Masui. The Japanese journal of anesthesiology
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The aortic root dilatation and its dissection are the most catastrophic events in pregnancy with Marfan syndrome as has been reported. It has been shown that prophylactic beta-adrenergic blocker is effective in reducing the aortic distensibility. However, its fetal toxicity should be considered. ⋯ We could maintain maternal hemodynamics stable and good post cesarean uterus contraction. No severe adverse effects were observed in the infant. In conclusion, it is useful for maintaining the hemodynamics stable in a pregnant woman with Marfan syndrome and keep the infant safe from any adverse effects by infusing of landiolol.
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A 38-year-old man diagnosed as esophageal achalasia developed masseter muscle rigidity after intravenous suxamethonium during anesthetic induction. Anesthesia was maintained with intravenous agents and epidural blockade, while the masseter muscle rigidity continued. ⋯ These symptoms were dissolved by dantrolene administration. He was later proved to be negative with CICR test.
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We often experience migration of an epidural catheter into an undesirable space. Migration of an epidural catheter into the subarachnoid space is a potentially lethal complication. ⋯ The symptoms caused by this migration were motor paralysis in the lower extremities and sensory disturbance of the trunk. Neurological and hemodynamic changes in a patient who is undergoing continuous epidural infusion of local anesthetics should be monitored carefully.
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The visibility and quality of the tracheal intubation may be improved by the video intubating laryngoscope (VIL). However, the efficacy using VIL among novice residents has not been reported. ⋯ The use of VIL improved success rate of tracheal intubation compared with OL. Retrospective analysis of video image revealed their progress and characteristics features in their laryngoscopic procedure. VIL was efficient in the education of the novice residents.