Thiopentone-based total intravenous anaesthesia for a patient with carnitine palmitoyltransferase II deficiency and malignant hyperthermia susceptibility.

In this case report, we discuss the use of a thiopentone infusion for the maintenance of anaesthesia in a patient with confirmed malignant hyperthermia susceptibility and carnitine palmitoyltransferase 2 deficiency. The concurrence of both diagnoses precluded the use of both propofol-based total intravenous anaesthesia and volatile inhalational anaesthesia. This patient had been anaesthetised previously with a triple infusion regimen of thiopentone, midazolam and remifentanil and this was a unique opportunity to compare the two instances.

Dexmedetomidine as a rescue agent during intracranial neurosurgery in the setting of opioid tolerance.

Dexmedetomidine is a versatile sedative agent widely used both in anaesthesia and intensive care. We present the case of a 32-year-old woman with a long-term history of non-prescribed intravenous opioid use who underwent elective resection of a skull base tumour. There was difficulty in achieving an adequate depth of anaesthesia despite the high levels of intravenous and volatile anaesthetic agent.