Pragmatic anesthetic approach for extracranial to intracranial bypass surgery in a patient with moyamoya disease and sickle cell disease: a case report.

Background: Moyamoya disease is a chronic progressive cerebrovascular disorder. A proportion of 10-20% of patients with sickle cell disease have associated moyamoya disease and may require surgical revascularization as definitive treatment.

Case Presentation: A 22-year-old African lady with sickle cell disease and moyamoya disease, with extensive cerebral vasculopathy, was scheduled for elective extracranial to intracranial bypass surgery.

The associations between severity of early postoperative pain, chronic postsurgical pain and plasma concentration of stable nitric oxide products after breast surgery.

In this study, we compared the effects of two analgesic regimens on perioperative nitric oxide index (NOx) and the likelihood of subsequent development of chronic postsurgical pain (CPSP) after breast surgery and sought to determine the association among early postoperative pain, NOx, and the likelihood of subsequent development of CPSP. Twenty-nine consecutive ASA I or II patients undergoing breast surgery with axillary clearance were randomly allocated to one of two groups. Patients in group S (n = 15) received a standard intraoperative and postoperative analgesic regimen (morphine sulfate, diclofenac, dextropropoxyphene hydrochloride + acetaminophen prn).