Canadian Anaesthetists' Society journal
-
Sixty-four cases of posterior lumbar extension osteotomy performed at the Toronto East General Hospital between 1969 and 1983 are reviewed. The anaesthetic management is presented. The procedure was performed with local infiltration anaesthesia, heavy sedation and a brief period of general anaesthesia induced with nitrous oxide, halothane or ketamine. ⋯ A method of supporting these deformed patients in the prone position in moulded plaster casts is described. Anaesthetic and surgical complications and postoperative psychological disturbances are described and discussed. It is suggested that caudal epidural opioid or local anaesthetic analgesia be explored as an aid in the management of these patients.
-
Case Reports
Ankylosis of the temporo-mandibular joint after temporal craniotomy: a cause of difficult intubation.
It is not generally appreciated that surgery in the region of the temporal fossa commonly produces, within a few weeks, a contracture of the temporalis muscle with "pseudo" ankylosis of the jaw. This usually, but not always, resolves within six months. ⋯ Organization of haematoma. It is recommended that active and passive jaw exercises be started early after surgery in the temporal fossa and that such postcraniectomy patients be carefully assessed for jaw ankylosis prior to undertaking anaesthesia.