Neurofibromatosis (NF) is a genetic and multisystemic disease with autosomal dominant transition. It can affect anesthesia applications by affecting more than one system. In the presence of neurofibromas in the airway, it can cause airway obstruction and difficulties in respiratory delivery during general anesthesia. The presence of tumors affecting the central nervous system makes spinal anesthesia risky. Anesthesiologists should act with awareness of each multisystemic complication when evaluating and managing patients. This case report aims to present our general anesthesia practice in an elective cesarean operation in a pregnant patient with neurofibromatosis type 1.
Objective : We aimed to examine the effect of different intervals of end tidal CO2 ( etCO2 ) values on hemodynamics and surgery in endoscopic endonasal transsphenoidal pituitary surgery.
Material and Methods: Two groups were evaluated retrospectively according to the maximum etCO2 values at the time of sellar resection. Group 1: 21 patients, etCO 2 =25-37 mmHg and Group 2: 21 patients, etCO 2=38-50 mmHg. The demographic characteristics, mean arterial pressure (MAP), heart rate (HR), etCO2 , pCO2 at the time of anesthesia induction, sellar excision moment and pre-extubation periods , total amount of bleeding, ease of surgery (good-moderate-bad) obtained from computer records, anesthesia receipts and surgical reports.
Results: There was no difference between the two groups in terms of demographic data, complications or bleeding. A relationship was found between arterial pCO2 at the time of sellar excision. Surgical satisfaction was evaluated as "good" in 9 patients in Group 1 and 12 patients in Group 2.
Conclusion: High etCO 2 values (38-50 mmHg) facilitated surgical excision of the mass and did not affect hemodynamics. Surgery has increased satisfaction. Keeping EtCO2 slightly higher than normal may be a good choice in these cases. Well-designed prospective studies are needed.
Acetaminophen (paracetamol) is a commonly used drug during pregnancy and is considered safe. However, it is among the most frequent agents of which overdoses are reported during pregnancy. The most important result of overdose use is hepatotoxicity, which can cause death. We herein present our approach to two pregnant cases we followed up in the intensive care unit due to acetaminophen intoxication.
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