Severe Polyethylene Glycol Allergy Considerations for Perioperative Management: A Case Report
We present a patient with known past anaphylactic reaction to PEG and a detailed account of her perioperative course. More broadly, we provide recommendations and resources for the safe management of similar patients with a severe PEG allergy. (Source: A&A Case Reports)
Source: A&A Case Reports - October 1, 2022 Category: Anesthesiology Tags: Perioperative Management/Medicine Source Type: research
Considerations to Prevent Intraoperative Fluid Spillage Into the Airway From a Bronchogenic Cyst During Anesthesia: A Case Report
In patients with bronchogenic cysts, spillage of cyst contents into the airway during anesthesia and surgery has been reported. Methods to prevent this complication are not definitive. A 21-year-old man with a large bronchogenic cyst was scheduled for cyst excision during which large quantities of purulent fluid spilled into the airway immediately after induction of anesthesia. This was due to unmasking of the existing communication between the cyst and the bronchial tree. Preoperative percutaneous drainage of the cyst contents, awake intubation, and lung isolation with a bronchial blocker before paralyzing and positioning...
Source: A&A Case Reports - October 1, 2022 Category: Anesthesiology Tags: Airway Management Source Type: research
Cardiac Arrest Following Remimazolam-Induced Anaphylaxis: A Case Report
This report highlights the potential risk of allergic reactions to remimazolam. (Source: A&A Case Reports)
Source: A&A Case Reports - September 1, 2022 Category: Anesthesiology Tags: Cardiovascular Anesthesiology Source Type: research
A Software-Guided Approach to Hemodynamic Management in a Renal Transplant Recipient: A Case Report
The function of renal allografts in the perioperative period is partly dependent on minimizing hemodynamic instability. We have developed hemodynamic monitoring software—named the “pressure field”—that was utilized in a 68-year-old high-risk kidney transplant recipient. The “pressure field” was used to individualize fluid and drug administration and replicate the preoperative hemodynamics. The patient received net zero fluid intraoperatively and had an uneventful postoperative course. We found the pressure field method helpful to manage perioperative hemodynamics in this high-risk patient. (Source: A&A Case Reports)
Source: A&A Case Reports - September 1, 2022 Category: Anesthesiology Tags: Cardiovascular Anesthesiology Source Type: research
Dehiscence and Deep Wound Infection After Spinal Cord Stimulator Implant Managed Without Explantation: A Case Report
Deep infections of spinal cord stimulator devices usually result in explantation, as recommended by some professional societies. However, alternative options should be explored to avoid potential complications that are associated with explantation, and possibly additional procedures required in consideration of reimplantation. In this case, the patient presented with wound dehiscence after implantation. There was suspicion for deep wound infection based on a wound culture that was positive for Staphylococcus aureus, but no purulent material was noted on further inspection. The patient was treated with standard wound-care m...
Source: A&A Case Reports - September 1, 2022 Category: Anesthesiology Tags: Case Report Source Type: research
Ultrasound-Guided Scalp Blocks for an Awake Craniotomy: A Case Report
In this report, we demonstrate that ultrasound-guided scalp blocks can be used effectively for a craniotomy. A 48-year-old patient with a brain tumor at the motor cortex was scheduled for an awake craniotomy. Ultrasound-guided scalp blocks targeting the bilateral supraorbital, supratrochlear, zygomaticotemporal, auriculotemporal, greater auricular, lesser occipital, greater occipital, and third occipital nerves were performed. A total of 29 mL of levobupivacaine 0.3% was used. No additional local anesthetic agent was given for skull pinning, skin incision, or the craniotomy. Postoperatively, the patient remained pain-fre...
Source: A&A Case Reports - September 1, 2022 Category: Anesthesiology Tags: Case Report Source Type: research
Radiotherapy for a Patient With Spinal Cord Stimulation: A Case Report
We present a case of successful administration of radiotherapy to a patient without damaging the SCS device implanted in proximity to the target lesion. (Source: A&A Case Reports)
Source: A&A Case Reports - September 1, 2022 Category: Anesthesiology Tags: Chronic Pain Medicine Source Type: research
VivaSight Single-Lumen Tube Combined With Hyperangulated Videolaryngoscopy to Rescue Failed Tracheal Intubation in a Patient With Goldenhar Syndrome: A Case Report
This report describes a patient with Goldenhar syndrome undergoing anesthesia for whom Macintosh videolaryngoscopy failed, as the epiglottis was adhered to the posterior pharynx and could not be lifted with a tracheal introducer (Cormack-Lehane grade 3B). Hyperangulated videolaryngoscopy revealed only the arytenoids (Cormack-Lehane grade 2B), even after direct lifting of the epiglottis, and endotracheal tube advancement failed due to unclear tissue resistance. Hyperangulated videolaryngoscopy was combined with a tube-mounted camera (VivaSight single lumen tube). The combination of both camera perspectives was successfully ...
Source: A&A Case Reports - September 1, 2022 Category: Anesthesiology Tags: Case Report Source Type: research
An Unexpected Magnet Response of a Biotronik Pacemaker in Automatic Mode: A Case Report
In patients with cardiovascular implantable electronic devices, asynchronous pacing is necessary for surgeries with a risk of electromagnetic interference. Magnets are often used for asynchronous pacing. In this case report, magnet application to a Biotronik Evia DR-T pacemaker (Biotronik) programmed to a magnet response mode called automatic magnet mode (AUTO) led to a brief period of asynchronous pacing before reverting to prior settings, an unexpected response that was not revealed on the preoperative interrogation report. For Biotronik pacemakers programmed to the AUTO mode, changes in programming are needed for asynch...
Source: A&A Case Reports - September 1, 2022 Category: Anesthesiology Tags: Case Report Source Type: research
Lost Venous Access Guidewire Identified by Its Late Cervical Protrusion: Case Report: Erratum
No abstract available (Source: A&A Case Reports)
Source: A&A Case Reports - August 1, 2022 Category: Anesthesiology Tags: ERRATUM Source Type: research
Echo Rounds: Intraoperative Doppler Assessment of Transjugular Intrahepatic Shunt Flow Using Transesophageal Echocardiography
The use of intraoperative transesophageal echocardiography (TEE) to assess venous congestion of the liver due to right heart dysfunction is well established, predominately through the Doppler interrogation of the hepatic and portal venous waveforms. Transjugular intrahepatic portosystemic shunts (TIPSs) are artificial intraparenchymal tracts through the liver that are placed to decompress the portal circulation in the setting of portal hypertension, most commonly due to cirrhosis. Herein, we describe the Doppler interrogation of a TIPS using intraoperative TEE, and how changes in the transmitted portal venous waveform were...
Source: A&A Case Reports - August 1, 2022 Category: Anesthesiology Tags: Echo Rounds Source Type: research
White Cane Approach to Teaching Spinal Anesthesia
With aging-associated obesity and osteoarthritis, anesthesiology trainees and their instructors face difficulties in identifying the surface anatomy and landmarks for spinal anesthesia, and successfully advancing the needle into the intrathecal space. Through a series of illustrations and instructions, this teaching tool suggests that using a spinal needle in the same way that a blind person uses a white cane may improve a trainee’s ability to successfully perform a lumbar puncture. Reviewing the technique and instructions with the trainee before approaching the patient can minimize verbal instructions in the patient’s...
Source: A&A Case Reports - August 1, 2022 Category: Anesthesiology Tags: Educational Tool Source Type: research
In-Circuit High-Frequency Jet Ventilation for Radiological Tumor Ablation: A Case Series
This study describes feasibility and safety of the technique in routine use. We describe our method for the use of HFJV and present 169 consecutive cases, including IGA of tumors of the lung, liver, kidney, and pancreas. Intended oncological treatment was delivered in all cases and HFJV used for the duration of treatment in all except one case. We describe the characteristics of patients, procedures, and adverse events. It is feasible to use HFJV as the routine standard of care for IGA. (Source: A&A Case Reports)
Source: A&A Case Reports - August 1, 2022 Category: Anesthesiology Tags: Case Series Source Type: research
Retrolaminar Continuous Nerve Block Catheter for Multiple Rib Fractures: A Case Report
We present a case of a continuous retrolaminar nerve block catheter placed without ultrasound guidance in a 67-year-old man with oxygen-dependent chronic obstructive pulmonary disease and a prior intrathecal pump, who presents with multiple unilateral rib fractures. (Source: A&A Case Reports)
Source: A&A Case Reports - August 1, 2022 Category: Anesthesiology Tags: Case Report Source Type: research
Intermediate Cervical Plexus Block for Refractory Bilateral Facial Pain From a Whiplash Injury in 3 Patients: A Case Report
This report includes 3 patients with refractory bilateral facial pain. A detailed review of history revealed whiplash before the onset of the symptoms. The authors present a novel intervention, an intermediate cervical plexus block that produced durable analgesia. (Source: A&A Case Reports)
Source: A&A Case Reports - August 1, 2022 Category: Anesthesiology Tags: Case Report Source Type: research
