2012, Number 2
Revista Cubana de Anestesiología y Reanimación 2012; 11 (2)
Colmenares SF, Pozo RJA, Correa BM, Pérez BL, Legrá BE
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ABSTRACTIntroduction: The Arnold-Chiari's syndrome es a uncommon and congenital malformation of the central nervous system, located in the posterior fossa or base of brain. Objective: To describe the anesthetic behavior for this type of surgical procedure.
Description: This is the case of a woman with a Type i Arnold Chiari's malformation programmed for an elective surgical treatment in the "Manuel Ascunce Domenech" University Hospital of Camagüey. There was preoperative medication and monitoring of EKG, invasive blood pressure, cardiac frequency, PVC (?), capnography, current volume, minute volume, intrapulmonary pressures, concentration of administered gases, SPO2 by pulsatile oximmetry, diuresis, blood losses, insensible losses and gasometry. Induction was carried out using 10 mg midazolam, fentanyl and 2% lidocaine hydrochloride. The neck hyperextension was avoided. Intubation was fast and without complications. It was incorporated to Fabius(?) with ventilatory parameters: VC = 8 ml/kg (520 ml), FR = 10', Vmin = 5.2 L/min. Maintenance using 02, N20 and isofluorane, fentanyl (fractioned doses) and vecuonium 0,1 mg/kg/30 min. The change of position was achieved without complications. A 20% mannitol infusion was administered (0,50 g/kg/dose). Intraoperative blood losses not exceed the estimated blood volume and were replaced with crystalloids and colloids. There were not intraoperative and postoperative complications.
Conclusions: The knowledge of disease, the pharmacokynetics and perioperative cares are the cornerstone of the success in treatment.