Diffuse Cerebral Atrophy, Central Sinus Venous Thrombosis, Hypoplastic Carpus Callosum, Adhd and Vsd in A Child; Anaesthestic Implications
Journal Title: International Journal of Anesthesiology & Research (IJAR) - Year 2014, Vol 2, Issue 2
Abstract
We report a 2.5 year old female child posted for squint surgery of both eyes under general anaesthesia. Child had microcephaly, subtle dysmorphic features, tracheostomy scar, global developmental delay and ADHD. Child also had diffuse cerebral atrophy, hypoplastic carpus callosum, acute on chronic central venous sinus thrombosis partially recanalised , subdural hygroma in left frontoparietal region and ventricular septal defect. ENT opinion was sought to rule out any bands within the trachea because of tracheostomy. Mother was accompanied with the patient in the operation theatre before induction to reduce the anxiety. Inhalational Induction was done in distraction technique with sevoflurane in an incremental manner quickly upto 8vol% via facemask. Direct laryngoscopy was done and trachea was incubated successfully in a second attempt. Anaesthesia was maintained with oxygen, nitrous oxide and sevoflurane. Procedure took three and half hours. Patient tolerated anaesthesia well. Child was extubated after the child was completely awake. Propofol one mg/kg was given ten minutes before extubation to avoid emergence delirium. Inravenous methylprednisolone 10 mg was given intravenously to reduce the edema of the muscles( especially both medial rectus) which might reducethe incidence of bradycardia in postoperative period. Ondasetron 0.1 mg was given slowly i/v in the peri and postoperatively to reduce PONV ( Both ADHD and squint surgery has increased risk of emesis). Child was monitored for seizures, bradycardia and other hemodynamic parameters in quiet intensive care environment.
Authors and Affiliations
Dr Narendra Kumar
Keywords
Related Articles
- EP ID EP196921
- DOI 10.19070/2332-2780-140009
- Views 100
- Downloads 0
Patient Transfer Unit: Clinical Experience On Medical Evacuation In North-East
Patient Transport unit (PTU) and its team CCATT (Critical Care Air transport Team) has been operating as a savior of north-east since 2008. It is an indigenously developed, stretcher modified unit. It houses the essentia...
Comparison of Continuous Epidural Analgesia and Continuous Femoral Analgesia on Postoperative Pain and Knee Rehabilitation after Total Knee Arthroplasty
This study assessed the efficacy of postoperative analgesia and rehabilitation scores of continuous epidural analgesia or continuousfemoral analgesia after total knee arthroplasty. Thirty patients received epidural analg...
Management of Postoperative Bleeding after Minimally Invasive Mitral Valve Repair: A Case Report
Excessive postoperative bleeding after cardiac surgery is one of the major risk factors for increased morbidity and mortality. Effective and timely management is essential in averting the need for surgical re-exploration...
Anti-Xa Assay Correlation to the Efficacy and Safety of Enoxaparin in the Treatment of Pulmonary Embolism
Background: Enoxaparin is one of the LMWH that has been used for long time in the treatment of acute pulmonary embolism. In this study, we will monitor anticoagulant therapy by anti-Xa assay and correlate its level to th...
Laparoscopic Guided Transversus Abdominus Plane (Tap) Block – A Modified Technique
We present a modified laparoscopic technique to administer quick and effective Tansversesus Abdominus Plane (TAP) block. The technique combines the benefit of laparoscopic guidance along with the knowledge of radiologica...