Dr Paulose

World Class ENT Plastic and Laser Surgeon

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Gilbert’s Syndrome – Anesthesia Issues


Gilbert’s syndrome is a genetic disorder with mild jaundice from time to time. It is usually harmless and does not require treatment. It is due to a reduced amount of a chemical in the liver which processes a breakdown product of blood cells, called bilirubin. It is caused by relative deficiency of glucuronyl transferase in the liver.Many anesthetic drugs metabolized in the liver through this pathway can potentially accumulate leading to adverse outcomes.
Dr Thomas , the senior anesthetist explains the issues of giving GA in such a patient who undergoes nasal surgery.

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Anesthesia (Intubation) in a Gilbert’s Syndrome Patient


Gilbert’s syndrome, caused by relative deficiency of glucuronyl transferase is the commonest cause of congenital hyperbilirubinemia -Jaundice.
It is important for the anesthesiologist to understand conditions leading to decreased glucuronosyl transferase activity in Gilbert’s syndrome patients to be submitted to anesthesia, to prevent intraoperative toxicity.
GA intubation in such a patient who under goes nasal surgery.

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feeling lump of being stuck in the throat-Globus pharygeus


Chronic eosinophilia with nasal allergy is a well-recognized in ENT practice.Allergic rhinitis is a very common disorder with nasal obstruction and sneezing. Many surgical options exist for the treatment of allergic rhinitis, directed primarily at the underlying nasal obstructive component. Diathermy of the inferior turbinates help these patients to large extent.

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