Acta chirurgica Iugoslavica
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Case Reports
Case of leptosuccin induced malignant hyperthermia in a patient with GIST of the rectum.
Malignant hyperthermia (MH) is a form of myopathy that is usually triggered by volatile anaesthetics such as halothane, sevoflurane and desflurane and depolarising muscle relaxants such as succinylcholine. Pathologic response in MH include increase in oxygen consumption, increase in endtidal CO2, tachycardia, hyperthermia, hyperkalemia and muscle rigidity. ⋯ Molecular genetic studies have confirmed that ryanodine muscle receptors are responsible for MH. We present a case of leptosuccin induced MH with masseter muscle rigidity, mild pCO2 increase (6.3 kPa), elevated body temperature measured with esophageal temperature probe (39.5 degrees C), tachycardia (115 beats/min) and respiratory and metabolic acidosis (pH was 7,23) in a patient who underwent low anterior resection of the rectum for gastrointestinal stromal tumor (GIST) of the rectum.
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Ambulatory surgery refers to hospitalization that does not exceed 24 hours, during which a surgical procedure is performed. Inguinal hernia repairs done under local anaesthesia on an outpatient basis are no longer performed exclusively in specialized hernia centers. They are becoming widely accepted by surgeons working in district hospitals, which was significantly contributed to by the publication of the EHS Guidelines on the Treatment of Inguinal Hernia. ⋯ In hernia repairs on an outpatient basis, "one-step procedure" in local anaesthetic administration is reliable, easy, safe, effective, and the type of the surgical technique is not a determining factor. The success rate and treatment outcome depend on the surgical technique and the surgeon's experience in using local anaesthesia in ambulatory surgery.
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Case Reports
[The selection of best anesthesiological technique for hip fracture surgery in older high-risk patients].
Hip fracture is a pathological condition, more common in older age, i.e. in people over 65 years. The prevalence of this disorder is continuously increasing, simultaneously with higher age limit. In evaluation of risk for operation and anesthesia, older age itself represents higher risk and calls for special attention. In selection of anesthesiological technique, it is more usual to apply neuroaxial block or peripheral nerve block, which is more advantageous over general anesthesia. ⋯ Peripheral nerve blocks are safe and effective anesthesiological technique, which may reduce the mortality in patients with the hip fracture and maintain the hemodynamic stability, both during and after the surgical intervention.