RESUMO
When conventional therapy fails in status epilepticus, general anesthesia is recommended. We present our experience with isoflurane, an inhalational anesthetic, in the management of a patient with refractory status epilepticus. The seizures were controlled with relatively small concentrations of isoflurane. Hypotension, the only adverse effect of isoflurane, was managed with fluid and dopamine infusions.
Assuntos
Isoflurano/uso terapêutico , Estado Epiléptico/tratamento farmacológico , Adulto , Anestesia por Inalação , Eletroencefalografia , Feminino , Humanos , Isoflurano/efeitos adversosRESUMO
A 19-year-old woman who sustained multiple trauma, but no head injury, developed the fat embolism syndrome. Her severe, fulminant and reversible neurological deterioration was associated with cerebral oedema. We suggest that cerebral oedema may contribute to the neurological deterioration in the fat embolism syndrome.
Assuntos
Edema Encefálico/etiologia , Embolia Gordurosa/complicações , Adulto , Edema Encefálico/diagnóstico por imagem , Edema Encefálico/terapia , Cuidados Críticos , Feminino , Humanos , Tomografia Computadorizada por Raios XRESUMO
A case of postoperative hypoglycaemia following removal of a phaeochromocytoma is presented. The hypoglycaemia is due to a reactive rise in insulin and is augmented by alpha adrenoceptor blocking agents. Beta adrenoceptor blockers impair recovery from this hypoglycaemia. Frequent monitoring of blood glucose and the administration of an appropriate solution of dextrose both during and after this operation is recommended.
