We present our experience in cardiac tumor resection surgery in adult patients: 30 subjects with sternotomy approach with later diagnosis of myxomas (12), fibroelastomas (7), sarcomas (4), cardiac methastasis of a breast cancer and cardiac invasion of renal tumor (6), and 3 with videothroacoscopic approach with diagnosis of atrial myxoma (2) and intraventricular sarcoma (1). We highlight the usefulness of TEE as an essential monitor in this subtype of cardiac surgery in allowing location confirmation and completion of resection. Likewise as anesthesiologists and active participants of the surgical team, we were able to document absence of residual heart defects, lesions or perforations or dysfunction of heart valves. Evaluation of preexisting anatomy and function and post Cardiopulmonary Bypass ventricular function and circulation were important in early diagnosis of complications.
Rhabdomyolysis is a pathology that rarely has causes in the perioperative period, where it has been commonly related as a complication of malignant hyperthermia, prolonged patient positioning with intraoperative muscle compression, in the postoperative period of bariatric surgery and in children. The purpose of this review is to present the case of a 49 year-old male patient, who underwent limb salvage surgery for treatment of a left femur osteosarcoma, with reconstruction via bone transplant and joint prosthesis. During the procedure hyperkalemia and elevation of Creatine-Phosphokinase (CPK) enzyme levels where detected, without changes compatible with renal failure, which required repeated treatment to normalize and that, after ruling out other causes, it was attributed to skeletal muscle destruction during the procedure. Rhabdomyolysis is a phenomenon inherent to this sort of procedures and may manifest initially as laboratory findings and that, if not diagnosed in time, may lead to fatal arrhythmias and acute renal failure. RESUMENLa rabdomiólisis es una patología que rara vez tiene origen en el período perioperatorio, donde comúnmente se le ha relacionado como complicación de la hipertermia maligna, de decúbitos prolongados con compresión muscular intraoperatoria, del posoperatorio de la cirugía bariátrica y en niños. El objetivo de este trabajo es presentar el caso de un hombre de 49 años, sometido a resección de un osteosarcoma de fémur izquierdo con reconstrucción mediante trasplante
Parkinson's disease is highly prevalent and one of its treatments in pursue of improving quality of life is deep brain stimulation of deep basal ganglia. Although the anesthetic management varies, we consider that the most appropriate approach with respect to risk/benefit ratio is the asleep/awake/ asleep technique, since it allows the interaction of the patient with the multidisciplinary team in order to guarantee a correct placement of the stimulation electrodes. We present a 10 case-series of patients where we describe the use of dexmedetomidine as the main drug to achieve the desired depth of anesthesia, ensuring collaboration during neurological check-up. The anesthesiologist as part of the neurosurgical team has an active role in achieving adequate levels of sedation, analgesia and awareness when needed during the different stages of this procedure, where dexmedetomidine has proven to be a fundamental pillar in this work to achieve the objectives. RESUMENLa enfemedad de Parkinson es prevalente y uno de sus tratamientos en busca de mejorar la calidad de vida es la estimulación cerebral profunda. Si bien el manejo anestésico es variado, consideramos que el más adecuado respecto a los riesgos/beneficios es la técnica dormido/despierto/dormido, ya que permite la interacción del paciente con el equipo multidisciplinario para garantizar una
Hemos analizado, mediante la descripción de 4 casos clínicos de cirugía de trasplante ortotópico hepático, las causas de inestabilidad hemodinámica mediante el uso intraoperatorio de ecocardiografía transesofágica. La identificación de la causa y el mecanismo preciso de la descompensación permitió el tratamiento adecuado de la complicación intraoperatoria.
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