. While preparations were made for treatment of malignant hyperthermia, the temperature probe was tested and found to be defective. ⋯ When the temperature probe was tested 6 days later, it was working properly. The cause of the problem may have been moisture in the connection between the probe and the exterior cable, which eventually evaporated. Decision algorithms can assist in such situations to distinguish between a medical problem and a mechanical problem with the monitor.
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Case Reports
Hypoplastic left heart syndrome: anesthetic care prior to transplantation or surgical palliation.
Hypoplastic left heart syndrome is the most common lethal cardiac defect in neonates. Options for treatment include cardiac transplantation and surgical palliation. ⋯ During this time, anesthetic care may be required for various surgical procedures. Associated anomalies seen in these infants and the anesthetic implications imposed by the abnormal cardiac anatomy are discussed.
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Randomized Controlled Trial Comparative Study Clinical Trial
Serum and urine inorganic fluoride levels following prolonged low-dose sevoflurane anesthesia combined with epidural block.
To determine whether serum and urine inorganic fluoride levels with prolonged (more than 7 hours) low-dose (0.8 to 2.0 vol %) sevoflurane anesthesia plus epidural anesthesia were increased as compared with isoflurane anesthesia plus epidural anesthesia. To measure the urine tubular enzymes N-acetyl-beta-glucosaminidase (NAG), alpha 1-microglobulin (alpha 1-M), and beta 2-microglobulin (beta 2-M) for renal tubular injury in both groups. ⋯ There was no increase in urinary enzymes, which are indicators of tubular injury, specific to sevoflurane. There was no postoperative renal dysfunction, as indicated by unchanged serum creatinine and blood urea nitrogen levels.