RESUMO
The authors report a new case of respiratory distress syndrome which occurred as complication of varicella in an otherwise healthy adult patient. The case is well documented by images and immunological studies which are discussed in the light of recently published data.
Assuntos
Varicela/complicações , Pneumopatias/complicações , Aciclovir/uso terapêutico , Adulto , Varicela/tratamento farmacológico , Varicela/imunologia , Humanos , Pneumopatias/tratamento farmacológico , Pneumopatias/imunologia , Masculino , Tomografia Computadorizada por Raios XRESUMO
A case of malignant phaeochromocytoma is reported. Computerized tomography and scintigraphy using metaiodobenzylguanidine localized the tumour and metastases. The anesthetic management included invasive monitoring of pulmonary pressures with a Swan-Ganz catheter and arterial pressure with a radial arterial cannula. Plasma catecholamine concentrations were measured before and during adrenalectomy and resection of a metastatic lesion on the fourth right rib. Induction of anaesthesia was carried out with droperidol, phenoperidine, thiopentone and pancuronium. After intravenous administration of droperidol, blood pressure increased together with the heart rate, vascular resistances and pulmonary pressure, whilst cardiac output decreased. Plasma noradrenaline levels were also greatly increased at the same time. The mechanism of this paradoxic pressor effect of droperidol is discussed.
Assuntos
Neoplasias das Glândulas Suprarrenais/cirurgia , Anestesia Geral , Droperidol/efeitos adversos , Hipertensão/induzido quimicamente , Feocromocitoma/cirurgia , Neoplasias das Glândulas Suprarrenais/sangue , Adulto , Catecolaminas/sangue , Hemodinâmica , Humanos , Masculino , Feocromocitoma/sangueRESUMO
Eleven patients, between 70 and 85 years old, with acoustic neurinoma, were operated by translabyrinthic approach. The size of the tumor was between 2 and 4 cm in five cases, 4 cm or more in six cases. Complete tumor removal was possible in six cases (55%), in five cases (45%) residual tumor was left behind. Complications included cerebrospinal fluid leakage (2 cases), meningitis (1 case), and hemorrhage (1 case, fatal four days later). Anesthetic management is described.