Conflict Management Education for Anesthesiology Residents: Bridging the Gap in Interpersonal and Communication Skills Competency
Effective communication and conflict management are important skills for anesthesiologists and are designated by the Accreditation Council for Graduate Medical Education (ACGME) as elements of the “interpersonal and communication skill” competency (ACGME Anesthesiology Milestone Project 2020). However, structured conflict management education for anesthesiology residents remains limited. To address this gap, we developed and implemented a conflict management session incorporating didactics and application exercises using role-play and high-fidelity simulation (SIM) for anesthesiology residents (postgraduate years 3 and...
Source: A&A Case Reports - October 1, 2021 Category: Anesthesiology Tags: Innovation Source Type: research
Anesthetic Management of Children and Adolescents With Giant Axonal Neuropathy: A Large Case Series
We report on 14 GAN patients who underwent 77 anesthetics during the conduct of an intrathecal gene transfer clinical trial from April 2015 to August 2020. We observed only a few nonsignificant perianesthetic complications. Our data expand the knowledge regarding safety of anesthesia for patients with this rare and potentially fatal disease and highlights the tolerability of shorter procedural sedation and anesthesia. (Source: A&A Case Reports)
Source: A&A Case Reports - October 1, 2021 Category: Anesthesiology Tags: Case Series Source Type: research
Continuous Local Anesthetic Infusion via Chest Wall Catheter for Analgesia After Thoracic Surgery in Neonates: A Case Series
Pain management options in neonates after thoracotomy have traditionally been limited to intravenous opioids and caudal catheters. However, because of increasing familiarity with ultrasound imaging, erector spinae and paravertebral nerve blocks are being performed more frequently. For thoracic procedures, we describe a case series of 4 neonates involving ropivacaine infusion via an extrathoracic chest wall catheter placed by the surgeon. This technique requires less time, is less invasive, does not require ultrasound, and enabled us to accomplish tracheal extubation in the operating room immediately after surgery, and decr...
Source: A&A Case Reports - October 1, 2021 Category: Anesthesiology Tags: Case Series Source Type: research
Minimally Invasive Anesthesia in Pediatric Circumcision: A Case Series
Anesthetic management of pediatric circumcisions typically involves intravenous access and advanced airway management. We explored the use of a minimally invasive anesthetic protocol for pediatric circumcisions akin to the anesthetic management for bilateral myringotomy and tympanostomy. Five pediatric circumcisions were performed under mask ventilation without intravenous access and evaluated for intraoperative anesthesia times, patient outcomes, and complications. The mean (standard deviation) intraoperative anesthesia time was 41.4 (5.7) minutes, and 1 patient experienced a mild intraoperative complication with emesis a...
Source: A&A Case Reports - October 1, 2021 Category: Anesthesiology Tags: Case Series Source Type: research
Diagnosis and Management of a Retained Local Anesthetic Needle Fragment in a Patient Who Underwent Scheduled Elective Cesarean Delivery: A Case Report
Cesarean deliveries are often performed with a neuraxial anesthetic technique. Fracture of needles used for local anesthetic infiltration is rare. During subcutaneous infiltration of local anesthetic for a combined spinal epidural (CSE) anesthetic technique performed for elective cesarean delivery, a fragment from a fractured 27-gauge local anesthetic needle was retained in the lumbar subcutaneous tissue. CSE anesthesia was then successfully performed at a different spinal interspace, and the patient had an uneventful cesarean delivery. The patient had the needle fragment removed on the first postoperative day by an interv...
Source: A&A Case Reports - October 1, 2021 Category: Anesthesiology Tags: Case Report Source Type: research
Persistent Postoperative Vasoplegia After Ureteronephrectomy Due To Suspected Intravesical Gemcitabine Toxicity
We describe a case of unusually persistent vasoplegia in the postoperative course of a patient recovering after elective right robotic nephroureterectomy with intravesical salvage gemcitabine. In the treatment of patients with intravesical adjuvant therapy, gemcitabine may precipitate persistent vasoplegia requiring further fluid resuscitative efforts, vasopressor support, and other supportive management. This potential adverse event should be considered when all common causes of persistent vasoplegia are ruled out, such as shock related to bleeding, infection, allergic reaction, or pulmonary embolic phenomenon. (Source: A&A Case Reports)
Source: A&A Case Reports - October 1, 2021 Category: Anesthesiology Tags: Case Report Source Type: research
Hyperventilation and Respiratory Alkalosis After Olanzapine for Insomnia: A Case Report
We present the unusual case of hyperventilation with respiratory alkalosis after the administration of olanzapine for insomnia in an elderly postoperative patient. This led to a second admission to the intensive care unit with invasive interventions including mechanical ventilation and vasopressor support. Caution must be exercised in prescribing antipsychotics for off-label use, especially in a population whose baseline characteristics can affect the pharmacokinetics of second-generation antipsychotics. (Source: A&A Case Reports)
Source: A&A Case Reports - October 1, 2021 Category: Anesthesiology Tags: Case Report Source Type: research
Facial Petechiae Following Laparoscopic Surgery: A Case Report of Rumpel-Leede Phenomenon
We describe the case of a patient who developed a facial petechial rash following a laparoscopic abdominal hysterectomy in steep Trendelenburg position. We review the physiological effects of laparoscopic surgical techniques and Trendelenburg positioning. These physiological effects lead to cephalad venous compression and are analogous to the venous compression caused by a tourniquet. The circumstances preceding its development and the characteristics of the facial rash lead us to conclude that the patient we present developed facial Rumple-Leede Phenomenon. (Source: A&A Case Reports)
Source: A&A Case Reports - October 1, 2021 Category: Anesthesiology Tags: Case Report Source Type: research
Severe Abdominal Wall Infection After Subcostal Transversus Abdominis Plane Block: A Case Report
Transversus abdominis plane (TAP) blocks are increasingly used for perioperative analgesia in patients undergoing abdominal surgeries. TAP blocks are easy to perform, reliably effective, and have an excellent safety profile. Nevertheless, we report a patient who underwent an open cholecystectomy and right hemicolectomy where a subcostal TAP block possibly contributed to an unusual abdominal wall abscess that lead to a prolonged and complicated postoperative course. (Source: A&A Case Reports)
Source: A&A Case Reports - October 1, 2021 Category: Anesthesiology Tags: Case Report Source Type: research
In Response
No abstract available (Source: A&A Case Reports)
Source: A&A Case Reports - September 1, 2021 Category: Anesthesiology Tags: Letter to the Editor Source Type: research
Diagnosing Myoclonic Epilepsy With Ragged-Red Fibers Syndrome Requires Documentation of a Causative Mutation
No abstract available (Source: A&A Case Reports)
Source: A&A Case Reports - September 1, 2021 Category: Anesthesiology Tags: Letter to the Editor Source Type: research
Anesthetic Management in Double-Trouble Kearns-Sayre Syndrome and Hereditary Neuropathy Is Feasible but Delicate
No abstract available (Source: A&A Case Reports)
Source: A&A Case Reports - September 1, 2021 Category: Anesthesiology Tags: Letter to the Editor Source Type: research
Echo Rounds: Partial Anomalous Systemic and Pulmonary Venous Return
Anomalous drainage of a right-sided superior vena cava to the left atrium is a rare variant of systemic venous return anomalies. During the course of investigation for a heart murmur, an asymptomatic child was found to have a superior sinus venosus atrial septal defect with partial anomalous systemic and pulmonary venous drainage. Despite the right superior vena cava overriding the upper end of the atrial septum and draining into the left atrium, the child did not exhibit hypoxemia. Saline contrast transesophageal echocardiography suggested an explanation for the absence of hypoxemia. (Source: A&A Case Reports)
Source: A&A Case Reports - September 1, 2021 Category: Anesthesiology Tags: Echo Rounds Source Type: research
An Unusual Case of Pulmonary Vein Stenosis Diagnosed With Intraoperative Transesophageal Echocardiography
No abstract available (Source: A&A Case Reports)
Source: A&A Case Reports - September 1, 2021 Category: Anesthesiology Tags: Echo Rounds Source Type: research
Nerve Blocks for Postoperative Pain Management in Children Receiving a Subcutaneous Implantable Cardioverter-Defibrillator: A Case Series: Retraction
No abstract available (Source: A&A Case Reports)
Source: A&A Case Reports - September 1, 2021 Category: Anesthesiology Tags: Retraction Source Type: research
