Masui. The Japanese journal of anesthesiology
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We experienced a case of difficult tracheal intubation in a 15-year-old boy with von Recklinghausen disease scheduled for resection of a right neck tumor. His scoliosis made it difficult to intubate and to manage airway because he easily developed dyspnea. We tried nasotracheal intubation with the patient awake under sedation using a bronchofiberscope, but we found an unexpected tumor jeopardizing his airway patency near his vocal cord. Preoperative examination of a tumor in the airway is essential in the anesthetic management of the patients with von Recklinghausen disease.
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We investigated the effect of intravenous magnesium, a N-methyl-D-asparate (NMDA) receptor antagonist, in 8 patients suffering from neuropathic pain (post herpetic neuralgia or causalgia etc.). After the nerve block, magnesium sulphate (0.5 mol.l-1) 5 ml was administered intravenously by bolus infusion taking 5 min, followed by continuous infusion of the same dose for one hour. All patients were treated with this therapy once a week. ⋯ Some patients felt heat sensation immediately after the bolus infusion of Mg, and had a good sleep after this therapy. However, there were not any severe side effects and significant change in HR or BP. We conclude that this therapy with magnesium once a week is safe and effective for relieving neuropathic pain.