Transesophageal Echocardiography for Ascending Thoracic Endovascular Aortic Repair of Stanford Type A Aortic Dissection
No abstract available (Source: A&A Case Reports)
Source: A&A Case Reports - July 15, 2019 Category: Anesthesiology Tags: Echo Rounds Source Type: research

Venoarterial Extracorporeal Membrane Oxygenation as Supportive Therapy After Cardiac Arrest After Amniotic Fluid Embolism: A Case Report
This report describes the indication, efficacy, and success of venoarterial extracorporeal membrane oxygenation in the early management of cardiac arrest, cardiac failure driven by amniotic fluid embolism, and acute respiratory distress syndrome. The use of venoarterial extracorporeal membrane oxygenation support after recovery from cardiac arrest after amniotic fluid embolism should be considered early during the management of these cases. (Source: A&A Case Reports)
Source: A&A Case Reports - July 15, 2019 Category: Anesthesiology Tags: Case Reports Source Type: research

Cangrelor Bridging Within 6 Months of a Drug-Eluting Stent in a Patient for Emergency Cervical Spine Surgery: A Case Report
We present the case of a patient with recent drug-eluting stent placement ( (Source: A&A Case Reports)
Source: A&A Case Reports - July 15, 2019 Category: Anesthesiology Tags: Case Reports Source Type: research

Titration of Bivalirudin Infusion in the Pediatric Cardiac Catheterization Laboratory: A Case Report
Bivalirudin is a direct thrombin inhibitor that is used as a procedural anticoagulant during percutaneous coronary interventions and cardiac surgery for patients with heparin-resistant thrombosis or heparin-induced thrombocytopenia. There is a robust literature describing its safety and efficacy in adults; however, its use in the pediatric population is relatively rare, with dosing extrapolated from adult data. In this case report, we describe a 4-year-old with complex congenital heart disease and history of heparin-induced thrombocytopenia who required bivalirudin dose uptitration during cardiac catheterization. (Source: ...
Source: A&A Case Reports - July 15, 2019 Category: Anesthesiology Tags: Case Reports Source Type: research

Diagnosis of an Additional Ventricular Septal Defect by Observing Dark Blood in Aortic Root Vent: A Case Report
We report a case where we observed an undiagnosed additional ventricular septal defect shunting deoxygenated dark blood into the aortic root vent during deairing of the heart, which was confirmed on transesophageal echocardiography and addressed with reinstitution of cardiopulmonary bypass. (Source: A&A Case Reports)
Source: A&A Case Reports - July 15, 2019 Category: Anesthesiology Tags: Case Reports Source Type: research

Neuraxial Anesthesia in a Patient With a History of Spontaneous Intracranial Hypotension: A Case Report
We present a patient with a history of spontaneous intracranial hypotension who underwent a total knee arthroplasty under spinal anesthesia without complication and discuss the pathophysiology, proposed etiologies and treatments, and safety of neuraxial anesthesia in spontaneous intracranial hypotension. (Source: A&A Case Reports)
Source: A&A Case Reports - July 15, 2019 Category: Anesthesiology Tags: Case Reports Source Type: research

Orthotopic Liver Transplant in a Patient Anticoagulated With Rivaroxaban: A Case Report
In this report, we describe the perioperative consequences, safety issues, and lessons learned from a patient undergoing an orthotopic liver transplant who was anticoagulated with rivaroxaban due to partial superior mesenteric vein thrombosis. (Source: A&A Case Reports)
Source: A&A Case Reports - July 15, 2019 Category: Anesthesiology Tags: Case Reports Source Type: research

Sacroiliac Joint Pain in Pregnancy: A Case Report
This article aims to review the diagnosis, pathophysiology, and treatment approaches to adequately manage sacroiliac joint pain in pregnant women. (Source: A&A Case Reports)
Source: A&A Case Reports - July 15, 2019 Category: Anesthesiology Tags: Case Reports Source Type: research

Awake Intubation via an Ambu AuraGain in a Patient With Extreme Obesity: A Case Report
We report a case of awake flexible bronchoscopic intubation via an Ambu AuraGain in a patient with a body mass index of 54 kg/m2 scheduled for elective thyroidectomy. The procedure was well tolerated and easily performed in the full sitting position for optimal airway and ventilation and cardiovascular stability during intubation. To our knowledge, this is the first published report of awake flexible bronchoscopic intubation via an AuraGain, and we discuss our rationale for using this technique. (Source: A&A Case Reports)
Source: A&A Case Reports - July 15, 2019 Category: Anesthesiology Tags: Case Reports Source Type: research

Mechanical Aortic Valve Thrombus in Pregnancy: A Case Report
We report on the management of a pregnant woman with a mechanical aortic valve found to have a thrombus at 37 weeks gestation. It was decided to perform cesarean delivery to allow for a reoperative mechanical aortic valve replacement 24 hours thereafter. (Source: A&A Case Reports)
Source: A&A Case Reports - July 15, 2019 Category: Anesthesiology Tags: Case Reports Source Type: research

Anesthetic Management in an Adult Patient With Costello Syndrome: A Case Report
Costello syndrome is a rare genetic disorder characterized by mental and growth retardation and distinctive coarse facies. A significant proportion of patients with Costello syndrome have hypertrophic cardiomyopathy, papillomata, and malignant tumors. General anesthesia practice, especially airway and cardiac management, in patients with Costello syndrome may be complicated by anatomical features and cardiac abnormalities. There have been several reports on the anesthetic management of children with Costello syndrome, but few have reported on the anesthetic management of adults with Costello syndrome. In adults, careful pr...
Source: A&A Case Reports - July 15, 2019 Category: Anesthesiology Tags: Case Reports Source Type: research

Not All Oxygrams Are Mirror Image of Capnograms: A Case Report
We report a situation where a leak in the sample line produced a typical tails-up capnogram that was not accompanied by a mirror image oxygram. Air entrainment through the breach led to dilution of the gases on their way to the analyzer. The result was an oxygram resembling a series of mountain peaks. (Source: A&A Case Reports)
Source: A&A Case Reports - July 15, 2019 Category: Anesthesiology Tags: Case Reports Source Type: research

Smartphone Photographs to Document Preoperative Dental Examination
Dental injury is a common cause of malpractice claims involving anesthesiologists. Inadequate preoperative dental evaluations and incomplete documentation are often cited as contributing factors during reviews of closed claims. Point-of-care smartphone photographs are widely used in other medical fields such as dermatology and plastic surgery. We discuss the use of smartphone photographs for documenting preoperative dental examinations. (Source: A&A Case Reports)
Source: A&A Case Reports - July 1, 2019 Category: Anesthesiology Tags: Innovation Source Type: research

Functional Abdominal Pain in a Pediatric Patient After Resolution of Acute Pancreatitis: A Case Report
We describe a 13-year-old boy who underwent an unrevealing, complex diagnostic evaluation for persistent abdominal pain after resolution of acute pancreatitis. His pain required an extended leave of absence from school and nasogastric tube feeds. After receiving abdominal nerve blocks and trigger point injections, he experienced near-complete resolution of pain with normalization of eating habits and daily function. Pain practitioners should think critically about the signs and symptoms of visceral versus somatic pain and try newer diagnostic interventions that may be therapeutic. (Source: A&A Case Reports)
Source: A&A Case Reports - July 1, 2019 Category: Anesthesiology Tags: Case Reports Source Type: research

Low-Dose Intrathecal Ziconotide for Spasticity From Primary Lateral Sclerosis: A Case Report
We present a case of severe spasticity from primary lateral sclerosis refractory to intrathecal baclofen in doses up to 1100 μg/d. Baclofen was weaned down and switched to intrathecal ziconotide at 0.6 μg/d. The dose was then titrated up to 3 μg/d with excellent control of spasticity. This case suggests that low-dose intrathecal ziconotide should be considered in patients with lower extremity spasticity refractory to intrathecal baclofen. (Source: A&A Case Reports)
Source: A&A Case Reports - July 1, 2019 Category: Anesthesiology Tags: Case Reports Source Type: research

Localized Corticosteroid Injections for Malignant Joint Pain in the Oncologic Population: A Case Series
We describe a case series of 3 cancer patients who have concurrent hip- and greater trochanteric–related pain. We performed a single-insertion-site, ultrasound-guided injection to target both the intra-articular hip and greater trochanteric bursa for each patient. All patients reported an improvement in pain symptoms and function with no major complications. Targeted corticosteroid injections provide a potential for relief of malignant joint pain. (Source: A&A Case Reports)
Source: A&A Case Reports - July 1, 2019 Category: Anesthesiology Tags: Case Reports Source Type: research

Failed Awake Intubation for Critical Airway Obstruction Rescued With the Ventrain Device and an Arndt Exchange Catheter: A Case Report
A 71-year-old man with advanced vocal cord carcinoma presented with severe airway obstruction. Therapeutic anticoagulation with enoxaparin complicated management. Failure of an oral awake bronchoscopic intubation was rescued by passing a guidewire through the working channel and threading an Arndt exchange catheter into the trachea under videoscopic vision. Ventilation with the Ventrain device lasting 40 minutes (15 L/min, inspiration/expiration 1:1, 15 breaths/min), during IV anesthesia with muscle paralysis, resulted in excellent blood gas values until placement of the tracheal cannula. This case report highlights the ef...
Source: A&A Case Reports - July 1, 2019 Category: Anesthesiology Tags: Case Reports Source Type: research

Nebulized Lidocaine in the Treatment of Refractory Postoperative Laryngospasm: A Case Report
Intraoperative laryngospasm occurs in (Source: A&A Case Reports)
Source: A&A Case Reports - July 1, 2019 Category: Anesthesiology Tags: Case Reports Source Type: research

Efficacy of Sugammadex in Preventing Skin Test Reaction in a Patient With Confirmed Rocuronium Anaphylaxis: A Case Report
We describe a case of rocuronium-induced anaphylaxis in which clinical improvement followed sugammadex administration. Intradermic skin tests confirmed rocuronium immunoglobulin E–mediated anaphylaxis but also showed intradermal injection of mixing in equal molecular ratio of sugammadex with rocuronium preventing rocuronium anaphylactic skin reaction. This observation demonstrates the efficacy of sugammadex to prevent rocuronium interaction with the skin immune system. (Source: A&A Case Reports)
Source: A&A Case Reports - July 1, 2019 Category: Anesthesiology Tags: Case Reports Source Type: research

Extraluminal Use of a Pediatric Bronchial Blocker With Confirmation by Point-of-Care Ultrasound: A Case Report
Lung isolation for pediatric thoracic surgery is especially challenging in a patient with chronic lung infection and need to protect the nonoperative lobes from the spread of infection during anesthesia and surgery. Typically, for pediatric thoracic surgery, a mainstem intubation or placement of an intraluminal bronchial blocker is sufficient for lung isolation. The patient whose case is reported here suffered from a pleuropulmonary blastoma compressing the left lower lobe bronchus and resultant chronic infection involving the left lower lobe. In this unusual situation, to isolate the chronic lung infection and to provide ...
Source: A&A Case Reports - July 1, 2019 Category: Anesthesiology Tags: Case Reports Source Type: research

Successful Use of Cangrelor and Heparin for Cardiopulmonary Bypass in a Patient With Heparin-Induced Thrombocytopenia and End-Stage Renal Disease: A Case Report
We present a case of a 63-year-old woman requiring aortic valve replacement with a history of heparin-induced thrombocytopenia and end-stage renal disease. Cangrelor and heparin were successfully used during cardiopulmonary bypass, offering an option for anticoagulation management for a uniquely challenging patient population. (Source: A&A Case Reports)
Source: A&A Case Reports - July 1, 2019 Category: Anesthesiology Tags: Case Reports Source Type: research

Supraglottic Airway Rescue After Failed Fiberoptic Intubation in a Patient With Osteogenesis Imperfecta: A Case Report
We describe the management of a pregnant patient with osteogenesis imperfecta with a history of numerous fractures, severe scoliosis, and anticipated difficult airway. Her pregnancy was complicated by progressive shortness of breath and a fetal diagnosis of osteogenesis imperfecta. Spine anatomy precluded neuraxial anesthesia. Cesarean delivery was performed under general anesthesia at 34 weeks. Immediately after awake fiberoptic intubation and induction of general anesthesia, capnography waveform was lost with rapid profound oxygen desaturation. A supraglottic airway device was placed, oxygenation maintained with supraglo...
Source: A&A Case Reports - July 1, 2019 Category: Anesthesiology Tags: Case Reports Source Type: research

Urgent Complex Intraoperative Reintubation in a Known Difficult Airway After Endotracheal Tube Damage: A Case Report
Treacher Collins syndrome is an inherited disorder resulting in maldevelopment of the first and second branchial arches. Patients have complex orofacial anatomy often requiring airway interventions from birth. A 17-year-old boy with Treacher Collins syndrome and history of difficult ventilation and intubation presented for elective maxillofacial reconstruction. After uneventful awake nasal fiberoptic intubation, the nasotracheal tube was damaged intraoperatively. Due to the patient’s unique anatomy, a fiberoptic bronchoscope and ventilating exchange catheter were utilized together to facilitate a nasotracheal tube ex...
Source: A&A Case Reports - July 1, 2019 Category: Anesthesiology Tags: Case Reports Source Type: research

Retrieval of a Esophageal pH Monitoring Probe Dislodged Into the Laryngopharynx: A Case Report
We present a case of a probe dislodgment where aspiration was avoided and describe how retrieval of this device is different from typical hypopharyngeal foreign body removal. (Source: A&A Case Reports)
Source: A&A Case Reports - July 1, 2019 Category: Anesthesiology Tags: Case Reports Source Type: research

Improving Preoperative Completion of Advanced Care Planning Documents in Patients With Expected Postoperative Intensive Care Unit Stay
Directed discussion about advanced care planning in the preoperative setting is often lacking. We implemented an educational intervention pilot to increase the number of high-risk patients who have health care proxy and advanced directives documents completed. We developed a novel short video describing the advanced care planning process and the intensive care setting, encouraging patients to have conversations about advanced care planning. Survey results showed that majority of patients felt the intervention increased their knowledge about advanced care planning (65%–70%) and that the video raised some topics worth ...
Source: A&A Case Reports - June 15, 2019 Category: Anesthesiology Tags: Innovation Source Type: research

Spinal Cord Trauma During Subarachnoid Anesthesia for Cesarean Delivery: A Case Report
Spinal cord trauma can occur during subarachnoid blockade and can result in significant morbidity for the patient. Careful attention to lumbar insertion level is essential to prevent injury. (Source: A&A Case Reports)
Source: A&A Case Reports - June 15, 2019 Category: Anesthesiology Tags: Case Reports Source Type: research

Maternal Mirror Syndrome Masquerading as Congestive Heart Failure: A Case Report
We report a case of a pregnant woman with a history of unspecified congenital heart disease, presenting with swelling and distension, with diagnostic findings not consistent with preeclampsia. Her course was complicated by dyspnea, oliguria, and fetal hydrops. A cesarean delivery under neuraxial anesthesia was performed. We review the clinical manifestations of Mirror syndrome and discuss anesthetic and obstetric management considerations for this condition. (Source: A&A Case Reports)
Source: A&A Case Reports - June 15, 2019 Category: Anesthesiology Tags: Case Reports Source Type: research

Transnasal Humidified Rapid-Insufflation Ventilatory Exchange for Deep Sedation in a Lung Transplant Candidate With Severe Cystic Fibrosis: A Case Report
We describe the use of transnasal humidified rapid-insufflation ventilatory exchange for deep sedation during dental extractions in a patient with severe cystic fibrosis as a precondition for lung transplantation. Patient wanted to have the procedure under general anesthesia with intubation due to extreme anxiety. However, we advocated deep IV sedation with transnasal humidified rapid-insufflation ventilatory exchange. Oxygenation was maintained without airway obstruction and pulmonary complications during the entire procedure of 110 minutes. (Source: A&A Case Reports)
Source: A&A Case Reports - June 15, 2019 Category: Anesthesiology Tags: Case Reports Source Type: research

Cerebral Oximetry Fails as a Monitor of Brain Perfusion in Cardiac Surgery: A Case Report
We present 2 cases where cerebral oximetry failed to accurately portray cerebral oxygenation. In the current form, cerebral oximetry may at best be an expensive tool without any benefit on outcomes. In addition, it may contribute to misleading and confusing clinical data. (Source: A&A Case Reports)
Source: A&A Case Reports - June 15, 2019 Category: Anesthesiology Tags: Case Reports Source Type: research

Prolonged Pulseless Electrical Activity Cardiac Arrest After Intranasal Injection of Lidocaine With Epinephrine: A Case Report
Local anesthetic toxicity is a rare but serious complication of local anesthetic administration. Although lidocaine has a safety profile superior to other amide local anesthetics, we report a case of cardiac arrest after intranasal injection of lidocaine. The case involves a 22-year-old healthy woman who experienced pulseless electrical activity shortly after a submucosal injection of 2.2 mg/kg of lidocaine with epinephrine. Resuscitative efforts were unsuccessful until a bolus of intralipid was given. This case emphasizes that even a “low” dose of a less lipophilic drug has the potential for severe toxi...
Source: A&A Case Reports - June 15, 2019 Category: Anesthesiology Tags: Case Reports Source Type: research

Epidural Anesthesia for Cesarean Delivery in a Parturient With Lumboperitoneal Shunt: A Case Report
This report emphasizes potential mechanisms for high neuraxial blockade and strategies to decrease risks in this unique patient population. (Source: A&A Case Reports)
Source: A&A Case Reports - June 15, 2019 Category: Anesthesiology Tags: Case Reports Source Type: research

Clinical Cyanosis in a Patient Presenting for Outpatient Colonoscopy: A Case Report of Hemoglobin Kansas
Gene mutations that affect the synthesis or structure of hemoglobin are present in 7% of the world’s population. These mutations lead to variant hemoglobinopathies with phenotypes that range from clinically insignificant to fatal. Because monitoring oxygen saturation is standard of care and critical to detecting hypoxemia, it is crucial to recognize factors that might interfere with the measurement of oxygen saturation or decrease oxygen delivery. We discuss the management of a patient who presented to a freestanding surgical center with the rare variant hemoglobin Kansas, clinical cyanosis, and an initial pulse oxim...
Source: A&A Case Reports - June 15, 2019 Category: Anesthesiology Tags: Case Reports Source Type: research

Lidocaine as a Rare and Hidden Allergen in the Perioperative Setting: A Case Report
We present an unusual case of immediate-type perioperative hypersensitivity to lidocaine with cross-reaction to mepivacaine, which was missed on initial investigation. This case illustrates that lidocaine may be a “hidden allergen” in the perioperative setting and should always be considered a potential culprit in cases of suspected perioperative hypersensitivity. The case also demonstrates that suspected perioperative hypersensitivity requires highly specialized investigation and close collaboration between allergists and anesthesiologists. (Source: A&A Case Reports)
Source: A&A Case Reports - June 15, 2019 Category: Anesthesiology Tags: Case Reports Source Type: research

Novel Axillary Block Management for Tendon Transfer Surgery: A Case Report
The outcome of upper limb tendon transfer surgery is improved when the patient is able to voluntarily contract specific muscles during the surgical procedure. Tumescent local anesthesia is suitable, but we describe an alternative option that involves the novel management of an axillary block. A 47-year-old man, injured in a motor vehicle crash, exhibited a thumb extensor deficit because of severe muscular trauma to the forearm. He underwent a tendon transfer of the fourth superficial flexor tendon to the extensor pollicis longus under an axillary block. First, individual injections of ropivacaine were performed around the ...
Source: A&A Case Reports - June 15, 2019 Category: Anesthesiology Tags: Case Reports Source Type: research

Acute Adrenal Insufficiency After an Antiemetic Dose of Dexamethasone: A Case Report
We present the case of a healthy 27-year-old woman who developed acute adrenal insufficiency after receiving intraoperative dexamethasone for postoperative nausea and vomiting prophylaxis during a laparoscopic left oophorectomy. (Source: A&A Case Reports)
Source: A&A Case Reports - June 15, 2019 Category: Anesthesiology Tags: Case Reports Source Type: research

Sudden Airway Collapse After Pneumoperitoneum With Undiagnosed Tracheomalacia in a Morbidly Obese 12-Year-Old Boy Undergoing Laparoscopic Cholecystectomy: A Case Report
We describe the case of a 12-year-old morbidly obese boy, without previous medical issues, scheduled for elective laparoscopic cholecystectomy. Immediately after pneumoperitoneum was established, mechanical ventilation could not be performed. Intraoperative exploration with flexible bronchoscopy showed that the tip of the endotracheal tube was nearly occluded by the posterior tracheal wall bulging anteriorly. Anesthesiologists should be aware of undiagnosed tracheomalacia as a cause of sudden airway collapse, even after the airway is secured with an endotracheal tube. (Source: A&A Case Reports)
Source: A&A Case Reports - June 15, 2019 Category: Anesthesiology Tags: Case Reports Source Type: research

Crossed Swords Sign: A 3-Dimensional Echocardiographic Appearance
We present a case of divergent mitral regurgitation jets that were detected intraoperatively and evaluated using 3-dimensional imaging. The accurate assessment of eccentric mitral regurgitation jets, especially bilateral eccentric mitral regurgitation jets, is challenging before surgical repair. Intraoperative 3-dimensional transesophageal echocardiography with and without color-flow Doppler can significantly improve the localization of the anatomical lesion. (Source: A&A Case Reports)
Source: A&A Case Reports - June 3, 2019 Category: Anesthesiology Tags: Echo Rounds Source Type: research

Anesthesia myTIPreport: A Web-Based Tool for Real-Time Evaluation of Accreditation Council for Graduate Medical Education’s Milestone Competencies and Clinical Feedback to Residents
This report describes the use of myTIPreport, a web-based tool, which streamlines the dual purpose of milestone evaluation and real-time feedback from faculty to residents in a US anesthesiology program. In a 6-month trial, faculty members and residents used myTIPreport for daily clinical feedback. We believe myTIPreport will be a valuable tool for clinical feedback given further refinement of the tool and improved faculty and resident development on program use. (Source: A&A Case Reports)
Source: A&A Case Reports - June 3, 2019 Category: Anesthesiology Tags: Educational Tool Source Type: research

Saved by the Massive Transfusion Protocol: A Case Report of an Obstetric Patient With Hemolysis, Elevated Liver Enzymes, and Low Platelet Count (HELLP) Syndrome and Glisson Capsule Rupture
A 31-year-old primigravid parturient with no pertinent medical history was admitted at 40 weeks and 4 days of gestation for postdate induction of labor. She was subsequently diagnosed with preeclampsia and developed hemolysis, elevated liver enzymes, and a low platelet count. An emergency cesarean delivery ensued owing to fetal bradycardia. Massive hemorrhage occurred on incision, and a diagnosis of ruptured subcapsular hepatic hematoma was made. The hemorrhage was managed using our institution’s massive transfusion protocol. Early transfusions and mobilization of necessary support stipulated in this protocol led to ...
Source: A&A Case Reports - June 3, 2019 Category: Anesthesiology Tags: Case Reports Source Type: research

Dexmedetomidine Sedation in Magnetic Resonance–Guided Focused Ultrasound Thalamotomy: A Case Series of 3 Patients
We report the first use of dexmedetomidine for sedation in magnetic resonance–guided focused ultrasound thalamotomy in 3 patients: none of them experienced relevant hemodynamic changes or apnea. (Source: A&A Case Reports)
Source: A&A Case Reports - June 3, 2019 Category: Anesthesiology Tags: Case Reports Source Type: research

Management of a Pregnant Patient With Central Poststroke Pain Syndrome Ultimately Having a Cesarean Delivery: A Case Report
We report a case of a parturient with intense central poststroke pain after an ischemic cerebrovascular incident at 15 weeks of gestation, attributed to cerebral venous thrombosis. After a multidisciplinary team consultation, she was scheduled for cesarean delivery at 35 weeks of gestation, under combined spinal-epidural anesthesia. Due to severe left-sided neurological deficits and ipsilateral intense neuropathic pain, the neuraxial technique was successfully performed using the paramedian approach. (Source: A&A Case Reports)
Source: A&A Case Reports - June 3, 2019 Category: Anesthesiology Tags: Case Reports Source Type: research

Sphenopalatine Ganglion Block May Be an Efficient Treatment of Headache After Lumboperitoneal Shunt Placement: A Case Report
A 20-year-old man submitted to surgical insertion of a lumboperitoneal drain as a treatment for intracranial hypertension, secondary to venous sinus thrombosis, developed severe headache accompanied by nausea, vomiting, and diplopia 24 hours postoperative. Cerebral spinal fluid low-pressure headache was diagnosed. A transnasal sphenopalatine ganglion block with ropivacaine was performed without complications. Pain relief was immediate, complete, and sustained for about 24 hours; a second block was performed effectively with pain control, and the patient was discharged. Sphenopalatine ganglion block may be a safe and effici...
Source: A&A Case Reports - June 3, 2019 Category: Anesthesiology Tags: Case Reports Source Type: research

A Missing Tooth Found in the Nasal Cavity After an Attempt at Insertion of a Nasogastric Tube: A Case Report
Dental injury is one of the most common complications of tracheal intubation. Although teeth dislodged during tracheal intubation are usually found in the oral cavity, we encountered a case of a missing tooth found in the nasal cavity in an intubated patient. A 62-year-old man with 4 loose teeth in the upper jaw was scheduled for laparoscopic hernia repair. After our second attempt at insertion of a nasogastric tube via the left naris, we discovered that a tooth had been dislodged. A lateral-view radiograph revealed the dislodged tooth in the nasal cavity. The ectopic tooth was removed by an otorhinolaryngologist. (Source:...
Source: A&A Case Reports - June 3, 2019 Category: Anesthesiology Tags: Case Reports Source Type: research

Ultrasound-Guided Pulsed Radiofrequency of C2 Dorsal Root Ganglion as Adjuvant Treatment for Chronic Headache Disorders: A Case Report
We present a patient with cluster headache presenting with chronic ipsilateral facial pain with nasal congestion and left eye pain who achieved sustained pain relief with an ultrasound-guided injection into the pterygopalatine fossa in conjunction with an ultrasound-guided pulsed radiofrequency ablation procedure involving the C2 dorsal root ganglion. (Source: A&A Case Reports)
Source: A&A Case Reports - June 3, 2019 Category: Anesthesiology Tags: Case Reports Source Type: research

Ultrasound-Assisted Combined Spinal-Epidural Anesthesia for Cesarean Delivery in a Parturient With Currarino Triad: A Case Report
We present the case of a parturient with Currarino triad and a low conus medullaris undergoing cesarean delivery where preprocedural magnetic resonance imaging and ultrasound imaging allowed for successful combined spinal-epidural anesthesia to be performed. Despite these measures, however, the patient did develop a high spinal and temporary postoperative dizziness. (Source: A&A Case Reports)
Source: A&A Case Reports - June 3, 2019 Category: Anesthesiology Tags: Case Reports Source Type: research

Limitations of Cerebral Oximetry in a Patient With an Intracerebral Hemorrhage and Brain Edema on Extracorporeal Membrane Oxygenation: A Case Report
We report a case where an intraparenchymal bleed in the supply zone of the middle cerebral artery—followed by severe hemispherical brain edema, leading to life-threatening intracranial hypertension—escaped cerebral oximetry monitoring using near-infrared spectroscopy. Potential explanations for our observation, as well as the specific limitations of these devices, are discussed. (Source: A&A Case Reports)
Source: A&A Case Reports - June 3, 2019 Category: Anesthesiology Tags: Case Reports Source Type: research

Perioperative Clinical Considerations in a Patient With Carotid Agenesis: A Case Report
An 86-year-old female with previously diagnosed congenitally absent right internal carotid artery presented for total shoulder arthroplasty. Bedside ultrasonography confirmed the anomaly and identified several arterial collateral vessels. No aberrant vessels were seen traversing the brachial plexus. The patient received brachial plexus blockade and general anesthesia for the procedure. Carotid agenesis is associated with increased prevalence of intracranial aneurysm. Patients are often asymptomatic due to adequate blood supply from collateral vessels. Ultrasonography for brachial plexus blockade or central line access may ...
Source: A&A Case Reports - June 3, 2019 Category: Anesthesiology Tags: Case Reports Source Type: research

Postoperative Acute Angle-Closure Glaucoma: A Rare but Serious Complication: A Case Report
This article concludes with a flowchart to aid anesthesiologists to accurately diagnose postoperative ophthalmic pathology. (Source: A&A Case Reports)
Source: A&A Case Reports - June 3, 2019 Category: Anesthesiology Tags: Case Reports Source Type: research

Intraoperative Transthoracic Echocardiography for a Neonate Using an Adult Multiplane Transesophageal Echocardiography Probe
No abstract available (Source: A&A Case Reports)
Source: A&A Case Reports - May 15, 2019 Category: Anesthesiology Tags: Echo Rounds Source Type: research

The OxyTain Algorithm: An Approach to Airway Management in the Cannot Intubate and Cannot Oxygenate Scenario
Although rare, cannot intubate and cannot oxygenate situations are challenging acute events. The development of management algorithms, standardized equipment provisions, and appropriate clinical training in the application of front-of-neck access techniques are necessary to optimize procedural success to ensure adequate oxygenation. The OxyTain algorithm is an institutionally developed protocol to manage cannot intubate and cannot oxygenate events. With proper implementation, this unique process aligning the cannula cricothyroidotomy and scalpel bougie as primary and secondary techniques, respectively, can potentially opti...
Source: A&A Case Reports - May 15, 2019 Category: Anesthesiology Tags: Innovation Source Type: research