thiopental and Abnormalities--Multiple

Topics: Abnormalities, Multiple; Amides; Analgesia, Epidural; Analgesics; Anesthetics, Inhalation; Anesthetics, Intravenous; Anesthetics, Local; Apnea; Child, Preschool; Clonidine; Facies; Fingers; Growth Disorders; Humans; Intellectual Disability; Male; Methyl Ethers; Nerve Block; Nitrous Oxide; Orchiectomy; Ropivacaine; Sevoflurane; Syndrome; Thiopental

Topics: Abnormalities, Multiple; Anticonvulsants; Apnea; Child; Chromosome Deletion; Chromosomes, Human, Pair 4; Craniofacial Abnormalities; Diazepam; Dose-Response Relationship, Drug; Drug Therapy, Combination; Emergency Medical Services; Epilepsy, Tonic-Clonic; Female; Humans; Infusions, Intravenous; Phenobarbital; Status Epilepticus; Syndrome; Thiopental; Valproic Acid

Robinow syndrome, originally described in 1969, consists of mesomelic brachymelia, short stature, genital hypoplasia and characteristic facies. Associated organ system involvement may include developmental delay, congenital heart disease, obstructive disorders of the urinary tract and renal cysts. As there is a potential for airway problems related to the facial features, such as midface hypoplasia and micrognathia, perioperative management of these patients is important. The authors present an 8-year-old boy, previously diagnosed with Robinow syndrome, who was admitted for an emergency surgical procedure. The perioperative implications of this disorder are reviewed.

Topics: Abnormalities, Multiple; Anesthesia; Anesthetics, Inhalation; Anesthetics, Intravenous; Appendectomy; Appendicitis; Child; Face; Fentanyl; Genitalia, Male; Growth Disorders; Humans; Isoflurane; Laparoscopy; Limb Deformities, Congenital; Male; Syndrome; Thiopental

Anesthesia was administered for six times to a patient with arthrogryposis multiplex congenita (AMC) at the age of 10 to 17 years. In the first four occasions of anesthesia, difficult tracheal intubation was encountered due to limited neck extension, inadequate mouth opening and the short epiglottis. On the fifth anesthesia, the patient remained conscious even after intravenous injection of thiopental 6.6 mg.kg-1, and enflurane in combination with nitrous oxide was administered to induce anesthesia. During the induction of the sixth anesthesia, excessive oral secretion and severe continued nausea were observed just after intravenous administration of thiopental 5.3 mg.kg-1. These were overcome by intravenous administration of ketamine 2.0 mg.kg-1. Problems such as difficulty in tracheal intubation and abnormal response to thiopental need special attention in patients complicated with AMC, particularly during induction of anesthesia.

Topics: Abnormalities, Multiple; Adolescent; Anesthesia, General; Anesthetics, Intravenous; Arthrogryposis; Humans; Intubation, Intratracheal; Reoperation; Thiopental

Topics: Abnormalities, Multiple; Biopsy; Blepharoptosis; Child, Preschool; Craniofacial Dysostosis; Electromyography; Eye Abnormalities; Facial Muscles; Foot; Hand; Humans; Karyotyping; Male; Radiography; Syndrome; Thiopental

Dermabrasion offers cosmetic improvement of acne pits and scars, but only well-adjusted patients should be selected for this esthetic improvement. In the dermabrasion operation the deep cup-shaped pits are made shallow by saucerization, for the deep sharp shadows are eliminated as the pits are shallowed. It is the elimination of the shadow effect which is so gratifying to the patient. Although dermabrasion is a superficial skin operation, it involves dangerous instruments and thousands of minute incisions. The procedure is a surgical operation, whether done in an office or in a hospital. The author performs the operation entirely as a hospital procedure, using pentothal anesthesia with meperidine added in small increments during the operation. Thus the operation may be unhurriedly and meticulously performed.

Topics: Abnormalities, Multiple; Acne Vulgaris; Anesthesia; Anesthesiology; Biological Transport; Cicatrix; Cleft Lip; Cleft Palate; Cysts; Dangerous Behavior; Dermabrasion; Hospitals; Humans; Lip; Meperidine; Thiopental