thiopental and Colonic-Neoplasms

A 43-year-old man with ulcerative colitis was scheduled for pancolectomy owing to adenomatous transformation of polyps. The patient had right ventricular arrhythmogenic dysplasia, with deteriorating ventricular function, and carried an automatic implantable defibrillator. We discuss the general features of arrhythmogenic right ventricular dysplasia and its implications for management and monitoring during major abdominal surgery. Perioperative management of a patient with an implantable defibrillator is also discussed, with special attention to the influence of electromagnetic interference that can affect how the device functions during surgery. Finally, we list signs that should lead to suspicion of arrhythmogenic right ventricular dysplasia in an asymptomatic patient.

Topics: Adenomatous Polyps; Adult; Analgesia, Epidural; Anesthesia, Epidural; Arrhythmogenic Right Ventricular Dysplasia; Ascites; Atracurium; Catheter Ablation; Colectomy; Colitis, Ulcerative; Colonic Neoplasms; Colonic Polyps; Defibrillators, Implantable; Equipment Failure; Fentanyl; Humans; Isoflurane; Male; Monitoring, Intraoperative; Pain, Postoperative; Postoperative Care; Postoperative Complications; Preanesthetic Medication; Respiration, Artificial; Thiopental

This study evaluated the anaesthetic management of 20 patients, undergoing intra-operative radiation therapy for pancreatic or rectal tumours. Patients with a re-approximated surgical incision were transferred from the operating room to the radiotherapy department while still under anaesthesia. The risks of such transport as well as guidelines for the patient's care during this phase are examined. The results of this study indicate that in order to transport anaesthetized patients safely it is necessary to ensure stable cardiovascular, respiratory and metabolic conditions prior to their transfer. It is also important to guarantee adequate analgesia and to establish appropriate monitoring during transport.

Topics: Aged; Anesthesia, General; Anesthesia, Inhalation; Anesthesia, Intravenous; Colonic Neoplasms; Combined Modality Therapy; Female; Humans; Isoflurane; Male; Middle Aged; Nitrous Oxide; Nuclear Medicine Department, Hospital; Operating Rooms; Oxygen; Pancreatic Neoplasms; Patient Transfer; Postoperative Complications; Rectal Neoplasms; Thiopental; Time Factors

Topics: Aged; Anesthesia; Bundle-Branch Block; Colonic Neoplasms; Electrocardiography; Female; Humans; Nitrous Oxide; Thiopental; Uterine Cervical Neoplasms