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Pulmonary artery sling is a rare congenital heart disease; most of the anesthesiologists are not familiar with the Pathophysiological concerns of that disease. Airway obstruction and tracheal compression is the leading complication for the disease, in this report we will discuss some of the anesthetic problems and management for the surgical repair of this disease.

Objective: To evaluate the clinical efficacy of intrathecal Dexmedetomidine (DXM) in comparison with intravenous injection regarding analgesia and sedation during knee arthroscopies.Background: Spinal block is the preferred mode of anesthesia in knee arthroscopies because of its rapid onset, superior block but lack of postoperative analgesia and relative short duration. Many adjuvants are used to potentiate its effect.Patients and methods: A total of sixty healthy adult consented patients of both sexes undergoing knee arthroscopy were randomized to receive intrathecal 15mg in 3ml hyperbaric bupivacaine with 5µg in 0.5ml DXM (Group A) or receiving intravenous bolus dose of DXM 0.5 µg/kg after standard spinal anesthesia (Group B). Assessment of sensory, motor and pain scales were done besides the hemodynamic monitoring, also the time of first rescue analgesic dose were recorded.Results: Intrathecal DXM potentiate the onset of spinal block and reach the target level of block more rapidly than intravenous route P≤0.05, there were no differences regarding the hemodynamic monitoring. Conclusion:This study confirmed that intrathecal DXM with dose of 5µg in 0.5 ml with spinal block might help in reaching the desired level of block more rapidly during knee arthroscopy procedures without Perioperative recorded complications with advantage of rapid recovery from the spinal block.

Background Coronavirus 2019(Covid-19) pandemic is representing a massive burden to the community with the new virus. There is few data regarding Covid -19 in liver transplant patients. Concerns were raised regarding the course of the disease in transplanted patients due to immunosuppression and risk of hepatic injuries. Aim To describe the outcomes of COVID-19 infection in recipients of living donor liver transplantation. Methods Retrospective analysis of forty-one recipients of living donor liver transplantation diagnosed with covid-19 by real time PCR or CT chest criteria of COVID 19 between April 2020 to April 2021. This Cohort was derived from Ain Shams Center for Organ Transplantation database, Ain Shams Specialized Hospital, Cairo, Egypt, which is considered one of the largest centers of LDLT in the Middle East. Patients were classified to mild, moderate, severe and critics according to clinical classification released by the National Health Commission of China. Results Forty-one (41) patients and 2 patients with reinfection were included in this cohort with mean age 54 y with 74% male and 26% female. The body mass index ranged from 19.3-37. Thirty (30%) percent were described as a mild case, 46.5% were moderate, 14% were severe and 9% were critical cases. Two cases developed infection twice. Twenty patients (46.5%) were managed in home isolation setting, 17 patients (39.5%) needed admission to ward, Four patients (9%) in intermediate care unit and Two patients (4%) admitted to intensive care unit (ICU).Sixty percent(60%) of cases were on room air, only 3 patients needed invasive methods, 2 patients needed face mask and one case needed invasive CPAP. Forty-one patients recovered (95%) and two patients (5%) died; one was Covid related and the other one was non-Covid related. Female gender, higher BMI and hypertension were associated with severe course of the disease. Conclusion In the setting of living donor liver transplantation, the possibilities of catching Covid-19 infection is high due to chronic immunosuppression use. Yet, the outcome of infection in term of morbidity and the needs for hospital admission or Intensive care is generally matched to general population.