Revista española de anestesiología y reanimación
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We present a case of a 62 year-old male scheduled for radical cystectomy, who, ten minutes into the surgery, presented with severe hypotension, tachycardia and increased airway pressure. There was no response to the administration of vasoactive drugs such as, ephedrine, phenylephrine, dopamine and norepinephrine. ⋯ Adrenaline was given, and the patient stabilized. An adrenaline infusion and mechanical ventilation was required for four days in the critical care unit.
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A 45-year-old woman was accidentally administered an epidural infusion of paracetamol instead of levobupivacaine for postoperative pain therapy during the postoperative period of abdominal hysterectomy under general anesthesia combined with epidural analgesia. The patient had no neurological symptoms at any time, although a slight tendency to arterial hypotension that did not require treatment was observed. No rescue analgesia was necessary until 8h after the start of epidural infusion. The incidence of these types of errors is probably underestimated, although there are several cases reported with various drugs.
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Rev Esp Anestesiol Reanim · Oct 2014
Review Case Reports[Anaesthetic implications in a pregnant patient with an extreme thrombocytopenia due to a May-Hegglin anomaly: general o regional anaesthesia?].
The May-Hegglin anomaly is an inherited disorder, so uncommon that the incidence is still unknown. It is characterized by macro-thrombocytopenia with normal platelet function and cytoplasmic inclusion bodies in granulocytes. The case is reported of a 28-year-old primiparous patient who had an urgent caesarean section due to failed induction of labour. ⋯ The platelet count prior to surgery was 20,900/mm(3) with normal platelet function. General anaesthesia was performed. No excessive bleeding occurred and a platelet transfusion was not needed.
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Rev Esp Anestesiol Reanim · Oct 2014
Case Reports[Treatment of a patient with refractory cardiac arrhythmias using stellate ganglion block. Access by the classical and ultrasound-guided approach].
Stellate ganglion block is a technique that is often used by anesthesiologists for the treatment of complex regional pain syndromes of the upper extremity. This technique interrupts cardiac sympathetic innervation and has been proposed as treatment for refractory arrhythmias. We present the case of a patient with arrhythmias that were refractory to pharmacological treatment, and were finally treated by continuous stellate ganglion block. Left stellate ganglion is a lynchpin of cardiac arrhythmias due to being a structure where the majority of postganglion sympathetic fibers responsible for preferentially innervating the atriventricular node, bundle of His and ventricular mass are originated, fundamentals in the origin and maintenance of ventricular arrhythmias.