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Scoliosis anaesthetic management

Mark Zachary Johnson, Cormac Francis Mullins, Declan Keane, Ingrid Browne
Melnick-Needles syndrome (M-NS) is a rare genetic disorder which primarily affects skeletal developments. M-NS may also affect the cardiorespiratory and renal systems. A 35 kg patient presented complaining of abdominal pain. Following a positive pregnancy test and ultrasound examination, she was diagnosed with a ruptured ectopic pregnancy. She had a significant background history of M-NS, obstructive sleep apnoea (with narrow gauge tracheostomy in situ), obstructive lung disease and scoliosis. She received fluid resuscitation, and the case was managed using an open salpingectomy and clot evacuation under combined spinal/epidural anaesthesia...
December 13, 2017: BMJ Case Reports
George I Mataliotakis, Athanasios I Tsirikos, Karen Pearson, Don S Urquhart, Carolyn Smith, Andrew Fall
Spinal deformity in patients with cystic fibrosis (CF) is usually mild requiring no treatment. These patients are rarely considered as surgical candidates for scoliosis correction, as the pulmonary condition and other comorbidities increase the risk of general anaesthesia and recovery. This paper reviews all the literature up to date with regard to scoliosis in patients with CF and reports this unique case of a 14-year-old Caucasian girl with progressive scoliosis, who was treated surgically at the age of 17...
2016: Case Reports in Orthopedics
Suman Lata Gupta, M V S Satya Prakash, Gunasekaran Prabu
We describe the anaesthetic management using i-gel for airway maintenance in a patient with kyphoscoliosis presenting for emergency caesarean section due to fetal distress and scar tenderness. The patient had a history of previous caesarean section under general anaesthesia, and presently her cardiorespiratory status is stable. We used i-gel, the new supraglottic airway device, for maintaining the airway under intravenous anaesthesia using propofol.
2014: BMJ Case Reports
Muralidhar Joshi, B Amarnath Reddy, Bhargavi Bollampally, Sachin D Joshi
No abstract text is available yet for this article.
January 2014: Indian Journal of Anaesthesia
Jasveer Singh, Dheeraj Kapoor, Meghana Srivastava, Manpreet Singh
Scoliosis may be of varied aetiology and may be associated with severe congenital anomalies. It often poses a challenge in its anaesthetic management. We present anaesthetic management of a child who underwent scoliosis reconstruction with a rare triad of cerebral palsy, glucose-6-phosphate dehydrogenase deficiency and severe mitral regurgitation. Anaesthetic management in these patients should focus primarily on associated co-morbidities and congenital anomalies affecting the course of the perioperative management and thereafter comprehensive pre-operative strategies must be executed to enhance the safety profile during the surgery...
November 2013: Indian Journal of Anaesthesia
S Evans, A Ramasamy, D S Marks, J Spilsbury, P Miller, A Tatman, A C Gardner
The management of spinal deformity in children with univentricular cardiac pathology poses significant challenges to the surgical and anaesthetic teams. To date, only posterior instrumented fusion techniques have been used in these children and these are associated with a high rate of complications. We reviewed our experience of both growing rod instrumentation and posterior instrumented fusion in children with a univentricular circulation. Six children underwent spinal corrective surgery, two with cavopulmonary shunts and four following completion of a Fontan procedure...
January 2014: Bone & Joint Journal
R Eddie Clutton, Enzo Vettoratto, Gudrun Schoeffman, Joan Docherty, John Burke, Alastair J N Gibson
The purpose of the study was to optimize postoperative comfort in lambs anaesthetized for the surgical creation of scoliosis while maintaining the ewe-lamb relationship to miminize rejection rates. The first management plan produced six scoliotic lambs but intraoperative hypoventilation and hypovolaemia followed by postoperative dyspnoea, pain, monitoring and nursing difficulties, hypothermia, hypoglycaemia and tympany were encountered. Three of eight lambs (38%) were rejected by their ewes. Perioperative management was amended which, combined with improved surgical technique, produced 16 scoliotic lambs...
January 2014: Laboratory Animals
C Bowens, K H Dobie, C J Devin, J M Corey
We report on a case in which computed tomography was used to guide placement of an epidural catheter in a patient with severe scoliosis and congenital dwarfism. In addition, the computed tomograms were corroborated with ultrasound and fluoroscopic images in the patient. Three years later, the patient had a spinal anaesthetic performed with only the use of ultrasound-guidance. Ease of placement of the epidural and spinal was greatly enhanced by imaging. We present an algorithmic approach to neuraxial anaesthesia in the patient with scoliosis to help guide placement...
November 2013: British Journal of Anaesthesia
C Pérez-Caballero Macarrón, E Sobrino Ruiz, J Burgos Flores, Jl Vázquez Martínez, A Coca Pérez, E Alvarez Rojas, Jj Sánchez Ruas
INTRODUCTION: The management of patients with Fontan physiology who undergo scoliosis surgery is difficult. The purpose of this article was to describe our experience in the management of patients with Fontan circulation undergoing spinal surgery for correction of scoliosis. MATERIALS AND METHODS: This was a retrospective study including patients with Fontan physiology who underwent spinal orthopaedic surgery. Anaesthetic management, post-operative complications, paediatric intensive care unit and total hospital stay, and the need for blood transfusions were analysed...
February 2014: Cardiology in the Young
E Freire Vila, A de la Iglesia López, J L Juncal Díaz
Rett syndrome is a severe and incapacitating neurological disease caused by a structural defect in the short arm of the X chromosome (Xq28). It affects females and consists of multiple and progressive neurological impairments that start from a young age, leading to lifelong disability and dependency. Scoliosis appears in more than 50% of patients and requires surgical correction in cases where the curvature is severe. Pre-anaesthetic assessment is essential in order to identify the risk factors and thus reduce the morbidity and mortality associated with the surgical procedure...
March 2013: Revista Española de Anestesiología y Reanimación
N Bansal, S Gupta
Use of neuraxial block in a patient with severe kyphoscoliosis is controversial. We describe the anaesthetic management by spinal anaesthesia of a parturient with severe kyphoscoliosis in obstructed labour. The perioperative course was uneventful. We suggest that a patient with severe kyphoscoliosis may be successfully managed by spinal anaesthesia for caesarean section.
July 2008: Kathmandu University Medical Journal (KUMJ)
Alain Borgeat, Stephan Blumenthal
PURPOSE OF REVIEW: The control of pain after scoliosis surgery is a real challenge for the anesthesiologist. The first reason is that major spine surgery for correction of scoliosis deformation causes severe postoperative pain, and second that patients undergoing these operations are most often children or adolescents who are known to suffer from increased pain sensation compared with adults. RECENT FINDINGS: A multimodal postoperative pain therapy is a well established procedure to control the pain after scoliosis surgery...
June 2008: Current Opinion in Anaesthesiology
F C Richa, P H Yazbeck
Freeman-Sheldon syndrome, or distal arthrogryposis type 2A, is a rare congenital myopathy and dysplasia characterised by multiple contractures, abnormalities of the head and face, defective development of the hands and feet and skeletal malformations. The facial muscle contracture produces the typical 'whistling face' appearance. Anaesthetic issues include difficult intravenous access, difficult airway and postoperative pulmonary complications. Although an association with malignant hyperthermia has been suggested, this has not been confirmed...
March 2008: Anaesthesia and Intensive Care
J J Greenwood, W E Scott
Charcot-Marie-Tooth disease is a rare hereditary motor and sensory demyelinating polyneuropathy with potentially severe and debilitating peripheral symptoms. Respiratory muscles and vertebral anatomy can be affected, both of which may have significant impact on any planned or unplanned anaesthetic intervention during labour. We describe two cases at opposite ends of a wide spectrum of disease severity. The first case illustrates an approach to the management of a mildly affected patient who was permitted to labour normally, but nevertheless needed a detailed antenatal plan in order to allay her anxiety and prepare for potentially complicated labour analgesia and operative delivery...
April 2007: International Journal of Obstetric Anesthesia
N Almenrader, D Patel
BACKGROUND: The perioperative management of children with non-idiopathic scoliosis undergoing spinal deformity surgery has not been standardized and the current practice is to routinely ventilate these patients in the postoperative period. This study reports the experience from a single institution and evaluates the need and reasons for postoperative ventilation. Details of ventilated patients are presented. METHODS: All patients undergoing spinal fusion surgery for non-idiopathic scoliosis were recorded prospectively (2003-4)...
December 2006: British Journal of Anaesthesia
P R J Gibson
Surgical correction of spinal deformities in children presents a challenge to the anaesthetist because of the extensive nature of the surgery, the co-morbidities of the patients and the constraints on anaesthetic techniques of intraoperative neurophysiological monitoring of the spinal cord. Adolescent idiopathic scoliosis is the most common deformity. Patients with scoliosis secondary to neuromuscular conditions are at greatest risk of perioperative problems, particularly excessive blood loss and respiratory failure...
August 2004: Anaesthesia and Intensive Care
M Q Hoda, S U Zafar
OBJECTIVE: To share our experience of anaesthetic management of scoliosis with intra-operative somatosensory evoked potential monitoring and wake up test. METHODS: All the cases of scoliosis surgery scheduled during a period of two years in which SSEP and intra-operative wake-up test was planned were included in the study. The patient in which intra-operative wake-up test was not planned were excluded from this case series. RESULTS: We managed a series of sixteen cases of scoliosis in our hospital...
November 2004: JPMA. the Journal of the Pakistan Medical Association
L McLoughlin, P Bhagvat
We describe the conduct of general anaesthesia for a patient with spinal muscular atrophy Type III (Kugelberg-Welander disease) undergoing elective caesarean section. Apart from a delayed return of skeletal muscle power following non-depolarising neuromuscular blockade the procedure was uneventful. We found no previously published reports of general anaesthesia for caesarean section in this condition in the English language literature. We review the available literature and discuss the potential anaesthetic problems in the management of obstetric patients with this degenerative neuromuscular disorder...
July 2004: International Journal of Obstetric Anesthesia
J E Llopis, R Garcia-Aguado, C Sifre, M T Rosso, M Vivó, J Martin-Jurado, F Grau
The case is described of a pregnant patient with Marfan's syndrome scheduled at 39 weeks' gestation for elective caesarean section carried out for the first time by total intravenous anaesthesia (TIVA) with continuous intravenous (i.v.) infusion of propofol. The diagnosis was based on a positive family history, classic phenotype, scoliosis, arachnodactyly, high narrow palate, hyperextensible joints, ectopia lentis and mitral valve prolapse, with a secondary low mitral insufficiency. Maternal and fetal surveillance did not detect complications during the course of pregnancy...
January 1997: International Journal of Obstetric Anesthesia
S Wyatt, D Brighouse
We report the anaesthetic management of vaginal delivery in a woman with Friedreich's ataxia, who had hypertrophic cardiomyopathy and had previously undergone thoracic spinal fusion with Harrington rod fixation. Combined spinal-epidural analgesia was used. Options for the anaesthetic management of labour and delivery are discussed.
July 1998: International Journal of Obstetric Anesthesia
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