A case of trigeminal hypersensitivity after administration of intrathecal sufentanil and bupivacaine for labor analgesia.

Rostral spread of intrathecal drugs and sensitization of supraspinal sites may provoke several adverse effects. This case describes a patient with right hemifacial paresthesia, trismus and dysphasia on the trigeminal nerve distribution after intrathecal sufentanil administration. Primigravida, 34 years, 39 weeks of pregnancy, with hypothyroidism and pregnancy induced hypertension.

Anesthesia for emergency separation of omphalopagus conjoined twins.

Background And Objectives: The rate of mortality during the surgical separation of conjoined twins in the neonatal period is 50% and can reach up to 75% if it occurs in emergency situations. The planning of the surgical separation procedure is detailed and involves imaging assessment, evaluation of cross-circulation and even other surgical preparation procedures, such as skin expansion.

Case Report: Eleven-day-old female omphalopagus conjoined twins underwent emergency surgical separation due to the death of one twin caused by sepsis associated to cardiopathy.

[Laryngospasm].

Background And Objectives: Airways management is fundamental for anesthesiologists, especially during induction of anesthesia and after extubation, when laryngeal spasm is more common. The anesthesiologist should know pharyngeal-laryngeal physiology and the risk factors for airways obstruction, since this is a potentially severe complication with a multifactorial etiology that can develop during anesthesia and whose consequences can be catastrophic. A delay in the diagnosis or treatment and its evolution can lead to hypoxemia, acute pulmonary edema, and, eventually, death of the patient.

Anesthesia in a patient with moebius sequence: case report.

Background And Objectives: Moebius sequence (MS) is a rare paralysis of the VI and VII cranial nerves. Craniofacial changes, which can hinder tracheal intubation considerably, are seen in approximately 90% of the patients.

Case Report: A male patient, 2 years and 5 months old, with MS, underwent flexible bronchoscopy for evaluation of laryngotracheomalacia.

Combined spinal-epidural block in a patient with amyotrophic lateral sclerosis: case report.

Background And Objectives: Amyotrophic lateral sclerosis starts between the fifth and sixth decades of life, causing degeneration and death of upper and lower motor neurons. When the muscles responsible for ventilation are affected, the patient dies of respiratory failure within a few years.

Case Report: This is a 63 years old female with amyotrophic lateral sclerosis who underwent surgical treatment of a transtrochanteric fracture of the femur.

Breakage of epidural catheters: etiology, prevention, and management.

Background And Objectives: The objective of this study was to review published cases of breakage of epidural catheters and, with the data gathered in the literature, to identify predisposing factors for catheter breakage, and list the recommended conducts to prevent and treat this complication.

Methods: The search included the data banks of Pubmed, Embase, and SciELO.

Results: A total of fifteen studies reporting 30 cases of breakage of epidural catheters were identified.

[Acute coronary syndrome in a patient with severe coronary artery disease after laparoscopic cholecystectomy].

Background And Objectives: Perioperative myocardial ischemia is rare, being frequently related with tachycardia and/or hypotension in patients with severe coronary artery disease.

Case Report: A male patient, 71 years old, with diabetes, hypertension, and coronary artery disease underwent laparoscopic cholecystectomy. Anesthesia was induced with propofol, cisatracurium, and remifentanil and maintained with sevoflurane and remifentanil.

[Severe hemodynamic instability during the use of isoflurane in a patient with idiopathic scoliosis: case report.].

Background And Objectives: Isoflurane is considered a safe inhalational anesthetic. It has a low level of biotransformation, and low hepatic and renal toxicity. In clinical concentrations, it has minimal negative inotropic effect, causes a small reduction in systemic vascular resistance, and, rarely, can cause cardiac arrhythmias.

Anesthesia for pacemaker implant in an adult patient with unoperated univentricular heart. Case report.

Background And Objectives: Single ventricle is a rare abnormality, affecting 1% of the patients with congenital cardiopathy. Only 11 cases of patients with unoperated univentricular heart older than 50 years were reported in the literature. The aim of this report was to describe the anesthetic conduct in a patient with univentricular heart undergoing pacemaker implant.

[Anesthesia in patient with moyamoya disease: case report].

Background And Objectives: Moyamoya disease is an uncommon progressive cerebral vasculopathy, more frequently diagnosed among Asian individuals, but which has also been described in Brazil. Moyamoya patients may be submitted to different surgical procedures throughout their lives. Anesthesiologists must understand the pathophysiology of the disease and institute adequate perioperative measures to improve patients' prognosis.

[Anesthesia in Mckusick-Kaufman syndrome patient: case report.].

Background And Objectives: Mckusick-Kaufman syndrome is an uncommon disease, typically characterized by hydrometrocolpos, polydactyly and congenital heart defects. These patients are often submitted to different surgical procedures throughout their lives and the anesthesiologist must be prepared to deal with possible complications. This article aimed at reporting the anesthetic management adopted for a patient with this syndrome.