Perineural Adductor Canal Catheter Placement for Prevention of Complex Regional Pain Syndrome-I Exacerbation After Knee Arthroscopy: A Case Report
We present a case of CRPS-I triggered by knee surgery on multiple prior occasions but finally prevented by perineural adductor canal catheter placement. The literature presents only moderate evidence supporting interventions such as intravenous regional anesthesia and sympathetic blockade; continuous nerve blockade may be an effective treatment of CRPS-I and in particular postoperative CRPS-I. (Source: A&A Case Reports)
Source: A&A Case Reports - April 1, 2022 Category: Anesthesiology Tags: Case Report Source Type: research
Anesthetic Management of a Patient With S-Adenosylhomocysteine Hydrolase Deficiency: A Case Report
S-adenosylhomocysteine hydrolase (AHCY) deficiency is a rare congenital disorder in methionine metabolism with minimal guidelines regarding anesthetic management. This case report describes a 19-year-old man presenting for a liver biopsy in interventional radiology due to a history of elevated aminotransferases and creatine kinase. He received dextrose-containing fluids and a total intravenous anesthetic to avoid rhabdomyolysis and hyperkalemia. Anesthetic goals for patients with AHCY deficiency should focus on avoiding rhabdomyolysis, minimizing postoperative ventilatory compromise, monitoring for potential coagulopathy, ...
Source: A&A Case Reports - April 1, 2022 Category: Anesthesiology Tags: Case Report Source Type: research
Bilateral Sphenopalatine Ganglion Block With Liposomal Bupivacaine Followed by Severe Hypertension: A Case Report
We reviewed a case of bilateral sphenopalatine ganglion (SPG) blockade with liposomal bupivacaine for sinus surgery. The case was complicated by severe postoperative hypertension refractory to antihypertensives and needing intensive care unit (ICU) admission. While SPG blockade has been used to treat headaches and provide perioperative analgesia, this complication and a possible mechanism have not been described. We discuss how local anesthetic spread beyond the SPG may have caused prolonged parasympathetic blockade and hypertension. Before approved indications are established, we recommend avoiding the use of liposomal bu...
Source: A&A Case Reports - March 1, 2022 Category: Anesthesiology Tags: Case Report Source Type: research
Asymptomatic Penetration of the Median Nerve by a Peripherally Inserted Central Catheter: A Case Report
We report a rare case in which a peripherally inserted central catheter (PICC) asymptomatically penetrated the median nerve. The patient was a 71-year-old man who displayed no neurological symptoms until 4 days after PICC placement. An ultrasound scan revealed that the PICC had penetrated the median nerve. He underwent surgery to remove the catheter and had no sequelae. When placing a PICC, selecting the brachial vein as a puncture site is associated with a high risk of nerve injury. Furthermore, circumspect observation is needed until withdrawal as neurological symptoms may be absent even when the catheter has punctured a...
Source: A&A Case Reports - March 1, 2022 Category: Anesthesiology Tags: Case Report Source Type: research
Lidocaine Infusion for the Treatment of Headache Associated With Subarachnoid Hemorrhage: A Case Report
We present an innovative approach wherein intravenous lidocaine infusions were used to successfully treat 2 patients with hyperalgesia refractory to traditional analgesic therapies. Opioid consumption fell to zero for both patients during lidocaine infusions without lidocaine toxicity. Moreover, after discontinuation of lidocaine infusions, both patients reported good pain control using only standard oral medications. (Source: A&A Case Reports)
Source: A&A Case Reports - March 1, 2022 Category: Anesthesiology Tags: Case Report Source Type: research
Postictal Trismus Complicating Electroconvulsive Therapy: A Case Report
We report a case of a 72-year-old woman who experienced postictal episodes of trismus lasting several minutes on 6 occasions during a series of 18 episodes of electroconvulsive therapy (ECT). There was no clear relationship between the development of trismus and any medications used during the treatments. The patient had no adverse outcomes or discomfort, but the development of trismus can put patients at significant risk. (Source: A&A Case Reports)
Source: A&A Case Reports - March 1, 2022 Category: Anesthesiology Tags: Case Report Source Type: research
A Case Report of “Propofol Frenzy”: Anesthetic Considerations for a Severe Propofol-Induced Neuroexcitation Reaction
We present a case of a healthy young patient whose postoperative course was complicated by propofol frenzy and functional limb paralysis following hip surgery with a spinal anesthetic and propofol sedation. This case highlights anesthesia considerations for propofol frenzy and discusses dexmedetomidine as a promising modality for prompt management. (Source: A&A Case Reports)
Source: A&A Case Reports - March 1, 2022 Category: Anesthesiology Tags: Case Report Source Type: research
Aneurysmal Oscillation of the Capnogram: A Case Report
Variations in the alveolar plateau phase of the capnogram are often confused with spontaneous breathing efforts in an intubated patient. The oscillations in the capnogram due to a large ascending thoracic aneurysm are a separate entity from cardiogenic oscillations, and can be an indicator of underlying bronchial or lung compression. (Source: A&A Case Reports)
Source: A&A Case Reports - March 1, 2022 Category: Anesthesiology Tags: Case Report Source Type: research
Postoperative Ketoacidosis With Hypoglycemia in a Nondiabetic Patient Taking Dapagliflozin for Heart Failure: A Case Report
We describe a case of postoperative ketoacidosis with hypoglycemia in an 83-year-old woman who took dapagliflozin for heart failure and underwent transcatheter aortic valve replacement. She was nondiabetic and took dapagliflozin on the day of the procedure. This case suggests the need to discontinue SGLT-2 inhibitors ahead of the day of surgery when used for heart failure. (Source: A&A Case Reports)
Source: A&A Case Reports - March 1, 2022 Category: Anesthesiology Tags: Case Report Source Type: research
Anesthetic Management of an Adult With Hyperekplexia Undergoing a Laparoscopic Colectomy: A Case Report
We report the case of a 20-year-old woman with hyperekplexia who safely received general anesthesia without neuromuscular blockade for a laparoscopic colectomy. (Source: A&A Case Reports)
Source: A&A Case Reports - March 1, 2022 Category: Anesthesiology Tags: Case Report Source Type: research
Inadvertent Placement of an Infraclavicular Catheter in the Interscalene Region With an Unusual Complication: A Case Report
We report the inadvertent placement of an infraclavicular catheter in the interscalene region when an ultrasound-guided infraclavicular catheter was threaded cranially. We proposed some strategies to avoid the occurrence of complications when performing this block. (Source: A&A Case Reports)
Source: A&A Case Reports - March 1, 2022 Category: Anesthesiology Tags: Case Report Source Type: research
In Response
No abstract available (Source: A&A Case Reports)
Source: A&A Case Reports - February 1, 2022 Category: Anesthesiology Tags: Response Letter to the Editor Source Type: research
Comment on-“Chest Wall Regional Anesthesia for Modified Radical Mastectomy and Axillary Lymph Node Dissection: A Case Report”
No abstract available (Source: A&A Case Reports)
Source: A&A Case Reports - February 1, 2022 Category: Anesthesiology Tags: Letter to the Editor Source Type: research
Device Closure of a Sinus Venosus Atrial Septal Defect
No abstract available (Source: A&A Case Reports)
Source: A&A Case Reports - February 1, 2022 Category: Anesthesiology Tags: Echo Rounds Source Type: research
Left Atrial Dissection Secondary to Retrograde Coronary Sinus Cannulation During a Stanford Acute Type-A Aortic Dissection Repair: A Case Report
Left atrial (LA) dissections are rare phenomena, often iatrogenic, caused by blood flow into a false lumen, potentially obstructing the pulmonary veins or flow into the left ventricle. Severity can range from an incidental observation or complete circulatory collapse. While LA dissections are often associated with mitral valve repair, there are 2 reported cases of LA dissections associated with retrograde cardioplegia cannula insertion through the coronary sinus. Here, we present a large LA dissection that was directly visualized and tracked to a coronary sinus injury from the retrograde cardioplegia cannula. The clinical ...
Source: A&A Case Reports - February 1, 2022 Category: Anesthesiology Tags: Case Report Source Type: research
