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    180 results match your criteria Case reports in anesthesiology[Journal]

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    Diagnosis and Thrombolytic Management of Massive Intraoperative Pulmonary Embolism Guided by Point of Care Transthoracic Echocardiography.
    Case Rep Anesthesiol 2018 4;2018:8709026. Epub 2018 Mar 4.
    Department of Anesthesiology, Perioperative Medicine, and Pain Management, University of Miami Miller School of Medicine, Miami, FL, USA.
    Perioperative pulmonary embolism can go undetected until the sudden onset of cardiopulmonary collapse. Point of care echocardiography in such setting can narrow the differential diagnosis of precipitous instability and facilitate tailored, rather than empiric, therapy in the event of a massive pulmonary embolism. We describe the diagnosis and successful multidisciplinary management of intraoperative massive pulmonary embolism aided by both transthoracic and transesophageal echocardiography. Read More

    Erector Spinae Plane Block for Different Laparoscopic Abdominal Surgeries: Case Series.
    Case Rep Anesthesiol 2018 18;2018:3947281. Epub 2018 Feb 18.
    Department of General Surgery, Maltepe University Faculty of Medicine, Istanbul, Turkey.
    The ultrasound guided erector spinae plane (ESP) block is a recent block described for various surgeries for postoperative analgesia. ESP block has effect on both visceral and somatic pain; therefore, its use in laparoscopic cholecystectomy and other abdominal surgeries can be advantageous. We describe successful ESP block application in three different cases for postoperative pain. Read More

    Anesthetic Considerations for an Adult Patient with Freeman-Sheldon Syndrome Undergoing Open Heart Surgery.
    Case Rep Anesthesiol 2018 13;2018:7862327. Epub 2018 Feb 13.
    Department of Anesthesiology and Critical Care Medicine, MediClin Heart Institute Lahr/Baden, Lahr, Germany.
    Freeman-Sheldon syndrome (FSS) or "whistling face" syndrome is a rare congenital disorder complicated by characteristic facial deformities and muscular contractures. We report on a 64-year-old male patient presenting for surgical replacement of his aortic valve and review the available literature on anesthetic considerations and perioperative management principles. FSS frequently poses a significant challenge to airway management and gaining vascular access. Read More

    Spinal Anaesthesia for Cesarean Section in a Patient with Vascular Type Ehlers-Danlos Syndrome.
    Case Rep Anesthesiol 2018 28;2018:1924725. Epub 2018 Jan 28.
    Department of Anesthesiology, Naval Medical Center Portsmouth, Portsmouth, VA, USA.
    We report the administration of spinal anaesthesia for cesarean delivery in a parturient with vascular Ehlers-Danlos syndrome. Parturients who genetically inherit this disorder are at risk for significant morbidity and mortality. Risks during pregnancy include premature labor, uterine prolapse, and uterine rupture. Read More

    Pulmonary Edema and Diastolic Heart Failure in the Perioperative Period.
    Case Rep Anesthesiol 2018 23;2018:5101534. Epub 2018 Jan 23.
    Department of Anesthesiology and Perioperative Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USA.
    Heart failure with preserved ejection fraction (HFPEF) is a diagnosis encountered with increasing frequency in the aging population. We present a case of postoperative pulmonary edema in 63-year-old male with HFPEF. This patient highlights the gap in risk stratification with respect to diastolic heart failure. Read More

    A Rare Central Venous Catheter Malposition in a 10-Year-Old Girl.
    Case Rep Anesthesiol 2018 23;2018:2658640. Epub 2018 Jan 23.
    Department of Anesthesiology and Critical Care, Dr. Ali Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
    Central venous catheters (CVCs) are placed in operating rooms worldwide via different approaches. Like any other medical procedure, CVC placement can cause a variety of complications. We report the case of an unexpected malposition of a catheter in the right internal jugular vein, where it looped back on itself during placement and went upward into the right internal jugular vein. Read More

    Ultrasound-Guided Interscalene Catheter Complicated by Persistent Phrenic Nerve Palsy.
    Case Rep Anesthesiol 2018 3;2018:9873621. Epub 2018 Jan 3.
    Department of Anesthesiology, The Ohio State University Wexner Medical Center, 410 W. 10th Ave., Columbus, OH 43210, USA.
    A 76-year-old male presented for reverse total shoulder arthroplasty (TSA) in the beach chair position. A preoperative interscalene nerve catheter was placed under direct ultrasound-guidance utilizing a posterior in-plane approach. On POD 2, the catheter was removed. Read More

    Unique Phrenic Nerve-Sparing Regional Anesthetic Technique for Pain Management after Shoulder Surgery.
    Case Rep Anesthesiol 2017 19;2017:1294913. Epub 2017 Dec 19.
    Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA.
    Background: Ipsilateral phrenic nerve blockade is a common adverse event after an interscalene brachial plexus block, which can result in respiratory deterioration in patients with preexisting pulmonary conditions. Diaphragm-sparing nerve block techniques are continuing to evolve, with the intention of providing satisfactory postoperative analgesia while minimizing hemidiaphragmatic paralysis after shoulder surgery.

    Case Report: We report the successful application of a combined ultrasound-guided infraclavicular brachial plexus block and suprascapular nerve block in a patient with a complicated pulmonary history undergoing a total shoulder replacement. Read More

    Inability to Utilize Retrograde Cardioplegia due to a Persistent Left Superior Vena Cava.
    Case Rep Anesthesiol 2017 3;2017:4671856. Epub 2017 Dec 3.
    Cardiothoracic Section, Department of Anesthesiology, Wake Forest School of Medicine, Medical Center Boulevard, Winston Salem, NC 27157-1009, USA.
    A persistent left superior vena cava is a congenital abnormality that affects a minority of the general population. While this finding is not hemodynamically significant in all patients, failure to recognize the altered anatomy in any of these patients can be consequential during procedures such as central venous catheter placement, pacemaker/defibrillator wire placement, and use of retrograde cardioplegia during cardiac surgery. We present a case of an intraoperative diagnosis of a persistent left superior vena cava that altered the original plan to arrest the heart using retrograde cardioplegia. Read More

    A Rare Complication of a TAP Block Performed after Caesarean Delivery.
    Case Rep Anesthesiol 2017 29;2017:1072576. Epub 2017 Oct 29.
    Department of Anesthesiology, Mount Sinai Medical Center of Florida, Miami Beach, FL 33139, USA.
    The transversus abdominis plane block is a regional anesthesia technique that has become popular. Being a relatively simple procedure, the TAP block has an excellent safety profile and major complications are rare. We present a case of transient femoral nerve palsy occurring after a TAP block with involvement of the sacral plexus for a patient who had undergone a caesarean section. Read More

    Conducting Prolonged General Anesthesia without Intravenous Access in a Child with Hypoplastic Left Heart Syndrome.
    Case Rep Anesthesiol 2017 17;2017:5604975. Epub 2017 Oct 17.
    Department of Anesthesiology, Rush University Medical Center, 1653 W. Congress Parkway, Jelke 7, Chicago, IL 60612, USA.
    Children with chronic medical conditions often need multiple intravenous (IV) access instances during their hospitalizations, both peripheral and central. Obtaining a working IV in this patient population undergoing general anesthesia can be challenging. In our case report, we describe a method of administering general anesthesia in an infant with partially repaired hypoplastic left heart syndrome without IV access. Read More

    An Undiagnosed Paraganglioma in a 58-Year-Old Female Who Underwent Tumor Resection.
    Case Rep Anesthesiol 2017 15;2017:5796409. Epub 2017 Oct 15.
    General, Vascular, Transplant Division, Department of Anesthesiology, Duke University Medical Center, Box 3823 Durham, NC 27710, USA.
    Paragangliomas and pheochromocytomas are rare neuroendocrine tumors that can have high morbidity and mortality if undiagnosed. Here we report a case of an undiagnosed paraganglioma in a 58-year-old female who underwent tumor resection. The patient became severely hypertensive intraoperatively with paroxysmal swings in blood pressure and then later became acutely hypotensive after tumor removal. Read More

    Dexmedetomidine as Part of a Multimodal Analgesic Treatment Regimen for Opioid Induced Hyperalgesia in a Patient with Significant Opioid Tolerance.
    Case Rep Anesthesiol 2017 25;2017:9876306. Epub 2017 Sep 25.
    Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, USA.
    Acute postoperative pain in patients with opioid tolerance creates a significant management challenge for anesthesiologists and pain medicine physicians. A multimodal approach is key; however other factors can complicate management such as opioid induced hyperalgesia. We present the case of a patient on large amounts of intrathecal opioids for chronic pain syndrome with opioid induced hyperalgesia after an exploratory laparotomy. Read More

    Previously Undiagnosed Spinal and Bulbar Muscular Atrophy as a Cause of Airway Obstruction after Robot-Assisted Laparoscopic Prostatectomy.
    Case Rep Anesthesiol 2017 17;2017:9780265. Epub 2017 Jul 17.
    Department of Anesthesiology and Pain Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.
    Background: Preoperative vocal cord paralysis is a risk factor for postoperative respiratory distress following extubation after general anesthesia. We present an unusual case where a geriatric patient developed airway obstruction after robot-assisted laparoscopic prostatectomy.

    Case Presentation: A 67-year-old male, who had suffered from left vocal cord paralysis of unknown etiology, was scheduled for robot-assisted laparoscopic prostatectomy (RALP). Read More

    Ultrasound-Guided Subclavian Vein Cannulation in Neonate via Supraclavicular Approach.
    Case Rep Anesthesiol 2017 9;2017:9789427. Epub 2017 Jul 9.
    Department of Anesthesiology & Pain Medicine, Dumlupinar University Hospital, Merkez, Kutahya, Turkey.
    Central venous cannulation of infants may be challenging. Ultrasonography is recommended and has been found superior to classic landmark technique in pediatric central venous cannulation. The cannulation of the subclavian vein using supraclavicular approach under real-time ultrasound guidance is a novel technique. Read More

    Ketamine Use for Successful Resolution of Post-ERCP Acute Pancreatitis Abdominal Pain.
    Case Rep Anesthesiol 2017 20;2017:7845358. Epub 2017 Jun 20.
    New York Medical College, Valhalla, NY, USA.
    We report a case in which a patient with intractable pain secondary to post-endoscopic retrograde cholangiopancreatography (ERCP) acute pancreatitis is successfully treated with a subanesthetic ketamine infusion. Shortly after ERCP, the patient reported severe stabbing epigastric pain. She exhibited voluntary guarding and tenderness without distension. Read More

    Discharge against Medical Advice in Surgical Patients with Posttraumatic Stress Disorder: A Case Report Series Illustrating Unique Challenges.
    Case Rep Anesthesiol 2017 21;2017:3045907. Epub 2017 Jun 21.
    VA Medical Center, Anesthesia Services, 4150 Clement Street, San Francisco, CA 94121, USA.
    Discharge against medical advice (DAMA) can have detrimental effects on patient outcomes. Recently, the diagnosis of posttraumatic stress disorder (PTSD) has been linked with DAMA in the setting. However, PTSD as a risk factor for DAMA in patients has not received much consideration, although such patients may be at risk for triggering or amplification of PTSD symptoms perioperatively. Read More

    Takotsubo Cardiomyopathy after Spinal Anesthesia for a Minimally Invasive Urologic Procedure.
    Case Rep Anesthesiol 2017 13;2017:8641641. Epub 2017 Jun 13.
    Department of Urology, University General Hospital of Heraklion, University of Crete, Medical School, Heraklion, Crete, Greece.
    We present the case of a patient who suffered from Takotsubo cardiomyopathy (TCM) immediately after the initiation of subarachnoid anesthesia for a minimally invasive urologic procedure (tension-free vaginal tape (TVT) surgery for stress urine incontinence). TCM mimics acute coronary syndrome and is caused by an exaggerated sympathetic reaction to significant emotional or physical stress. Our patient suffered from chest pain, palpitations, dyspnea, and hemodynamic instability immediately following subarachnoid anesthesia and later in the postanesthesia care unit. Read More

    Acute Abdominal Compartment Syndrome following Extraperitoneal Bladder Perforation.
    Case Rep Anesthesiol 2017 30;2017:3073160. Epub 2017 May 30.
    Austin Health, 145 Studley Road, Heidelberg, VIC 3084, Australia.
    Extraperitoneal bladder perforation is a known complication of a commonly performed rigid cystoscopy. If unrecognized, this complication can lead to continuous intra-abdominal fluid leakage with consequent organ function impairment and symptoms. This is the first case report in literature of a transurethral bladder perforation causing an acute abdominal compartment syndrome, which was subsequently managed conservatively with supportive management only. Read More

    Pneumomediastinum and Bilateral Pneumothoraces Causing Respiratory Failure after Thyroid Surgery.
    Case Rep Anesthesiol 2017 24;2017:8206970. Epub 2017 Apr 24.
    Anesthesiology, University of Denver School of Medicine, Aurora, CO, USA.
    We report the first case of severe respiratory failure after thyroid surgery requiring venovenous extracorporeal membrane oxygenation (vvECMO). The patient was a 41-year-old woman with metastatic thyroid cancer. She underwent thyroidectomy, including left lateral and bilateral central neck dissection. Read More

    Postoperative Airway Obstruction by a Bone Fragment.
    Case Rep Anesthesiol 2017 30;2017:4381819. Epub 2017 Mar 30.
    Department of Anesthesiology, VU University Medical Center, De Boelelaan 1117, 1007 MB Amsterdam, Netherlands.
    Postoperative airway obstructions are potentially life-threatening complications. These obstructions may be classified as (sagging tongue, laryngospasm, or bronchospasm), (airway swelling or hematoma within the airways), or . Various cases of airway obstruction by foreign bodies have previously been reported, for example, by broken teeth or damaged airway instruments. Read More

    Management of Residual Neuromuscular Blockade Recovery: Age-Old Problem with a New Solution.
    Case Rep Anesthesiol 2017 14;2017:8197035. Epub 2017 Mar 14.
    Department of Anesthesiology and Perioperative Medicine, Drexel University College of Medicine, 245 N. 15th Street, Suite 7502, MS 310, Philadelphia, PA 19102, USA.
    Neostigmine has been traditionally used as the agent of choice to reverse Neuromuscular Blockade (NMB) after muscle paralysis during general anesthesia. However, the use of neostigmine has not been without untoward events. Sugammadex is a novel drug that selectively binds to aminosteroid nondepolarizing muscle relaxants and reverses even a deep level of NMB. Read More

    Pitfalls in Interventional Pain Medicine: Hyponatremia after DDAVP for a Patient with Von Willebrand Disease Undergoing an Epidural Steroid Injection.
    Case Rep Anesthesiol 2017 14;2017:6467090. Epub 2017 Mar 14.
    Division of Medical Oncology, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS, USA.
    Desmopressin (DDAVP), a synthetic analog of vasopressin, has been used in patients with von Willebrand disease (VWD), mild hemophilia A, and platelet dysfunction to reduce the risk of bleeding associated with surgical and interventional procedures. We report the case of a patient with VWD presenting with a bulging disc and radicular pain that underwent transforaminal epidural steroid injections. Her course was complicated with the interval development of headaches and dizziness symptomatic of moderate hyponatremia, likely due to excessive fluid intake. Read More

    Effect of Arm Positioning on Entrapment of Infraclavicular Nerve Block Catheter.
    Case Rep Anesthesiol 2017 28;2017:7196340. Epub 2017 Feb 28.
    Department of Anesthesiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
    Continuous brachial plexus nerve block catheters are commonly inserted for postoperative analgesia after upper extremity surgery. Modifications of the insertion technique have been described to improve the safety of placing an infraclavicular brachial plexus catheter. Rarely, these catheters may become damaged or entrapped, complicating their removal. Read More

    In-Flight Hypoxemia in a Tracheostomy-Dependent Infant.
    Case Rep Anesthesiol 2017 28;2017:3210473. Epub 2017 Feb 28.
    Department of Anesthesiology, Educational Affairs, Vanderbilt University Medical Center, 2301 VUH, Nashville, TN 37232-7237, USA.
    Millions of passengers board commercial flights every year. Healthcare providers are often called upon to treat other passengers during in-flight emergencies. The case presented involves an anesthesia resident treating a tracheostomy-dependent infant who developed hypoxemia on a domestic flight. Read More

    The Anaesthesiologist and Palliative Care in a Newborn with the Adam "Sequence".
    Case Rep Anesthesiol 2017 23;2017:6230923. Epub 2017 Feb 23.
    Fluminense Federal University (UFF), Niteroi, RJ, Brazil.
    Reports focusing on biomedical principlism and the role of anaesthesiologists in palliative care are rare. We present the case of a newborn with multiple craniofacial anomalies and a diagnosis of ADAM "sequence," in which surgical removal of placental adhesions to the dura mater and the correction of meningocele was not indicated due to the very short life expectancy. After 48 hours, the odor from the placenta indicted a necrotic process, which prevented the parents from being close to the child and increased his isolation. Read More

    Anesthetic Considerations in a Patient with Myotonic Dystrophy for Hip Labral Repair.
    Case Rep Anesthesiol 2017 20;2017:6408956. Epub 2017 Feb 20.
    Department of Anesthesiology, New York-Presbyterian, Columbia University Medical Center, New York, NY, USA.
    Myotonic Dystrophy (DM) affects multiple organ systems. Disorders such as hyperthyroidism, progressive musculoskeletal weakness, cardiac dysrhythmias, hypoventilation, and cognitive-behavioral disorders may be present in these patients. Thorough preoperative assessment and anesthetic planning are required to minimize the risk of anesthetic complications. Read More

    From Bad to Worse: Paraganglioma Diagnosis during Induction of Labor for Coexisting Preeclampsia.
    Case Rep Anesthesiol 2017 18;2017:5495808. Epub 2017 Jan 18.
    Department of Anesthesiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
    Pheochromocytomas and extra-adrenal paragangliomas are catecholamine-secreting tumors that rarely occur in pregnancy. The diagnosis of these tumors in pregnancy can be challenging given that many of the signs and symptoms are commonly attributed to preeclampsia or other more common diagnoses. Early diagnosis and appropriate management are essential in optimizing maternal and fetal outcomes. Read More

    Surdity in the OR: An Unusual Case of Brainstem Anesthesia.
    Case Rep Anesthesiol 2017 9;2017:4645381. Epub 2017 Jan 9.
    Department of Anesthesiology, Miller School of Medicine, University of Miami, Miami, FL, USA.
    Brainstem anesthesia is a potentially life-threatening complication of regional ophthalmic anesthesia. This case report chronicles an unusual presentation of brainstem anesthesia following an eye block. The unique features of this case were the presenting symptoms of deafness and slurred speech in the absence of loss of consciousness, respiratory depression, or contralateral ophthalmoplegia. Read More

    Bilateral Intra-Articular Radiofrequency Ablation for Cervicogenic Headache.
    Case Rep Anesthesiol 2017 9;2017:1483279. Epub 2017 Jan 9.
    Department of Physical Medicine & Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
    . Cervicogenic headache is characterized by unilateral neck or face pain referred from various structures such as the cervical joints and intervertebral disks. A recent study of patients with cervical pain showed significant pain relief after cervical medial branch neurotomy but excluded patients with C1-2 joint pain. Read More

    Orotracheal Intubation Using the Retromolar Space: A Reliable Alternative Intubation Approach to Prevent Dental Injury.
    Case Rep Anesthesiol 2016 25;2016:3529415. Epub 2016 Dec 25.
    UT MD Anderson Cancer Center, Anesthesiology & Perioperative Medicine, 1400 Holcombe Blvd, Unit 409, Houston, TX 77030, USA.
    Despite recent advances in airway management, perianesthetic dental injury remains one of the most common anesthesia-related adverse events and cause for malpractice litigation against anesthesia providers. Recommended precautions for prevention of dental damage may not always be effective because these techniques involve contact and pressure exerted on vulnerable teeth. We describe a novel approach using the retromolar space to insert a flexible fiberscope for tracheal tube placement as a reliable method to achieve atraumatic tracheal intubation. Read More

    Epidural Catheter Migration in a Patient with Severe Spinal Stenosis.
    Case Rep Anesthesiol 2016 20;2016:6124086. Epub 2016 Dec 20.
    Acute Pain Service, Department of Anesthesiology, University of Rochester School of Medicine and Dentistry, 601 Elmwood Ave, P.O. Box 604, Rochester, NY 14642, USA.
    Establishment of appropriate neuraxial catheter positioning is typically a straightforward procedural undertaking. It can, however, lead to deception of even the most experienced clinician and occur despite the most meticulous attention to detail. Written and verbal consent were obtained from the patient to prepare, discuss, and publish this case report; we describe the occurrence of what we believe was the intraoperative migration of an epidural catheter in the setting of significant tissue changes resulting from a previous spinal fusion. Read More

    Unilateral Vocal Cord Paralysis following Insertion of a Supreme Laryngeal Mask in a Patient with Syndrome.
    Case Rep Anesthesiol 2016 27;2016:8185628. Epub 2016 Nov 27.
    Department of Anesthesiology, Intensive Care and Pain Medicine, Catharina Ziekenhuis, Eindhoven, Netherlands.
    Since its introduction in 1988 by Dr. Archie Brain, the laryngeal mask airway (LMA) is being used with increasing frequency. Its ease of use has made it a very popular device in airway management and compared to endotracheal intubation it is less invasive. Read More

    High Dose, Prolonged Epsilon Aminocaproic Acid Infusion, and Recombinant Factor VII for Massive Postoperative Retroperitoneal Hemorrhage following Splenectomy.
    Case Rep Anesthesiol 2016 10;2016:1630385. Epub 2016 Nov 10.
    Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, USA.
    The antifibrinolytic agent -aminocaproic acid is used to decrease procedural blood loss in a variety of high risk surgeries. The utility of recombinant factor VII administration in massive hemorrhage has also been reported in a variety of settings, though the impact in a surgical context remains unclear. We describe the case of a patient who underwent massive open splenectomy and developed diffuse retroperitoneal bleeding on postoperative day one. Read More

    Perioperative Severe Hypotension in a Patient with Multiple Endocrine Neoplasia Type IIb and Bilateral Adrenalectomies: Time to Review the Evidence for Stress Dose Steroids.
    Case Rep Anesthesiol 2016 9;2016:8153296. Epub 2016 Nov 9.
    Department of Anesthesiology and Perioperative Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
    Multiple endocrine neoplasia type IIb (MEN IIb) is an endocrine disorder which can manifest with tumors such as pheochromocytomas and neuromas. We present the case of a patient with MEN IIb, after bilateral adrenalectomies, on maintenance steroid replacement, who underwent a neuroma resection and developed severe hypotension. There is persistent controversy regarding the general administration of perioperative "stress dose" steroids for patients with adrenal insufficiency. Read More

    An Unusual Lacerated Tracheal Tube during Le Fort Surgery: Literature Review and Case Report.
    Case Rep Anesthesiol 2016 8;2016:6298687. Epub 2016 Nov 8.
    Perelman School of Medicine at the University of Pennsylvania and the Children's Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA 19104, USA.
    Maxillofacial surgeries can present unique anesthetic challenges due to potentially complex anatomy and the close proximity of the patient's airway to the surgical field. Damage to the tracheal tube (TT) during maxillofacial surgery may lead to significant airway compromise. We report the management of a patient with a partially severed TT during Le Fort surgery for midfacial hypoplasia and management strategies based on peer-reviewed literature. Read More

    Cardiac Arrest after Local Anaesthetic Toxicity in a Paediatric Patient.
    Case Rep Anesthesiol 2016 31;2016:7826280. Epub 2016 Oct 31.
    Edgard Santos Professor University Hospital, Federal University of Bahia, Salvador, BA, Brazil.
    We report a case of a paediatric patient undergoing urological procedure in which a possible inadvertent intravascular or intraosseous injection of bupivacaine with adrenaline in usual doses caused subsequent cardiac arrest, completely reversed after administration of 20% intravenous lipid emulsion. Early diagnosis of local anaesthetics toxicity and adequate cardiovascular resuscitation manoeuvres contribute to the favourable outcome. Read More

    Ultrasound-Guided Genicular Nerve Thermal Radiofrequency Ablation for Chronic Knee Pain.
    Case Rep Anesthesiol 2016 16;2016:8292450. Epub 2016 Oct 16.
    Divisions of Pain Medicine, Regional Anesthesia & Liver Transplant Anesthesia, Columbia University Medical Center, Department of Anesthesiology, New York, NY, USA; Kaiser Permanente, San Francisco, CA, USA; Anesthesiology, Perioperative & Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA.
    Osteoarthritis (OA) of the knee is one of the most common joint diseases affecting adults in the United States. For elderly patients with multiple medical comorbidities who do not wish to undergo total knee arthroplasty (TKA), lifestyle modification, pharmacologic management, and injections are the mainstay of therapy. Previously, pain management interventions were limited to intra-articular joint injections and viscosupplementation with hyaluronic acid. Read More

    Ultrasound-Guided Femoral and Sciatic Nerve Blocks for Repair of Tibia and Fibula Fractures in a Bennett's Wallaby ().
    Case Rep Anesthesiol 2016 10;2016:8909205. Epub 2016 Oct 10.
    Department of Clinical Sciences and Services, Royal Veterinary College, University of London, Hatfield, Hertfordshire AL97TA, UK.
    Locoregional anesthetic techniques may be a very useful tool for the anesthetic management of wallabies with injuries of the pelvic limbs and may help to prevent capture myopathies resulting from stress and systemic opioids' administration. This report describes the use of ultrasound-guided femoral and sciatic nerve blocks in Bennett's wallaby () referred for orthopaedic surgery. Ultrasound-guided femoral and sciatic nerve blocks were attempted at the femoral triangle and proximal thigh level, respectively. Read More

    An Unexpected Airway Complication in a Male Patient with Goltz Syndrome.
    Case Rep Anesthesiol 2016 18;2016:4659891. Epub 2016 Sep 18.
    Penn State Hershey Anesthesia, 500 University Drive, H187, Hershey, PA 17033, USA.
    Goltz syndrome, also known as focal dermal hypoplasia, is a rare X-linked dominant multisystem syndrome presenting with cutaneous, skeletal, dental ocular, central nervous system and soft tissue abnormalities. This case report discusses an adult male patient with Goltz syndrome that was noted to have large, papillomatous, hypopharyngeal lesions upon induction of general anesthesia. We highlight challenges with airway management intraoperatively and postoperatively in patients with Goltz syndrome. Read More

    Bronchoesophageal Fistula Stenting Using High-Frequency Jet Ventilation and Underwater Seal Gastrostomy Tube Drainage.
    Case Rep Anesthesiol 2016 8;2016:8175127. Epub 2016 Sep 8.
    Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, No. 1, Youyi Road, Yuanjiagang, Yuzhong District, Chongqing 400016, China.
    Managing a patient scheduled for bronchoesophageal fistula repair is challenging for the anesthetist. If appropriate ventilation strategy is not employed, serious complications such as hypoxemia, gastric distension, and pulmonary aspiration can occur. We present the case of a 62-year-old man with a bronchoesophageal fistula in the left main stem bronchus requiring the insertion of a Y-shaped tracheobronchial stent through a rigid bronchoscope, under general anesthesia. Read More

    Epidural Analgesia with Ropivacaine during Labour in a Patient with a SCN5A Gene Mutation.
    Case Rep Anesthesiol 2016 7;2016:9278409. Epub 2016 Sep 7.
    Department of Anesthesiology, Erasmus University Medical Centre, Rotterdam, Netherlands.
    SCN5A gene mutations can lead to ion channel defects which can cause cardiac conduction disturbances. In the presence of specific ECG characteristics, this mutation is called Brugada syndrome. Many drugs are associated with adverse events, making anesthesia in patients with SCN5A gene mutations or Brugada syndrome challenging. Read More

    Epidural Anesthesia Complicated by Subdural Hygromas and a Subdural Hematoma.
    Case Rep Anesthesiol 2016 29;2016:5789504. Epub 2016 Aug 29.
    Monash Health, 246 Clayton Road, Clayton, Melbourne, VIC 3168, Australia.
    Inadvertent dural puncture during epidural anesthesia leads to intracranial hypotension, which if left unnoticed can cause life-threatening subdural hematomas or cerebellar tonsillar herniation. The highly variable presentation of intracranial hypotension hinders timely diagnosis and treatment. We present the case of a young laboring adult female, who developed subdural hygromas and a subdural hematoma following unintentional dural puncture during initiation of epidural anesthesia. Read More

    Anesthetic Management of a Surgical Patient with Chronic Renal Tubular Acidosis Complicated by Subclinical Hypothyroidism.
    Case Rep Anesthesiol 2016 28;2016:2434381. Epub 2016 Aug 28.
    Department of Anesthesiology, National Hospital Organization Tokyo Medical Center, 2-5-1 Higashigaoka, Meguro-ku, Tokyo 152-8902, Japan.
    A 53-year-old man with chronic renal tubular acidosis and subclinical hypothyroidism underwent lower leg amputation surgery under general anesthesia. Perioperative acid-base management in such patients poses many difficulties because both pathophysiologies have the potential to complicate the interpretation of capnometry and arterial blood gas analysis data; inappropriate correction of chronic metabolic acidosis may lead to postoperative respiratory deterioration. We discuss the management of perioperative acidosis in order to achieve successful weaning from mechanical ventilation and promise a complete recovery from anesthesia. Read More

    A Rare Case of C2 Sensory Blockade with Preserved Phrenic Nerve Function in an Obstetric Patient.
    Case Rep Anesthesiol 2016 31;2016:3064373. Epub 2016 Jul 31.
    Department of Anesthesiology, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA.
    High neuraxial blockade is a serious complication in obstetric patients and requires prompt recognition and management in order to optimize patient outcomes. In cases of high neuroblockade, patients may present with significant hypotension, dyspnea, agitation, difficulty speaking or inability to speak, or even loss of consciousness. We report the unusual presentation of an obstetric patient that remained hemodynamically stable and had the preserved ability to initiate breaths despite sensory blockade up to C2. Read More

    The Auscultation of a Carbon Dioxide Embolization Event during Endoscopic Vein Harvest.
    Case Rep Anesthesiol 2016 31;2016:6947679. Epub 2016 May 31.
    Department of Anesthesiology, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
    Endoscopic vein harvest in preparation for coronary artery bypass surgery has become a preferred method of procuring saphenous vein. Several case reports have documented carbon dioxide (CO2) embolization with this procedure as well as CO2 embolization during other laparoscopic surgeries (Markar et al., 2010). Read More

    Sedation Monitoring and Management during Percutaneous Endoscopic Lumbar Discectomy.
    Case Rep Anesthesiol 2016 19;2016:3931567. Epub 2016 May 19.
    Anesthesiology and Reanimation Department, Ankara Ataturk Training and Research Hospital, 06800 Ankara, Turkey.
    Percutaneous endoscopic laser discectomy (PELD) is a painful intervention that requires deep sedation and analgesia. However, sedation should be light at some point because cooperation by the patient during the procedure is required for successful surgical treatment. Light sedation poses a problem for endotracheal intubation, while patients placed in the prone position during percutaneous endoscopic discectomy pose a problem for airway management. Read More

    Thoracic Paravertebral Block, Multimodal Analgesia, and Monitored Anesthesia Care for Breast Cancer Surgery in Primary Lateral Sclerosis.
    Case Rep Anesthesiol 2016 21;2016:6301358. Epub 2016 Apr 21.
    Anesthesiology and Pain Management, Columbia University Medical Center, 622 West 168th Street, PH 5, New York, NY 10032, USA.
    Objective. Primary lateral sclerosis (PLS) is a rare idiopathic neurodegenerative disorder affecting upper motor neurons and characterized by spasticity, muscle weakness, and bulbar involvement. It can sometimes mimic early stage of more common and fatal amyotrophic lateral sclerosis (ALS). Read More

    Anesthesiological Management of a Patient with Williams Syndrome Undergoing Spine Surgery.
    Case Rep Anesthesiol 2016 16;2016:1371095. Epub 2016 Mar 16.
    Anestesia e Rianimazione Pediatrica, Azienda Ospedaliero-Universitaria "Ospedali Riuniti Umberto I-G. M. Lancisi-G. Salesi", 60126 Ancona, Italy.
    Williams Syndrome (WS) is a complex neurodevelopmental disorder associated with a mutation on chromosome 7. Patients with WS usually display dysmorphic facial and musculoskeletal features, congenital heart diseases, metabolic disturbances and cognitive impairment. Structural cardiovascular abnormalities are present in the majority of the children and may provide a substrate for perioperative Sudden Cardiac Death, as presented by several reports, something that creates a great challenge to the anesthetic conduct. Read More

    Use of an Esophageal Heat Exchanger to Maintain Core Temperature during Burn Excisions and to Attenuate Pyrexia on the Burns Intensive Care Unit.
    Case Rep Anesthesiol 2016 25;2016:7306341. Epub 2016 Feb 25.
    Welsh Centre for Burns, Morriston Hospital, Swansea SA6 6NL, UK.
    Introduction. Burns patients are vulnerable to hyperthermia due to sepsis and SIRS and to hypothermia due to heat loss during excision surgery. Both states are associated with increased morbidity and mortality. Read More

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