Acta anaesthesiologica Belgica
-
Acta Anaesthesiol Belg · Jan 2008
Case ReportsSuccessful but prolonged resuscitation after local anesthetic-induced cardiac arrest: is clonidine effective?
Local anesthetics when injected intravascularly result in serious cardiac complications including therapy-resistant cardiac arrest. We report a case of cardiac arrest after lumbar plexus block using a combination of 0.5% bupivacaine and 2% lidocaine with epinephrine (1:200.000). Resuscitation was performed by a combination of chest compression, repeated external countershocks and i.v.epinephrine. ⋯ The patient was discharged four days later without any sequelae. Blood sampling at 10 minutes showed a concentration of 2.02 mg/l lidocaine and 0.87 mg/l bupivacaine. Prolonged resuscitation is necessary in local anesthetic-induced cardiac arrest.
-
Acta Anaesthesiol Belg · Jan 2008
Case ReportsParaplegia after combined general and epidural anesthesia: a case report.
Neurological complications after epidural anesthesia performed for abdominal surgery are uncommon, but of important consequence with significant morbidity. Paraplegia is very rare and may be a result of multiple factors. We report a case of elective colectomy under combined general and epidural anesthesia for a carcinoma. ⋯ A spinal cord infarction at the level of T10 extending to T2 was diagnosed with magnetic resonance imaging. The association of hypotension as a cause of spinal cord infarction is discussed. The factors that may have contributed to paraplegia and preventive neuroprotective strategies are reviewed.
-
Acta Anaesthesiol Belg · Jan 2008
Survey of Turkish practice evaluating the management of postdural puncture headache in the obstetric population (1).
Many surveys and meta-analysis concerning the management of postdural puncture headache (PDPH) in the obstetric population were published in the literature. Therefore, we aimed to determine the current practice and ideas in the management of PDPH in the Turkish obstetric population and to provide awareness of the responders about new solutions with a survey. ⋯ The management strategies against accidental dural puncture during epidural insertion were to leave the catheter in situ as a spinal catheter (36%, n = 28) or to re-site it at a different level (64%, n = 50). Although these results might reflect the current practice of this small sample, in order to follow the changes in these strategies and to catch almost a standard approach for the prevention and management of PDPH which is a serious complication affecting morbidity in this particular population, further surveys including most of the centers are required.
-
Acta Anaesthesiol Belg · Jan 2008
Peripartum care of the parturient with acute fatty liver of pregnancy.
Acute fatty liver of pregnancy (AFLP) is a rare, but serious life-threatening clinical entity, the etiology of which is unknown. The clinical presentation of this disease is varied and timely diagnosis often difficult. ⋯ We herein present a case of acute fatty liver and hepatic failure that developed during the third trimester of pregnancy. Favorable maternal and fetal outcome was accomplished.