Presentation
It is intended that the present case serve as a guide for fellow surgeons to identify and manage this syndrome. The present case was explained and a review of the literature was performed. [ncbi.nlm.nih.gov]
Entire Body System
- Hypothermia
In turn this results in redistribution of body heat from core to periphery with subsequent rapid hypothermia during anaesthesia. [web.archive.org]
A myotonic crisis can be induced by numerous factors including hypothermia, shivering, and mechanical or electrical stimulation. [ncbi.nlm.nih.gov]
Severe hypothermia may result in coagulopathy, delayed awakening, or arrhythmia. [emedicine.medscape.com]
"Thermal insulation for preventing inadvertent perioperative hypothermia". The Cochrane Database of Systematic Reviews (6): CD009908. doi:10.1002/14651858.CD009908.pub2. [en.wikipedia.org]
Respiratoric
- Hoarseness
On the first postoperative day, she complained left sided tongue deviation, subtle hoarseness and swallowing difficulty. [ncbi.nlm.nih.gov]
These include: Breathing problems Nausea and vomiting Sore throat or hoarseness (usually temporary) Allergic reaction to the anesthetic Irregular heartbeat (rare) Cardiac arrest (rare) Anesthesia safety Follow all instructions you are given for how long [fairview.org]
Also, some people have a sore throat or hoarseness from the breathing tube inserted after the person is unconscious. Inserting the breathing tube can sometimes cause damage to a person's mouth or teeth, but this is uncommon. [peacehealth.org]
Musculoskeletal
- Chest Deformity
Noonan syndrome (NS) is an autosomal dominant disorder characterized by facial anomalies, short stature, chest deformity, congenital heart diseases, and other comorbidities. [ncbi.nlm.nih.gov]
Neurologic
- Amnesia
Under general anesthesia, the patient is unable to feel pain and may also have amnesia. [medicalnewstoday.com]
Anesthesia causes amnesia. General anesthesia keeps you relaxed, blocks pain, and may also cause amnesia. [medicaldaily.com]
It has 3 objectives: - Avoid pain; - Induce deep sleep and amnesia -- that is to say, a hypnotic state; - Induce muscle relaxation to make the surgeon's work easier. [youtube.com]
- Agitation
It can also decrease postoperative pain and incidence of the emergence agitation. Due to the small number of studies, further clinical trials are needed to confirm these results. [ncbi.nlm.nih.gov]
Attempts should be made to avoid the use of physical restraints, which may worsen delirium and agitation. [anesthesiology.pubs.asahq.org]
- Stupor
Catatonia — Psychomotor disturbance characterized by muscular rigidity, excitement or stupor. Hypnotic agent — A drug capable of inducing a hypnotic state. [medical-dictionary.thefreedictionary.com]
Opium was praised by the Persian philosopher and physician Avicenna in the eleventh century as the most powerful of stupor-producing substances. [encyclopedia.com]
- Altered Mental Status
General anesthesia or sedation can mask a hypoglycemia-altered mental status. Acute hypoglycemia might result in permanent brain injury. [ncbi.nlm.nih.gov]
Workup
Postoperative workup did not reveal any organic pathology. Unbeknown to the treating physicians, the patient had a comorbid untreated psychiatric history. [ncbi.nlm.nih.gov]
EEG
- Burst Suppression
Demographic data, indication for surgery, clinical history, history of prior seizures, duration of surgery and duration of burst suppression were recorded. Cases where seizures were observed were analyzed in detail. [ncbi.nlm.nih.gov]
Serum
- Hypercapnia
Severe hypercapnia is a rare but harmful complication of general anesthesia. We report the case of a newborn who developed severe hypercapnia with unknown reasons during general anesthesia but recovered well. [ncbi.nlm.nih.gov]
• Cardiac arrhythmias: serious if hypercapnia develops due to hypoventilation and an increase in the plasma concentration of catecholamines) • Hypotensive effect (phenylephrine recommended) • Hepatotoxic: is oxidatively metabolized in the liver to tissue [slideshare.net]
- Glucose Increased
RESULTS: Resting energy expenditure (B1: 1230 ± 228; B2: 1317 ± 282; C: 1012 ± 153 kcal/h; B2 vs C, P CONCLUSIONS: The administration of amino acids and glucose increased measured energy expenditure, alleviated nitrogen balance, and may decrease the length [ncbi.nlm.nih.gov]
Treatment
Here we describe dental treatment under general anesthesia performed for a 28-year-old man with NS. He had characteristic features of NS along with mild pulmonary valve stenosis. [ncbi.nlm.nih.gov]
While the child is asleep our doctors will be able to complete all of the child’s dental treatment in one visit. [leapkidsdental.com]
Kids – when children need complex dental treatments or surgeries, it may be beneficial to consider general anesthesia as it can be difficult for young patients to stay calm during more complex treatment. [provinespcfi.com]
Prognosis
The separation phenomenon of decrease in PETCO2 and increase in PaCO2 might be a useful and suggestive sign, enabling prompt management and therefore improving the prognosis. [ncbi.nlm.nih.gov]
Outlook (Prognosis) General anesthesia is generally safe because of modern equipment, medicines, and safety standards. Most people recover completely and do not have any complications. References Cohen NH. Perioperative management. [mountsinai.org]
Fetal prognosis after anesthesia during gestation. Analg. 42;521-6 Shnider, SM, Webster, GM. 1965. Maternal and fetal hazards of surgery during pregnancy. Am. J. Obstet. Gynecol. 92;891-900. Sylvester, GC, et al. 1994. [mothertobaby.org]
This content is for informational purposes only and does not substitute for formal and individualized diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed medical professional. [healdove.com]
Etiology
The specific etiology of this condition is widely speculated. [ncbi.nlm.nih.gov]
The etiologic diagnosis of perioperative anaphylaxis relies on a triad including clinical, biologic, and allergologic evidence. Fig. 1. [doi.org]
Epidemiology
BACKGROUND: Epidemiological data demonstrate that the worldwide prevalence of chronic obstructive pulmonary disease is increasing. These patients have an increased risk of mortality and morbidity and have constant limitations in airflow. [ncbi.nlm.nih.gov]
In 2017, we have 47 ongoing studies among 27 investigators throughout our subspecialties, including clinical, bench, education, and epidemiological studies. [anesthesiology.cumc.columbia.edu]
This may have been a chance finding, as analyses did not adjust for multiple endpoints. 43 The PANDA study addressed many of the limitations of the previous epidemiologic studies. [fda.gov]
In fact, they have created their own section called Epidemiology and Safety. The other direction the Foundation went was to publish a quarterly Anesthesia Patient Safety Foundation Newsletter which has been immensely successful. [web.archive.org]
Pathophysiology
Early detection is even more difficult for patients under general anesthesia as common symptoms are not available and the pathophysiological course of intra-operative APE is influenced by procedures of surgery and anesthesia, which makes patients under [ncbi.nlm.nih.gov]
Pathophysiologic Elements Anaphylaxis occurring during the perioperative period is a clinical syndrome involving multiple organ systems. [doi.org]
The underlying pathophysiology of delirium in general, and PD specifically, remains elusive. [anesthesiology.pubs.asahq.org]
- Pathophysiological and clinical aspects of the CO2 pneumoperitoneum (CO2-PP). Surg Endosc, 1997;11:864-867. [ Links ] 13. [scielo.br]
Prevention
Effective management of ammonia levels in this patient using preoperative hydration and dexmedetomidine as an adjunct to general anesthesia may have helped to prevent delayed emergence. [ncbi.nlm.nih.gov]
BVA anesthesiologists are skilled at techniques at preventing and treating nausea. [bouldervalleyanesthesiology.com]
This will help to prevent food from being inhaled (aspirated) into your lungs. Be sure to carefully follow the directions you are given. [peacehealth.org]
The medicine will help to: Prevent pain Relax the muscles Stop certain reflexes Prevent awareness of what is happening Possible Complications Many steps are taken to prevent problems. [winchesterhospital.org]