33 research outputs found
Acyanotic congenital heart disease and transesophageal echocardiography
The spectrum of congenital heart disease (CHD) seen in the adult varies widely. Malformations range from mild anomalies requiring no intervention to extremely complex pathologies characterized by the presence of multiple coexistent defects. Echocardiography represents the primary noninvasive imaging modality in the assessment of these lesions. The transesophageal approach expands the applications of echocardiography by allowing the acquisition of anatomic and functional information that may not be obtainable by transthoracic imaging
Anesthesia management of awake craniotomy performed under asleep-awake-asleep technique using laryngeal mask airway: Report of two cases
Asleep-awake-asleep technique of anesthesia is used during awake
craniotomy with or without securing airway. We assessed this technique
using laryngeal mask airway (LMA) in two patients. Patients underwent
awake craniotomy for epilepsy surgery and the removal of a
frontotemporal glioma. After anesthesia induction, airway was secured
using LMA. Anesthesia was maintained using oxygen, nitrous oxide and
sevoflurane, supplemented with an infusion of propofol and
remifentanil. Twenty minutes before corticography, anesthesia was
discontinued and LMA removed. Both patients were awake and cooperative
during the neurological assessment and surgery on eloquent areas. The
LMA was reinserted before the closure of the dura and remained in place
until the end of surgery. Both patients had no recall of events under
anesthesia, although experienced mild pain and discomfort during awake
phase of surgery. Both expressed complete satisfaction over the
anesthetic management. Asleep-awake-asleep technique using LMA offers
airway protection. The painful aspect of surgery can be performed under
anesthesia, hence minimizing the duration of stress and pain. Patients
remained awake and cooperative throughout the time of neurological
testing