Adjuvant drugs for end-stage liver failure and transplantation.

End-stage liver failure is currently treatable both by dialysis and by liver transplantation, but this does not detract from its being a complex pathophysiological and pharmacological entity. More patients survive after transplant because of the impressive developments that enabled improved liver preservation, anesthesia and surgical techniques, as well as immunosuppressive drug therapy. Because of its multifaceted metabolism, liver failure can nevertheless cause a complex of pathophysiological conditions and, as such, poses a challenge for surgeons and anesthesiologists alike, not only before surgery but during transplantation as well.

Preoperative fasting after soft drink intake: 2 hours may be enough.

Sufficient preoperative fasting time is essential for safe induction of anesthesia to prevent aspiration of gastric contents. However, the time recommended for sufficient preoperative fasting varies greatly, depending on the nature of the oral intake, from 2 h for clear liquids to 6 h for solid foods. We report the case of a 30-year-old man who drank about 600 ml of the carbonated, glucose-rich soft drink, 7-UP, 2 h before surgery and absorbed nearly all of it within these 2 preoperative hours.

Laryngeal mask anesthesia in children: a case report.

The laryngeal mask airway has become one of the major tools of modern anesthesia airway management. Despite the fact that no time limit has been recommended regarding its safe use in spontaneously breathing children, or adults, there is still reluctance to use the laryngeal mask airway in operations of long duration. We report the case of an uneventful 5-hour long laryngeal mask anesthesia in a spontaneously breathing 11-year-old boy undergoing lower limb surgery.