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FCA Part II Anaesthetic Refresher Course University of The FCA Part II Anaesthetic Refresher 2017Course Department of Anaesthesia University of the Witwatersrand SUPPLEMENT COVER.indd 1 2017/05/09 11:32 AM ContentsContents South Afr J Anaesth Analg • 2017 • Volume 23 • Number 2 • Supplement 1 • Peribulbar (extraconal) eye block and its complications S3 KK Purbhoo ..................................................................................................................................... • Molar pregnancies with a focus on the thyroid S7 F Bham ............................................................................................................................................. • Cerebral perfusion monitoring during non-neurosurgical procedures: The practicalities of Near Infrared Spectroscopy (NIRS)/Bispectral Index (BIS) S12 M Mphomane ................................................................................................................................. FCA Part II • Anaesthesia for related living donor liver transplantation S15 Anaesthetic M Hatchett ...................................................................................................................................... • The bleeding parturient: anaesthetic perspective S18 Refresher D Nel ................................................................................................................................................. • Carcinoid syndrome S26 Course 2017 MA Eagar ......................................................................................................................................... • Analgesia for thoracic surgery S31 NT Hlongwane-Gukuta ................................................................................................................ • Extracorporeal Membrane Oxygenation (ECMO) S36 A Alli .................................................................................................................................................. • Anaesthetic considerations for inhaled and ingested foreign bodies in children: What? Where? When? S42 AZ Bhettay ....................................................................................................................................... • Anaesthesia for audiology brainstem response testing in children with autism spectrum disorders S46 MR Correia ....................................................................................................................................... • Anaesthesia for craniosynotosis surgery S53 D Lines .............................................................................................................................................. • Anaesthesia for thoracoscopy in paediatric patients S59 S Spijkerman ................................................................................................................................... • Mediastinoscopy in paediatric patients S65 S Spijkerman ................................................................................................................................... • The obese parturient S70 E Mostert .......................................................................................................................................... • Laryngospasm in anaesthesia S74 S Spijkerman ................................................................................................................................... • Epilepsy and anaesthesia S81 C Hosking ............................................................................................................................................ • Neonatal eye surgery S84 KL Borrill ............................................................................................................................................ • Conventional cardiopulmonary bypass and mini-cardiopulmonary bypass S87 MEA Kemp ....................................................................................................................................... • Posterior of fossa surgery S92 MMA Mashinini .............................................................................................................................. FCA Part II Anaesthetic Refresher 2017Course Department of Anaesthesia University of the Witwatersrand SUPPLEMENT COVER.indd 1 2017/05/09 11:32 AM Contents • The anaesthetist’s role in the endoscopy suite S98 C Quan ............................................................................................................................................. • Inadvertent burns in the theatre S103 EE Oosthuizen ................................................................................................................................ • The postoperative management of a supraventricular tachyarrhythmia S106 HJ Moutlana .................................................................................................................................... • A study of perioperative deaths in Charlotte Maxeke Johannesburg Academic Hospital, a South African level four central hospital S110 C Lundgren, P Cleaton-Jones ....................................................................................................... • Anaesthetic considerations for children with malignancies S114 C Lee .................................................................................................................................................. • Can you sedate a child for a dental procedure? S119 BM Gardner ...................................................................................................................................... • Anaesthesia in pregnancy for non-obstetric surgery S123 FCA Part II NR Madima ...................................................................................................................................... • Anaesthesia for cleft lip and palate surgery Anaesthetic S128 A Oosthuizen ................................................................................................................................... Refresher • New concepts in anaesthetic emergence S134 AW Moodley .................................................................................................................................... Course 2017 • Three-stage oesophagectomy S138 ME Sethusa ...................................................................................................................................... • Managing an acute pulmonary embolism on the table S140 E Welch .............................................................................................................................................. • Clinical use of nerve stimulators S143 E Welch .............................................................................................................................................. • Anaesthesia for a patient with Achondroplasia presenting for Caesarean section S147 T Kleyenstuber ................................................................................................................................. • Anaesthetic management in paediatric burns S149 P N Mogane ..................................................................................................................................... © 2017 SASA. Unless otherwise stated, opinions expressed in the editorial columns of SAJAA should not be taken as reflecting official SASA policy. The appearance of advertising in this publication does not denote a guarantee or an endorsement by SASA of the products or the claims made for the products by the manufactures. Southern African Journal of Anaesthesia and Analgesia 2017; 23(2)(Supplement 1) South Afr J Anaesth Analg ISSN 2220-1181 EISSN 2220-1173 Open Access article distributed under the terms of the © 2017 The Author(s) Creative Commons License [CC BY-NC-ND 4.0] http://creativecommons.org/licenses/by-nc-nd/4.0 FCA 2 REFRESHER COURSE Peribulbar (extraconal) eye block and its complications K K Purbhoo Department of Anaesthesia, Helen Joseph Hospital, University of the Witwatersrand Correspondence to: [email protected] Local anaesthesia is preferred over general anaesthesia by Type of anaesthesia chosen many ophthalmic surgeons with the main reasons being lower This would depend on: perioperative morbidity with quicker patient recovery and fewer 1. The type of surgery complications.1–3 2. The surgeon’s preference Anaesthetists have become increasingly involved in eye blocks 3. Patient’s suitability, and that were previously performed by surgeons. Good anaesthesia 4. Patient cooperation is essential for the performance of safe intraocular surgery and may contribute to the success or failure of the surgery.4,5 Preoperative considerations A routine preoperative assessment has to be done to ensure that Goals of anaesthetic care during elective eye surgery co-morbid conditions are reasonably well controlled. 1. Anaesthesia of the globe, lids and adnexa ensuring pain-free A focused medical history needs to be taken and should include surgery a history determining if the patient is a suitable candidate for 2. Akinesia of the globe and lids facilitating the surgical same day surgery.6 A history of anticoagulant or antithrombotic procedure, and therapies is vital. Patients having cataract surgery that are at a 3. Rapid recovery with adequate postoperative analgesia4,5 high risk of clotting and embolic complications due to cardiac or vascular pathology should continue therapeutic doses of aspirin Anaesthetic techniques available: and warfarin throughout the perioperative period.7,8 There is, Anaesthesia for eye surgery Local
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