Jehovah's Witness patients who require an operation represent a challenge to the physician because of the patients' refusal to accept a blood transfusion. We report 5 years experience with a consecutive series of 12 Jehovah's Witness patients in the Obstetric & Gynecological department who underwent operation. In 12 cases, death ensued in one patient who underwent subtotal hysterectomy for ectopic pregnancy. The cause of death was severe anemia & complicated respiratory problems. We discussed the problem of elective & emergency operations on Jehovah's Witness patients. Anesthesiologists must understand legal aspects, as well as and ethical, if they are to conduct their practice as an art as well as science.
Anemia ; Blood Transfusion* ; Cause of Death ; Disulfiram* ; Emergencies ; Female ; Humans ; Hysterectomy ; Jurisprudence ; Pregnancy ; Pregnancy, Ectopic

It is a well known fact that the major craniofacial operation is a complicated procedure. In this procedure, the operative period is extremely long and blood loss is large, extremely difficult to estimate and continuous into the early postoperative period. The air was should be protected intraoperatively and postoperatively due to frequent airway obstruction. We had experienced of an anesthetic management for correction of hypertelorism. Anesthetic management of this case should focus on reduction intracranial pressure and volume. WE had performed neurolept anesthesia with controlled hyperventilation. The careful monitoring and frequent measuring of blood gas analysis, hematocrit, hourly urine output, electrolytes, body temperature, CVP, ECG, and acid-base balance status are recommended. We report a case of anesthetic management for a patient.
Acid-Base Equilibrium ; Airway Obstruction ; Anesthesia ; Blood Gas Analysis ; Body Temperature ; Electrocardiography ; Electrolytes ; Hematocrit ; Humans ; Hypertelorism* ; Hyperventilation ; Intracranial Pressure ; Postoperative Period

We have experienced the anesthetic management of bilateral adrenalectomy in a 17 years old male, who was diagnosed as Cushing's syndrome. Anesthetic problems in Cushing`s Syndrome are hypertension, tachrcardia, hyperglycemia, hypokalemia and acute adrenal insufficiency. Therefore anesthetic management of this disease should focus on the through understanding of pathophysiology and adequate control of preoperative condition. Careful monitoring of the patient and frequent measurement of electrolytes and acid base balance status during the operation are also needed. We report the case of anesthetic experience of Cushing`s Syndrome and review anesthetic choice and management for better outcome of the patient.
Acid-Base Equilibrium ; Adolescent ; Adrenal Insufficiency ; Adrenalectomy ; Cushing Syndrome ; Electrolytes ; Humans ; Hyperglycemia ; Hypertension ; Hypokalemia ; Male

BACKGROUND: The purpose of this study is to assess the risk of hemorrhage from coexisting unsecured, unruptured aneurysms during hypervolemic hypertensive therapy after treatment for ruptured aneurysms in patients with multiple intracranial aneurysms. METHODS: From 1995 to 2004, the authors treated 1052 patients of ruptured and unruptured aneurysms, in which 201 patients had multiple aneurysms. Of the 201 patients, 45 patients had unsecured, unruptured aneurysms after the initial treatment of ruptured aneurysms. We performed retrospective analysis for these 45 patients' data including the characteristics of unsecured, unruptured aneurysms at risk, hemodynamic parameters and duration of hypervolemic hypertensive therapy. RESULTS: The total number of aneurysms for the 45 patients was 103, where 53 aneurysms were secured at the acute period of post-subarachnoid hemorrhage. Twenty nine out of 45 patients with unsecured, unruptured aneurysms after treatment of ruptured aneurysms had been managed with hypervolemic hypertensive therapy for symptomatic cerebral vasospasm. These 29 patients harbored 30 aneurysms. In 29 patients with hypervolemic hypertensive therapy, the mean systolic blood pressure was 181.4+/-20.7 mm Hg, the mean central venous pressure 12.5+/-2.2 mm Hg, and the mean duration of hypervolemic hypertensive therapy was 10.2+/-5.1 days. There was no hemorrhage from the 50 unsecured, unruptured aneurysms in all 45 patients with or without hypervolemic hypertensive therapy. CONCLUSION: It is presumed that the advantage of hypervolemic hypertensive therapy in the patients with symptomatic vasospasm after surgery of ruptured aneurysms endorses its use, even in the presence of unsecured, unruptured aneurysms in patients with multiple aneurysms.
Aneurysm* ; Aneurysm, Ruptured ; Blood Pressure ; Central Venous Pressure ; Hemodynamics ; Hemorrhage ; Humans ; Hypertension ; Intracranial Aneurysm* ; Retrospective Studies ; Subarachnoid Hemorrhage ; Vasospasm, Intracranial