Anesthetic-Induced Intraoperative Dream Associated With Remission of a Psychiatric Disorder: A Case Report
We report on a patient undergoing surgical hand repair after a recent knife attack who experienced vivid dreaming and subsequent remission of acute stress disorder. After local anesthesia with propofol sedation she recalled a dream wherein she relived the attack, sought medical care, completed surgery, and returned home with a healed hand. While intraoperative dreaming is common, this case details potential associations between anesthetic state, dreaming, intraoperative electroencephalography, and remission of a psychiatric disorder. Our experience suggests a novel intervention for stress disorders. (Source: A&A Case Reports)
Source: A&A Case Reports - August 1, 2022 Category: Anesthesiology Tags: Case Report Source Type: research
Use of a Spinal-Caudal Epidural Technique for Abdominal Surgery in a Newborn With Noonan Syndrome and Severe Hypertrophic Cardiomyopathy
We report the use of a combined spinal-caudal epidural anesthesia technique during urologic surgery (pyeloplasty) in an 8-week-old infant with Noonan syndrome and HCM. A spinal-caudal epidural technique provides favorable hemodynamic conditions, avoids the need for airway instrumentation, and may serve as an alternative to general anesthesia in these high risk patients. (Source: A&A Case Reports)
Source: A&A Case Reports - August 1, 2022 Category: Anesthesiology Tags: Case Report Source Type: research
Lance Adams Syndrome After Hypoxic Cardiac Arrest: A Case Report
In this report, we discuss the diagnosis, treatment, and prognosis of patients with Lance-Adams syndrome. (Source: A&A Case Reports)
Source: A&A Case Reports - August 1, 2022 Category: Anesthesiology Tags: Case Report Source Type: research
Carbon Monoxide Poisoning Presenting With Neurological Signs During Hysteroscopic Bipolar Surgery With Spinal Anesthesia: Two Case Reports
Loss of consciousness suddenly occurred in 2 healthy and nonsmoking patients undergoing bipolar resection for intramural myomas under spinal anesthesia. One patient had nystagmus and emesis. In both cases, neurological symptoms were of short duration. All other usual causes were excluded. Initial venous carboxyhemoglobin concentrations were 7% and 23%, respectively. These concentrations decreased within several hours with oxygen therapy. Carbon monoxide (CO) is a product of diathermic vaporization and may enter the blood and cause intraoperative cardiovascular symptoms. These are the first cases with neurological presentat...
Source: A&A Case Reports - August 1, 2022 Category: Anesthesiology Tags: Case Report Source Type: research
Total Intravenous Anesthesia Using Remimazolam and Continuous Cardiac Output Monitoring for Dental Anesthesia in a Patient With Takayasu’s Arteritis: A Case Report
This report highlights the use of remimazolam and remifentanil to reduce hemodynamic perturbations using estimated continuous cardiac output monitoring. (Source: A&A Case Reports)
Source: A&A Case Reports - August 1, 2022 Category: Anesthesiology Tags: Case Report Source Type: research
Inhaled Tranexamic Acid for the Management of Hemoptysis in a Patient With Right and Left Ventricular Assist Devices: A Case Report
We describe a case of a patient supported by a right ventricular assist device with an oxygenator and a left ventricular assist device who developed pulmonary hemorrhage that was successfully treated with nebulized tranexamic acid (TXA). Following a 5-day treatment course, bleeding resolved, no adverse side effects were noted, and systemic anticoagulation was resumed. (Source: A&A Case Reports)
Source: A&A Case Reports - August 1, 2022 Category: Anesthesiology Tags: Case Report Source Type: research
Intraoperative Management of a Child Undergoing Cardiac Surgery With Congenital Methemoglobinemia Detected in the Operating Room: A Case Report: Erratum.
No abstract available (Source: A&A Case Reports)
Source: A&A Case Reports - July 1, 2022 Category: Anesthesiology Tags: ERRATUM Source Type: research
Design and Evaluation of Novel Bite Block for Invasive Imaging Procedures
Commercially available bite blocks used for invasive imaging procedures have design limitations, including bulky profile, being made of hard plastic that may damage surrounding tissue, and tendency to dislodge. We designed a novel bite block to address these limitations and evaluated this bite block in 50 patients undergoing diagnostic or intraprocedural transesophageal echocardiography examinations. Nine of 11 (82%) imagers who used the redesigned bite block preferred it over the standard bite block used at our institution. The novel bite block is an alternative device to standard bite blocks that was redesigned to protec...
Source: A&A Case Reports - July 1, 2022 Category: Anesthesiology Tags: Innovation Source Type: research
Effect of Fetal Delivery on Pao2/Fio2 Ratio During Mechanical Ventilation in Parturients With COVID-19: A Case Series
It is controversial whether fetal delivery improves maternal oxygenation during mechanical ventilation. We evaluated maternal arterial partial pressure of oxygen (Pao2) to fractional oxygen concentration (Fio2) (P/F) ratios before and after delivery in this series of 15 parturients with coronavirus disease 2019 (COVID-19). Compared to the immediate postpartum period, P/F ratio was increased at 48 hours (212 ± 101 vs 271 ± 90; P = .006). Linear regression demonstrated improvement in P/F ratio during the study period (slope, 3.1; 95% confidence interval [CI], 0.87–5.34; P = .007), although predelivery and postdel...
Source: A&A Case Reports - July 1, 2022 Category: Anesthesiology Tags: Case Series Source Type: research
Real-Time Ultrasound-Guided Spinal Injection Using a Transverse In-Plane Dependent Technique: A Case Series
This report evaluated the feasibility of performing USG spinal injection, using an alternative transverse interspinous scan with in-plane needle insertion, a transverse in-plane dependent (TIPD) technique, in 30 adult patients undergoing elective surgery under spinal anesthesia. Dural puncture was successfully achieved in 29 of 30 (96.6%) patients with 2 (1–3) attempts in 5 (4–8) minutes using the TIPD technique. Multiple interspinous osteophytes accounted for technical failure in 1 patient. (Source: A&A Case Reports)
Source: A&A Case Reports - July 1, 2022 Category: Anesthesiology Tags: Case Series Source Type: research
Fire Hazard in an Anesthesia Machine: A Case Report
We present 2 fire incidents in the rear cabinet of an anesthesia machine, not previously reported in the literature. An anesthesia machine in standby mode is considered safer than in use, but in the first case, the fire occurred while the machine was on standby mode. In another case, the fire erupted while surgery was in progress. Here, we discuss the management of an anesthesia machine fire and emphasize the need for improved fire safety in advanced anesthesia machines. (Source: A&A Case Reports)
Source: A&A Case Reports - July 1, 2022 Category: Anesthesiology Tags: Case Report Source Type: research
The Retro Superior Costotransverse Ligament Space as a New Target for Ultrasound-Guided Intertransverse Process Block: A Report of 2 Cases
This report describes a transverse ultrasound imaging technique to identify the retro-SCTL space and perform an ITPB with a retro-SCTL space injection, in 2 patients undergoing video-assisted thoracoscopic surgery. The resultant bilateral, symmetrical, thoracolumbar anesthesia was consistent with epidural spread of the LA and effective for perioperative analgesia. (Source: A&A Case Reports)
Source: A&A Case Reports - July 1, 2022 Category: Anesthesiology Tags: Case Report Source Type: research
Bedside Diagnosis of Pulmonary Embolism Using Electrical Impedance Tomography: A Case Report
We present a case of a postoperative hypoxic patient in the intensive care unit (ICU) who was too unstable for transport for computed tomography (CT) imaging but was diagnosed and treated for a pulmonary embolism using EIT at the bedside. After the patient clinically improved, CT imaging confirmed the pulmonary embolism diagnosis. EIT is a promising diagnostic tool that may have great utility in ICUs, where it can be safely applied at the bedside. (Source: A&A Case Reports)
Source: A&A Case Reports - July 1, 2022 Category: Anesthesiology Tags: Case Report Source Type: research
“Combination of Thoracic Epidural Anesthesia, Supraclavicular Brachial Plexus Block and Supraclavicular Nerve Block as Surgical Anesthesia for Modified Radical Mastectomy—A Case Series”
Sensory innervation of the breast is complex, thereby making it difficult to perform any surgical procedure with a single regional anesthesia technique. Because of the involvement of pectoral muscles and extension of the incision into the axilla, a modified radical mastectomy makes it further challenging and requires multiple techniques. We have used a new combination of regional techniques in this case series and found that it provided complete surgical anesthesia with a smaller volume of local anesthetic. (Source: A&A Case Reports)
Source: A&A Case Reports - June 1, 2022 Category: Anesthesiology Tags: Case Series Source Type: research
Viscoelastic Testing and Factor Concentrate Therapy to Reduce Bleeding and Transfusions in the Surgical Separation of Ischiophagus Twins: A Case Report
We present a case of the surgical separation of ischiopagus tetrapus twins using a patient blood management strategy encompassing a tranexamic acid infusion, intraoperative viscoelastic testing, and early fibrinogen supplementation to reduce bleeding and transfusions. This approach allowed early detection and treatment of acquired hypofibrinogenemia, which resulted in minimal exposure to blood products. This case reflects the increasing clinical interest in early avoidance of fibrinogen deficiency in complex noncardiac pediatric surgery. (Source: A&A Case Reports)
Source: A&A Case Reports - June 1, 2022 Category: Anesthesiology Tags: Case Report Source Type: research
