RESUMO
Se describe el procedimiento anestésico en dos pacientes obesos con broncopatía crónica obstructiva que se llevó a cabo mediante la combinación de anestesia epidural y ventilación no invasiva. Esta técnica permitió evitar la intubación, la anestesia general y complicaciones pulmonares perioperatorias(AU)
We report two cases of anesthesia for radical retropubic prostatectomy (RRP) in obese-chronic obstructive pulmonary disease (COPD) patients using the combination of epidural anesthesia and non-invasive ventilation (NIV). This technique avoided intubation, general anesthesia and perioperative pulmonary complications(AU)
Assuntos
Humanos , Masculino , Anestesia Epidural/instrumentação , Anestesia Epidural/métodos , Anestesia Epidural , Prostatectomia/métodos , Respiração Artificial/instrumentação , Respiração Artificial/métodos , Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico , Anestesia Epidural/tendências , Obesidade/complicações , Obesidade/diagnóstico , Respiração Artificial/tendências , Respiração Artificial , Doença Pulmonar Obstrutiva Crônica/terapia , Doença Pulmonar Obstrutiva CrônicaRESUMO
We report two cases of anesthesia for radical retropubic prostatectomy (RRP) in obese-chronic obstructive pulmonary disease (COPD) patients using the combination of epidural anesthesia and non-invasive ventilation (NIV). This technique avoided intubation, general anesthesia and perioperative pulmonary complications.
Assuntos
Anestesia Epidural , Ventilação não Invasiva , Obesidade/complicações , Prostatectomia , Doença Pulmonar Obstrutiva Crônica/complicações , Idoso , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Acquired C1-INH deficiency or acquired angiodema (AAE) is an uncommon cause of angiedema that can induce severe airway complications during surgical procedures. We present the perioperative management of a patient with AAE secondary to a malignant bladder tumor. Anesthetic guidelines could be useful in the management of this disorder.
Assuntos
Proteínas Inativadoras do Complemento 1/deficiência , Assistência Perioperatória , Procedimentos Cirúrgicos Operatórios , Uretra/cirurgia , Neoplasias da Bexiga Urinária/cirurgia , Idoso , Idoso de 80 Anos ou mais , Feminino , HumanosRESUMO
Stellate ganglion block is a common treatment for neuropathic pain. The technique is not without potentially severe complications when a paratracheal approach is used. A 33-year-old woman complained of atypical facial pain of 15 years' duration with pain intensity of 6 to 8 on a visual analog scale and no pain-free periods upon use of inadequate analgesia. One minute after performing a second stellate ganglion block the patient showed signs of apnea and paralysis of the upper extremities and face, with no involvement of oculomotor muscles or the lower extremities, and no loss of consciousness. Assisted ventilation was started. Signs and symptoms resolved fully after 15 minutes. A few days later, the patient reported having perceived paresthesia in the affected zone during the procedure. Central spread of a portion of local anesthetic by way of the spinal nerve sheath toward the subarachnoid space may cause partial cervical and basal nuclear blockade. Signs would be apnea, involvement of the upper extremities and facial muscles, although paresthesia during the injection is the only evidence supporting this hypothesis. Bone contact and negative aspiration while performing a stellate ganglion block do not guarantee avoidance of complications.
