• Fractured cervical spine and aortic transection.

      Griffin, M J; Harnett, M; Kenefick, P; Department of Anaesthesia and Intensive Care, Cork University Hospital, Wilton,, Ireland. (2012-02-03)
      A 17-year-old victim of a road traffic accident presented. Following investigation diagnoses of fractured first cervical vertebra, aortic transection, diffuse cerebral oedema, fractured right ribs 2-4 and pubic rami were made. Management of this case presented a number of anaesthetic dilemmas: management of the airway, use of cross-clamp vs. shunting or heparinization and bypass, cardiovascular and neurological monitoring, maintenance of cardiovascular stability during and post cross-clamp, minimizing the risk of post-operative renal and neurological dysfunction.
    • Train of four fade in a child with stiff baby syndrome.

      Murphy, C; Shorten, G; Department of Anaesthesia and Intensive Care Medicine, Cork University Hospital, and University College Cork, Ireland. (2012-02-03)
      A case is described of a child with stiff baby syndrome who underwent open reduction and femoral shortening of congenital dislocated hip under general anaesthesia. Neuromuscular function was measured electromyographically and demonstrated a great degree of train of four fade (57%) after sevoflurane inhalational induction of anaesthesia. The response to suxamethonium (2 mg x kg(-1)) was normal. The neuromuscular response to volatile anaesthetic agents and suxamethonium may be abnormal in these children with stiff baby syndrome and intraoperative neuromuscular monitoring is recommended.