Acta anaesthesiologica Belgica
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Acta Anaesthesiol Belg · Jan 2011
Case ReportsAnesthesia for laparoscopic surgery in a patient with myotonic dystrophy (Steinert's disease): beneficial use of sugammadex, but incorrect use of pethidine: a case report.
Patients with Myotonic Dystrophy show an unpredictable response to several anesthetic drugs including opioids, neuromuscular blocking agents and especially reversal agents like neostigmine. We describe the case of a 40 year old patient with myotonic dystrophy who underwent laparoscopic cholecystectomy and ovarian cyst removal under general anesthesia. The authors suggest the use of the new reversal agent suggamadex, for reversing neuromuscular blockade caused by rocuronium, in patients suffering from neuromuscular disease and especially from Myotonic Dystrophy, because it rapidly and completely reverses any residual neuromuscular blockade, but also underline the increased susceptibility of these patients to opioids.
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Acta Anaesthesiol Belg · Jan 2011
Case ReportsUnintentional side error for continuous sciatic nerve block at the popliteal fossa.
Among all fields of healthcare about 45% of medical errors occur in the operating theatre. Wrong site procedures remain one of the most preventable medical errors. ⋯ The surgical safety checklist was established in 2008 by the world Health organization (WHO) as a part of the "Safe surgery save Lives" initiative. We report in this article a case of wrong sided continuous popliteal sciatic nerve block and discuss the role of the WHO's checklist in preventing wrong side peripheral nerve block and surgery.
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Acta Anaesthesiol Belg · Jan 2011
Case ReportsGross tracheal deviation: airway challenges and concerns--two case reports.
Practical guidelines and algorithms may not always help in difficult airway management. Large thyroid swellings may be responsible for several difficulties during the perioperative period, such as distortion of the airway, endocrine disturbances and metabolic effects. ⋯ One of those patients had also retrosternal extension of goiter. Both patients were scheduled for an excision of their colloid goiter.