Utkarsha Pradeep Bhojane

Abstract

Lower limb long bone fractures are vulnerable for venous thromboembolism leading to pulmonary thromboembolism. Here, we present a case of preexisting pulmonary thromboembolism with pulmonary artery hypertension posted for bipolar hemiarthroplasty.In hemodynamically stable patients it is better to operate the underlying fracture early to avoid recurrence and worsening of pulmonary thromboembolism. This case was successfully managed under general anesthesia.   Keywords : Pulmonary thromboembolism, Pulmonary artery hypertension, Bipolar hemiarthroplasty, Computed tomography pulmonary angiography, General anesthesia.

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Abstract

Chondrosarcoma is the tumor which affects bone and soft tissue with only 2% spinal involvement. Anesthetic management becomes challenging in patients with cervical chondrosarcoma. Here, we are presenting a case of huge neck mass due to cervical spine chondrosarcoma in 70 year old male hypertensive patient. The patient has distorted anatomy with mucosal edema with left tracheal deviation and compression from right side. Awake Nasal Fiberoptic intubation was done with cuffed ETT no 8. The neck mass was removed and Anterior Cervical Discectomy and Fusion (ACDF) with bone grafting. The case was managed with adequate analgesia, replacement of fluids and Blood and Blood products. Considering complex cervical spine surgery and airway edema the patient was shifted to Surgical Intensive Care Unit (ICU) for elective ventilation and advanced monitoring. After serial ABG and proper weaning the patient was extubated next morning smoothly. Key Message: Extensive preoperative evaluation, planning, clinical judgement and skilled experienced personale are essential for proper execution of difficult airway cases.   Keywords: Chondrosarcoma, Difficult intubation, Fiberoptic intubation, Huge neck mass.

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