Twitter Hashtags for Anesthesiologists: Building Global Communities
Twitter is a social media platform that has been encouraged for use among anesthesiologists as a way to stimulate conversation, distribute research, enhance conference experiences, and expand journal club sessions. We aimed to establish the typical baseline use of hashtags that are not related to events such as conferences. Systematic searches were performed on Twitter, as well as through hashtag-tracking services, to identify actively used anesthesia-related hashtags. The most frequently used general anesthesia hashtags were #anesthesia and #anaesthesia. The most popular and relevant hashtags within anesthesia subspecialt...
Source: A&A Case Reports - January 15, 2019 Category: Anesthesiology Tags: Educational Tool Source Type: research

Postdural Puncture Headache in a Postpartum Female With Previous Spinal Surgery—Successful Treatment With Caudal Epidural Blood Patch: A Case Report
The occurrence of a postdural puncture headache (PDPH) is a known risk associated with epidural procedures. The primary nonconservative treatment option for PDPH is the performance of an epidural blood patch. This case report describes the use of image guidance for placement of a caudal epidural to treat a PDPH in a postpartum patient. A caudal catheter was placed under real-time guidance and visualization of the deposition of the blood was obtained. By entering via the caudal foramen and utilizing a catheter, manipulations in catheter placement could be performed to adjust deposition of the blood. (Source: A&A Case Reports)
Source: A&A Case Reports - January 15, 2019 Category: Anesthesiology Tags: Case Reports Source Type: research

Novel Preoxygenation Technique to Deliver High-Flow Oxygen in a Patient With Facial Trauma: A Case Report
This study supports the use of this novel Optiflow-tracheostomy mask fusion device in appropriately selected cases. (Source: A&A Case Reports)
Source: A&A Case Reports - January 15, 2019 Category: Anesthesiology Tags: Case Reports Source Type: research

Spinal Cord Stimulation as Treatment for Truncal Chronic Regional Pain Syndrome After Cardiac Surgery: A Case Report
A 59-year-old man presented 7 months after coronary artery bypass with continued bilateral axillary pain. His symptoms progressed over a period of months to allodynia, edema, erythema, decreased range of motion, and skin changes consistent with complex regional pain syndrome type I. After failing multiple treatment options, the patient underwent a trial of spinal cord stimulation. Leads positioned in the posterior epidural space from the seventh cervical to the third thoracic vertebral levels resulted in complete paresthesia coverage of his truncal chronic regional pain syndrome (CRPS) and the stimulation was associated wi...
Source: A&A Case Reports - January 15, 2019 Category: Anesthesiology Tags: Case Reports Source Type: research

Electricity: How Much for the Contemporary Tertiary Care Operating Room? A Case Report
Surgery requires many electrically driven devices. Three events occurred recently in an operating room (OR) suite circa the 1980s wherein circuit breakers tripped due to overloaded circuits. This led to us to (1) increase OR electric capacity; (2) record each instrument’s power requirements, map their OR location, and determine when during surgery they were used; (3) provide users with instruction and diagrams into which outlet to plug each instrument. When introducing surgeries requiring devices, especially with high electrical power (current or amperage) demands, or renovating older or planning new ORs, it is impor...
Source: A&A Case Reports - January 15, 2019 Category: Anesthesiology Tags: Case Reports Source Type: research

Methylnaltrexone-Associated Bowel Perforation in Postoperative Opioid-Induced Constipation and Ogilvie Syndrome: A Case Report
We report the case of an opioid-dependent 56-year-old man who underwent lumbar decompression for spinal stenosis. Postoperatively, he developed OIC and Ogilvie syndrome, then following treatment with methylnaltrexone experienced an acute bowel perforation. We briefly review the recommended management of OIC as well as indications and contraindications of methylnaltrexone and similar new medications. (Source: A&A Case Reports)
Source: A&A Case Reports - January 15, 2019 Category: Anesthesiology Tags: Case Reports Source Type: research

The Role of ECMO in the “At-Risk” Tracheal Extubation: A Case Report
We present the extubation of a patient with severe ankylosing spondylitis after cervical spine surgery. We discuss the use of extracorporeal membrane oxygenation (ECMO) in this “at-risk” extubation, where our ability to oxygenate was uncertain and reintubation was predicted to be difficult. To our knowledge, ECMO has not previously been used in this context. We suggest preparing ECMO for rescue oxygenation when all other fundamental oxygenation techniques are predicted to be difficult or impossible. ECMO could be included in airway management and extubation guidelines. (Source: A&A Case Reports)
Source: A&A Case Reports - January 15, 2019 Category: Anesthesiology Tags: Case Reports Source Type: research

Transesophageal Echocardiographic Observation of Caval Thrombus Followed by Intraoperative Placement of Inferior Vena Cava Filter for Presumed Pulmonary Embolism During Cesarean Hysterectomy for Placenta Percreta: A Case Report
During a cesarean hysterectomy for placenta percreta, transesophageal echocardiography was used to monitor volume status and guide resuscitation. After delivery of the neonate but before massive surgical hemorrhage, a thrombus appeared in the inferior vena cava. Roughly 3 hours later, the patient had hemodynamic changes consistent with an intraoperative pulmonary embolism. Boluses of epinephrine stabilized the patient. An inferior vena cava filter was placed via an in situ internal jugular central venous cannula to prevent further embolic events. We believe transesophageal echocardiography is a useful monitor during surger...
Source: A&A Case Reports - January 15, 2019 Category: Anesthesiology Tags: Case Reports Source Type: research

Ultrasonographic Diagnosis for Dysfunction of the Diaphragm After Iatrogenic Tension Pneumoperitoneum by a Gastrointestinal Endoscopic Procedure: A Case Report
We present a case of diaphragm dysfunction caused by an excessive pneumoperitoneum in a 65-year-old woman. Her abdomen became distended during endoscopic investigation and circulatory failure occurred. A computed tomography scan revealed excessive pneumoperitoneum. Urgent laparotomy was performed to repair gastric perforation. Tracheal extubation was successfully performed in the intensive care unit. After extubation, a paradoxical breathing pattern appeared in addition to tachypnea. A diagnosis of dysfunction of the bilateral diaphragm was made by ultrasonography. Although nasal high-flow cannula therapy was required for ...
Source: A&A Case Reports - January 15, 2019 Category: Anesthesiology Tags: Case Reports Source Type: research

Real-Time Assessment of Renal Venous Flow by Transesophageal Echography During Cardiac Surgery
No abstract available (Source: A&A Case Reports)
Source: A&A Case Reports - January 1, 2019 Category: Anesthesiology Tags: Echo Rounds Source Type: research

Combining Videolaryngoscopy With Fiber-Optic Orotracheal Intubation for Inclusion in the Nonemergency Pathway of the Difficult Airway Algorithm
As technology progresses, our clinical treatment options rise steadily. We are comfortable now with the handling of ready-to-use high-quality videolaryngoscopes and fiber optics, and there is increasing knowledge and practice that the combination of these 2 techniques has a high “rescue rate” in situations when fiber-optic intubation or videolaryngoscopic intubation fails. Therefore, we would recommend to specifically include this technique in the “difficult airway algorithm—nonemergency pathway,” so it comes routinely into mind when faced with a “can ventilate, but cannot intubate&rdquo...
Source: A&A Case Reports - January 1, 2019 Category: Anesthesiology Tags: Innovation Source Type: research

Unilateral Rhinorrhea and Sneezing After Upper Gastrointestinal Endoscopy Under Intravenous Propofol Sedation With Supplemental Oxygen Administered via a Nasal Cannula: A Case Report
We present a rarely described complication of unilateral rhinorrhea and sneezing in a patient who received intravenous sedation with propofol and supplemental oxygen via a nasal cannula during upper gastrointestinal endoscopy. The literature is reviewed and a mechanism is proposed. Mechanical irritation of the nasal mucosa is felt to be the trigger. Suggestions to avoid and to treat are offered. (Source: A&A Case Reports)
Source: A&A Case Reports - January 1, 2019 Category: Anesthesiology Tags: Case Reports Source Type: research

Profound Bradycardia and Cardiac Arrest After Sugammadex Administration in a Previously Healthy Patient: A Case Report
We report the case of a 60-year-old man who underwent open radical prostatectomy for prostate adenocarcinoma. He had no known cardiac disease or symptoms other than controlled hypertension and remote history of cocaine use. The patient was given sugammadex for reversal of neuromuscular blockade and, within 1 minute, developed severe, drug-resistant bradycardia followed by pulseless electrical activity arrest. Advanced cardiac life support was initiated and continued for 15 minutes before the return of spontaneous circulation. Subsequent cardiac workup showed no abnormalities. We believe the cause of arrest was sugammadex, ...
Source: A&A Case Reports - January 1, 2019 Category: Anesthesiology Tags: Case Reports Source Type: research

Acute Respiratory Distress in the Operating Room and Prone Ventilation: A Case Report
There have been many advances in the management of acute respiratory distress syndrome, a condition which Bellani et al, in the LUNG SAFE trial (Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure), found represents up to 10.4% of intensive care unit admissions and 23.4% of patients requiring mechanical ventilation, with an unadjusted intensive care unit and hospital mortality of 35.3% and 40%, respectively. Studies have shown that prone positioning can improve oxygenation in patients who are mechanically ventilated for acute respiratory distress syndrome. This case report describe...
Source: A&A Case Reports - January 1, 2019 Category: Anesthesiology Tags: Case Reports Source Type: research

Exchange Autotransfusion for Rapid Correction of Hyperkalemia During Liver Transplantation: A Case Report
A 46-year-old woman with alcoholic cirrhosis and hepatorenal syndrome requiring hemodialysis presented with hyperkalemia (5.5 mEq/L) immediately before liver transplantation. For correction of hyperkalemia, an exchange transfusion began by removing her blood into an autotransfusion system to wash out noncellular components while maintaining normovolemia. Additionally, she received washed homologous red blood cells, insulin, and glucose to minimize or reduce the degree of hyperkalemia. Serum potassium level decreased to 4.0 mEq/L within 3 hours and was 5.0 mEq/L 30 seconds after reperfusion of the grafted liver. Postreperfu...
Source: A&A Case Reports - January 1, 2019 Category: Anesthesiology Tags: Case Reports Source Type: research

Cesarean Hysterectomy in a Parturient With Morbidly Adherent Placenta Complicated by Postoperative Ischemic Stroke Secondary to Vertebral Artery Dissection: A Case Report
We report a case of cesarean hysterectomy in a parturient with morbidly adherent placenta that was complicated by an estimated blood loss of 25 L, with the usage of massive transfusion protocols. On the third postoperative day, symptomatology suggestive of a stroke was elicited. Imaging showed a right vertebral artery dissection with cerebellar, midbrain, and pontine infarcts. She showed gradual recovery in the following months with almost complete return to baseline function. We present this case to highlight vertebral artery dissection as a potential complication after peripartum massive blood transfusion and to c...
Source: A&A Case Reports - January 1, 2019 Category: Anesthesiology Tags: Case Reports Source Type: research

Osteopetrosis—Anesthetic Considerations for Total Knee Arthroplasty: A Case Report
We present a case report detailing our experience and discuss considerations for the care of future patients with autosomal dominant osteopetrosis. (Source: A&A Case Reports)
Source: A&A Case Reports - January 1, 2019 Category: Anesthesiology Tags: Case Reports Source Type: research

Ultrasound Assessment of Gastric Volume After Bariatric Surgery: A Case Report
Gastric ultrasound is emerging as a tool that can be used to assess gastric content and volume in patients with an unknown fasting history. This information can impact the choice of anesthetic technique or the timing of surgery due to the presumed risk of aspiration. Currently, no data are available regarding the use of gastric ultrasound for patients who have had prior gastric operations, despite the increasing number of patients undergoing bariatric surgery. Our experience suggests that a patient with a prior Roux-en-Y gastric bypass may present with altered anatomy, rendering gastric ultrasound an ineffective technique ...
Source: A&A Case Reports - January 1, 2019 Category: Anesthesiology Tags: Case Reports Source Type: research

Initial Evaluation for Low-Pressure Cardiac Tamponade Using Focused Cardiac Ultrasound
No abstract available (Source: A&A Case Reports)
Source: A&A Case Reports - December 15, 2018 Category: Anesthesiology Tags: Echo Rounds Source Type: research

Collaborative Establishment of Difficult Vascular Access for General Anesthetic Management of an Adult With Tetra-Amelia: A Case Report
We describe the anesthetic management of a 29-year-old woman with tetra-amelia who underwent general anesthesia for tympanomastoidectomy with meatoplasty for an extensive right ear cholesteatoma. Anesthetic challenges related to tetra-amelia include difficult intravenous access, lack of sites for blood pressure monitoring, and possible difficult airway management due to craniofacial anomalies. Our case report focuses on the complex establishment of iliac artery access for invasive blood pressure monitoring by initially cannulating the carotid artery. (Source: A&A Case Reports)
Source: A&A Case Reports - December 15, 2018 Category: Anesthesiology Tags: Case Reports Source Type: research

Anesthetic Management of a Pediatric Patient With Pelizaeus-Merzbacher Syndrome: A Case Report
A 3-year-old pediatric patient with previously diagnosed Pelizaeus-Merzbacher syndrome presented for outpatient dental restoration. Given the infrequency of this demyelinating disorder, an anesthetic plan was tailored to address the patient’s hypotonia and aspiration risk, as well as minimize potential complications including seizures, hemodynamic instability, and postoperative respiratory support. Multimodal analgesia, along with an appropriate ventilation strategy and normothermia, allowed the patient to successfully undergo a general anesthetic and be safely discharged home the same day. (Source: A&A Case Reports)
Source: A&A Case Reports - December 15, 2018 Category: Anesthesiology Tags: Case Reports Source Type: research

Airway Fire During Left Internal Mammary Dissection in Cardiac Surgery: A Case Report
We present a case of an airway fire, diagnosed by the sound of a pop, the appearance of a spark, and the development of an airway circuit leak in a patient with a 4-year-old tracheostomy scar who presented for coronary artery bypass with a left internal mammary artery. The case description is followed by a brief discussion of operating room fires and their management. (Source: A&A Case Reports)
Source: A&A Case Reports - December 15, 2018 Category: Anesthesiology Tags: Case Reports Source Type: research

Transtracheal Use of the CriCath Cannula in Combination With the Ventrain Device for Prevention of Hypoxic Arrest due to Severe Upper Airway Obstruction: A Case Report
A patient recently treated with surgery and radiation for oropharyngeal cancer presented with impending hypoxic respiratory and cardiac arrest in a difficult airway scenario. A CriCath cannula in combination with the Ventrain device and its active expiratory ventilation technology enabled oxygenation and ventilation for 60 minutes until a surgical airway was established. This case report is the first to describe the intended use of Ventrain technology in an emergent “can’t ventilate–can’t intubate” scenario. (Source: A&A Case Reports)
Source: A&A Case Reports - December 15, 2018 Category: Anesthesiology Tags: Case Reports Source Type: research

Pectointercostal Fascial Block Catheters for Thoracic Injuries: A Case Series
Providing analgesia for patients with anterior rib and sternum fracture has been addressed from various types of modalities. Regional anesthesia via epidurals or peripheral nerve blocks, opiates, and other forms of multimodal pain regimens have been used. However, in the polytraumatic injury patient, positioning for an epidural may be problematic, and a predominantly opiate-based treatment plan may compromise respiratory status. In this case series, we describe the pectointercostal fascial block as another tool to treat patients with anterior rib and sternal fracture with polytraumatic injuries. All 3 of the block’s ...
Source: A&A Case Reports - December 15, 2018 Category: Anesthesiology Tags: Case Reports Source Type: research

Echo Findings of Intraoperative Surgical Glue Remnant on the Aortic Valve: A Case Report
Surgical adhesive agents are frequently applied to reinforce aortic sutures in cardiac and aortic surgery. They are thought to provide hemostasis and safely and effectively reduce morbidity. Complications owing to surgical glue remnants, however, have been reported. In our recent case, a surgical glue remnant was detected on the aortic valve by transesophageal echocardiography. For detection of such surgical glue remnants, and to prevent associated serious potential complications, comprehensive transesophageal echocardiography is important. If surgical glue is applied during operative procedures, the heart and aorta should...
Source: A&A Case Reports - December 15, 2018 Category: Anesthesiology Tags: Case Reports Source Type: research

Left Subclavian Transcatheter Aortic Valve Replacement Under Combined Interscalene and Pectoralis Nerve Blocks: A Case Series
The treatment for aortic stenosis is evolving rapidly with new developments in transcatheter aortic valve replacement (TAVR). While the procedure was initially performed under general anesthesia with invasive monitoring and transesophageal echocardiography, recent trends have shifted toward less invasive strategies. Transfemoral TAVRs are frequently performed under sedation; however, TAVRs using alternative access sites, such as the subclavian artery, are typically performed under general anesthesia. This case series describes 3 patients who underwent subclavian TAVR under combined pectoralis and interscalene blocks. All p...
Source: A&A Case Reports - December 15, 2018 Category: Anesthesiology Tags: Case Reports Source Type: research

Epoprostenol Therapy for a Pediatric Patient With Subacute Heparin-Induced Thrombocytopenia and a Ventricular Assist Device Undergoing Heart Transplant: A Case Report
We describe the safe and effective use of epoprostenol sodium as an alternative therapy before heparin exposure for a pediatric patient with subacute heparin-induced thrombocytopenia and a ventricular assist device undergoing heart transplant. (Source: A&A Case Reports)
Source: A&A Case Reports - December 15, 2018 Category: Anesthesiology Tags: Case Reports Source Type: research

Gastric Carbon Dioxide Insufflation Can Lead to Misleading Capnography Trace During Esophageal Intubation
No abstract available (Source: A&A Case Reports)
Source: A&A Case Reports - December 1, 2018 Category: Anesthesiology Tags: Letter to the Editor Source Type: research

Applying Performance Frontiers in Operating Room Management: A Tutorial Using Data From an Academic Medical Center
Although the primary goal of operating room (OR) management is to minimize inefficiencies, it may be difficult for OR managers to track metrics when one extrapolates possible scenarios across every OR on a daily basis. With the ability to visualize the statistical relationships to help simplify the analysis of large datasets, a more elaborate efficiency framework can be established using Pareto optimality (or performance frontiers), a multicriteria framework that includes variables that serve as proxies for a variety of outcomes. Applied to OR management, performance frontiers allow for the evaluation of common and well-un...
Source: A&A Case Reports - December 1, 2018 Category: Anesthesiology Tags: Educational Tool Source Type: research

Unexpected Color Flow Signal in the Ventricular Septum of a Patient Undergoing Off-Pump Coronary Artery Bypass Grafting Surgery
No abstract available (Source: A&A Case Reports)
Source: A&A Case Reports - December 1, 2018 Category: Anesthesiology Tags: Echo Rounds Source Type: research

One Laryngospasm, 2 Realities: A Case Report Highlighting the Impact of Data Granularity on Post Hoc Analysis of Perioperative Events
We present the case of a laryngospasm event in a 21-month-old child in which the changes in pulse oximetry and end-tidal carbon dioxide were recorded by both our Anesthesia Information Management System and middleware medical device integration platform. When this case was analyzed retrospectively, we noted that the 2 systems recorded the event very differently with respect to pulse oximetry. This case report illustrates the impact of data sampling rates on post hoc analysis of perioperative events and highlights the importance of understanding data collection processes when using electronically recorded data. (Source: A&A Case Reports)
Source: A&A Case Reports - December 1, 2018 Category: Anesthesiology Tags: Case Reports Source Type: research

Airway Management of Near-Complete Tracheal Transection by Through-the-Wound Intubation: A Case Report
We present an approach to airway management in a patient with machete injuries culminating in near-complete cricotracheal transection, in addition to a gunshot wound to the neck. Initial airway was established by direct intubation through the cricotracheal wound. Once the airway was secured, a bronchoscopy-guided orotracheal intubation was performed with simultaneous retraction of the cricotracheal airway to optimize the surgical field. This case offers insight into a rarely performed approach to airway management. Furthermore, our case report demonstrates that, in select airway injuries, performing through-the-wound intub...
Source: A&A Case Reports - December 1, 2018 Category: Anesthesiology Tags: Case Reports Source Type: research

Supraclavicular Brachial Plexus Neurolysis for a Malignant Peripheral Nerve Sheath Tumor: A Case Report
The perineural administration of alcohol or phenol results in protein denaturation and, consequently, neurolysis. This can produce long-lasting analgesia, with a duration of 3–6 months. Although neurolytic blocks for the brachial plexus have been described in multiple review articles and textbooks, they are rarely performed. As such, little is known about the efficacy and adverse effect profile of this commonly described treatment. In this article, we report the outcomes of a patient who underwent a left brachial plexus neurolytic block for the management of upper limb pain arising from a malignant peripheral nerve s...
Source: A&A Case Reports - December 1, 2018 Category: Anesthesiology Tags: Case Reports Source Type: research

Anesthetic Management of a Patient With Ongoing Thrombolytic Therapy During Decompressive Craniectomy: A Case Report
We describe a case in which DC was performed on a 38-year-old man who received thrombolytic therapy for an ischemic stroke involving the middle cerebral artery. His neurological and hemodynamic status worsened during its administration, and DC was performed 6 hours after thrombolysis was performed. Fibrinolytic coagulopathy was successfully managed by monitoring fibrinogen levels and with the administration of cryoprecipitate and tranexamic acid. (Source: A&A Case Reports)
Source: A&A Case Reports - December 1, 2018 Category: Anesthesiology Tags: Case Reports Source Type: research

Severe Disruption of Water and Electrolyte Balance After Appendectomy: A Case Report
Perioperative derangements of fluid and electrolyte homeostasis are rare complications in healthy children. Nonetheless, early diagnosis and treatment are mandatory to avoid a potentially life-threatening situation. However, the variety of underlying pathologies may prove to make accurate diagnosis challenging. This case report presents the management of an unexpected occurrence of a perioperative partial diabetes insipidus with massive fluid loss. Diagnostic and therapeutic procedures are discussed in the context of laboratory findings, and an overview of the existing literature is given. Finally, we emphasize that a mult...
Source: A&A Case Reports - December 1, 2018 Category: Anesthesiology Tags: Case Reports Source Type: research

Anesthetic Considerations for Ivor-Lewis Esophagectomy in a Patient With Hereditary Spastic Paraplegia: A Case Report
We describe the anesthetic management of a 52-year-old man with HSP who underwent an Ivor-Lewis esophagectomy for esophageal adenocarcinoma. This is the first report in the literature describing the anesthetic management of a patient with HSP successfully undergoing complex thoracoabdominal surgery. Key to the provision of postoperative analgesia was the intraoperative placement of catheters in the right thoracic paravertebral space and retro-rectus plane for continuous infusion of ropivacaine 0.2% for 3 days, as well as a fentanyl patient-controlled analgesia for 7 days. (Source: A&A Case Reports)
Source: A&A Case Reports - December 1, 2018 Category: Anesthesiology Tags: Case Reports Source Type: research

Spinal Anesthesia for Pediatric Laparoscopic Hernia Repair: A Case Report
This article presents the case of an ex-premature infant who underwent laparoscopic inguinal hernia repair under spinal anesthesia. The infant remained calm and stable throughout the uneventful procedure and postoperative period. Spinal anesthesia may be feasible for laparoscopic herniotomy when pneumoperitoneum pressure and operative time are restricted to 8 mm Hg and 60 minutes, respectively, with sensory level at T10 or higher. (Source: A&A Case Reports)
Source: A&A Case Reports - December 1, 2018 Category: Anesthesiology Tags: Case Reports Source Type: research

What Every Anesthesiologist Should Know About the Manual Resuscitation Bag
This article explains its construction, functioning, and limitations. This article also attempts to clarify some common misconceptions such as whether a resuscitation bag can be used to preoxygenate or provide continuous positive airway pressure or positive end-expiratory pressure and the highest percentage of oxygen that it can deliver. (Source: A&A Case Reports)
Source: A&A Case Reports - November 15, 2018 Category: Anesthesiology Tags: Educational Tool Source Type: research

Nonoperating Room Anesthesia Tardiness
This article studies nonoperating room anesthesia (NORA) tardiness at the University of Vermont Medical Center in cases performed in the 2015 calendar year. Tardiness was measured by subtracting actual start times from extracted scheduled start times for each NORA services line. On average, tardiness in NORA sites increased as the day progressed, with the exception of diagnostic radiology. This is likely due to limited tactical and operational opportunities to improve workflow. (Source: A&A Case Reports)
Source: A&A Case Reports - November 15, 2018 Category: Anesthesiology Tags: Innovation Source Type: research

The Use of Transesophageal Echocardiography in the Management of Baffle Leaks in a Patient With Transposition of the Great Arteries
No abstract available (Source: A&A Case Reports)
Source: A&A Case Reports - November 15, 2018 Category: Anesthesiology Tags: Echo Rounds Source Type: research

Blue Vision (Cyanopsia) Associated With TURP Syndrome: A Case Report
There have been many complications associated with transurethral resection of the prostate (TURP), known as TURP syndrome. Of the various irrigation fluids used for TURP, glycine irrigant has been historically popular given its relatively low cost. It is also a nonconductive solution and only slightly hypoosmolar, reducing the risk of burn injury or significant hemolysis. However, there have been many case reports of central nervous system toxicity such as transient blindness and encephalopathy related to glycine toxicity. Here, we report blue vision (cyanopsia), which has never been reported as a symptom of TURP syndrome....
Source: A&A Case Reports - November 15, 2018 Category: Anesthesiology Tags: Case Reports Source Type: research

Anesthetic Considerations for a Patient With Chronic Systemic Capillary Leak Syndrome: A Case Report
We present a patient with chronic SCLS who underwent general and regional anesthesia for elective surgery. (Source: A&A Case Reports)
Source: A&A Case Reports - November 15, 2018 Category: Anesthesiology Tags: Case Reports Source Type: research

Misadventures of a Pigtail: Case Report of Accidental Insertion of a Chest Tube Into the Left Atrium During Interventional Radiology-Guided Placement
We report an extremely rare case of accidental insertion of a chest tube into the left atrium via the right pulmonary vein during an interventional radiology-guided placement of the catheter. To our knowledge, such a case has not been reported to date. The anesthetic and surgical management of this injury are discussed. (Source: A&A Case Reports)
Source: A&A Case Reports - November 15, 2018 Category: Anesthesiology Tags: Case Reports Source Type: research

Eisenmenger Syndrome in Pregnancy: When Is It Time for ECMO? A Case Report
We report the case of a 21-year-old primiparous woman at 22 weeks gestation who presented with a large uncorrected ventricular septal defect, severe pulmonary hypertension, and Eisenmenger syndrome. The patient elected for termination of pregnancy, which was performed under regional anesthesia. Hemodynamic changes apparently associated with uterine contraction immediately after termination resulted in increased right to left shunting across the ventricular septal defect requiring urgent venovenous extracorporeal membrane oxygenation. Thrombocytopenia and systemic anticoagulation for extracorporeal membrane oxygenation pres...
Source: A&A Case Reports - November 15, 2018 Category: Anesthesiology Tags: Case Reports Source Type: research

Peripheral Nerve Block Provides Effective Analgesia for a Patient With Peripheral Nerve Hyperexcitability Syndrome: Isaacs Syndrome Case Report
Isaacs syndrome is a rare peripheral nerve hyperexcitability syndrome. The painful discharges in Isaacs syndrome are abolished by the blockade of the neuromuscular junction but not by peripheral nerve blocks (PNB). However, the efficacy of PNB for intraoperative and postoperative analgesia among those with Isaacs syndrome is unknown. A 41-year-old woman with Isaacs syndrome underwent open reduction and internal fixation of radius fractures. Ultrasound-guided bilateral axillary brachial plexus blocks were performed, followed by general anesthesia. The patient required only a single low dose of rocuronium for intubation and ...
Source: A&A Case Reports - November 15, 2018 Category: Anesthesiology Tags: Case Reports Source Type: research

In Situ Cold Perfusion of the Liver on Cardiopulmonary Bypass: Coagulopathy and Its Correction A Case Report
We report a case of profound coagulopathy after the dual insult of cold in-situ perfusion of the liver and cardiopulmonary bypass in a patient undergoing complex hepatobiliary and cardiovascular surgery. Management of this coagulopathy with conventional blood products was hindered by elevated venous pressures, thought to contribute to persistent bleeding and risked liver and right ventricular dysfunction, necessitating a change in strategy. Anesthesiologists should consider fluid-restrictive strategies to correct coagulopathy in combined liver and cardiac surgery. (Source: A&A Case Reports)
Source: A&A Case Reports - November 15, 2018 Category: Anesthesiology Tags: Case Reports Source Type: research

In Response
No abstract available (Source: A&A Case Reports)
Source: A&A Case Reports - November 1, 2018 Category: Anesthesiology Tags: Letters to the Editor Source Type: research

Is Selective Brachial Plexus Block Necessary After Erector Spinae Plane Block in Breast Surgery?
No abstract available (Source: A&A Case Reports)
Source: A&A Case Reports - November 1, 2018 Category: Anesthesiology Tags: Letters to the Editor Source Type: research

Two- and Three-Dimensional Transesophageal Echocardiographic Interrogation of an Atrial Septal Pouch Thrombosis
No abstract available (Source: A&A Case Reports)
Source: A&A Case Reports - November 1, 2018 Category: Anesthesiology Tags: Echo Rounds Source Type: research

Anesthetic Management of Staged Bilateral Adrenalectomy for Neuroendocrine Tumors in a Heart-Lung Transplant Patient: A Case Report
We present the anesthetic management of a patient who was diagnosed with bilateral neuroendocrine tumors soon after heart-lung transplantation and underwent successful staged bilateral adrenalectomy. (Source: A&A Case Reports)
Source: A&A Case Reports - November 1, 2018 Category: Anesthesiology Tags: Case Reports Source Type: research