Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · Jun 1997
Case Reports[Subcutaneous, pneumomediastinal, pneumopericardial emphysema and pneumothorax following retrosigmoid resection].
Pulmonary alveolar rupture can occur spontaneously or as a result of mechanical ventilation or other causes, and may give rise to bullae or emphysema without producing extrapulmonary air. Most but not all cases occur in patients with underlying lung disease. ⋯ Soon after the patient awoke from anesthesia, subcutaneous, pneumomediastinal and pneumopericardiac emphysema developed, along with bilateral pneumothorax. We discuss the possible causes of extra-alveolar air was well as ways to detect and treat it.
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Rev Esp Anestesiol Reanim · Jun 1997
Clinical Trial[Propofol in continuous infusion for performing nuclear magnetic resonance in children: an effective alternative to sedation with other drugs].
Sedation is often needed for obtaining nuclear magnetic resonance (NMR) images in children. The aim of this study was to evaluate the efficacy of propofol administered by continuous infusion to non-intubated children for whom our hospital's usual method of sedation (oral chlorohydrate 75 mg/kg at a maximum dose of 2 g plus 4 hours sleep privation the night before) had failed. Deep sedation was induced in 37 ASA I-II children aged 4 and 14 year old, with 2.5 mg/kg propofol followed by 6 mg/kg/h in continuous infusion. ⋯ Sedation failed in one child, who required general anesthesia when opisthotonos presented after the induction dose. Awakening was early and satisfactory in all patients, with a score of 2 on the Ramsay scale 15 minutes after NMR. Deep sedation with propofol is a safe and effective method of performing NMR in a child for whom other methods of sedation have failed, provided the child is ASA I-II, monitoring is exhaustive and procedure is carried out by an anesthesiologist.
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Rev Esp Anestesiol Reanim · Jun 1997
Case Reports[General convulsive crisis related to pneumocephalus after inadvertant dural puncture in an obstetric patient].
We report a case of iatrogenic pneumocephalus in an obstetric patient after accidental dural puncture during repeated attempts to locate the epidural space by the technique of loss-of-resistance to air. Analgesia was provided throughout labor. Two days after puncture, typical spinal headache developed and was treated with bed rest, oral analgesics and hydration. ⋯ A computerized tomography (CT) scan revealed pneumocephalus, to which the convulsions were attributed. No further convulsions occurred in spite of the fact that anticonvulsives were not prescribed. A CT scan one month later was normal.