Nerve Blocks for Postoperative Pain Management in Children Receiving Subcutaneous Implantable Cardioverter-Defibrillators: A Case Series
Subcutaneous implantable cardioverter-defibrillator (S-ICD) placement may cause significant postoperative pain. Limited research exists on regional anesthesia for pediatric S-ICD placement. This case series examined transversus thoracic plane blocks (TTPBs), pectointercostal fascial plane blocks (PIFBs), pectoralis nerve I and II blocks, paravertebral, serratus anterior plane, and erector spinae plane blocks (ESPBs) in 10 children receiving S-ICDs. Parasternal nerve blocks consisting of TTPB or PIFB and left ESPB appeared to provide adequate pain control. These children had reduced opioid consumption, lower mean pain score...
Source: A&A Case Reports - September 1, 2021 Category: Anesthesiology Tags: Case Series Source Type: research
An Eye-Popping Experience Immediately After Intubation: A Case Report
This case presents and discusses a case of unilateral proptosis immediately following intubation in a patient who underwent laparoscopic ventral hernia repair under general anesthesia. The patient developed a right-sided proptosis following intubation when noninvasive blood pressure was measured as 167/111 mm Hg. The operation was postponed, and anesthesia was terminated. Proptosis resolved spontaneously following extubation. To the best of our knowledge, there is no case report of proptosis secondary to intubation. The aim of this report is to increase the awareness of rare complications caused by intubation, especially o...
Source: A&A Case Reports - September 1, 2021 Category: Anesthesiology Tags: Case Report Source Type: research
Administering Labor Analgesia Under General Anesthesia in an Intellectually Disabled Patient
This report describes a unique approach to providing labor analgesia in the intellectually disabled patient. (Source: A&A Case Reports)
Source: A&A Case Reports - September 1, 2021 Category: Anesthesiology Tags: Case Report Source Type: research
Not All Subarachnoid Hemorrhages in Pregnancy Are Intracranial in Origin: A Case Report
We present an unusual case of subarachnoid hemorrhage in a term parturient where the bleeding originated from an extracranial source, namely a cervicothoracic arteriovenous malformation. This case highlights the challenge of diagnosing this condition when the initial presentation may be nonspecific, lacking in neurologic deficits, and confounded by the simultaneous presence of preeclampsia. (Source: A&A Case Reports)
Source: A&A Case Reports - September 1, 2021 Category: Anesthesiology Tags: Case Report Source Type: research
Efficacy of Ultrasound-Guided Intermediate Cervical Plexus Block by Anterior Route for Perioperative Analgesia in Robotic Thyroidectomy by Retroauricular Approach: A Case Series
Retroauricular or facelift approach for robotic thyroidectomy involves a long incision with extensive subcutaneous dissection causing severe pain and discomfort. Multimodal analgesic regimen with inclusion of intermediate cervical plexus block by anterior route provided excellent perioperative analgesia without affecting recurrent laryngeal nerve monitoring in 10 cases. All the patients were monitored with bispectral index (maintained 40–60) and extubated on table. Median numeric pain rating scale score in 24 hours postoperatively was 3. None of the cases had any significant complications on follow-up. (Source: A&A Case Reports)
Source: A&A Case Reports - August 1, 2021 Category: Anesthesiology Tags: Case Series Source Type: research
Pulse Oximetry Waveform Represents an Earlier Ventricular Contraction in Relation to the Intraarterial Blood Pressure Tracing and Electrocardiogram on Multichannel Monitors: A Case Series
In conclusion, the pulse oximetry plethysmograph tracing is offset by 1 ventricular depolarization on the electrocardiogram (QRS) and the arterial tracing on multichannel monitors. (Source: A&A Case Reports)
Source: A&A Case Reports - August 1, 2021 Category: Anesthesiology Tags: Case Series Source Type: research
Blue Rubber Bleb Nevus Syndrome in the Obstetric Patient: A Case Report of Anesthetic Implications and Management
Blue rubber bleb nevus syndrome (BRBNS) is a rare systemic syndrome characterized by venous malformations usually found in the skin and visceral organs. To date, 11 case reports describing BRBNS during pregnancy have been published. To our knowledge, this is the first report describing intracranial, airway, epidural, and birth canal involvement of venous malformations in the same parturient. Key lessons learned include clinical presentation, workup, team management, and care of obstetric patients with this disorder. (Source: A&A Case Reports)
Source: A&A Case Reports - August 1, 2021 Category: Anesthesiology Tags: Case Report Source Type: research
Epidural Placement in a Patient With a Type 2 Split Cord Malformation in the Interventional Pain Management Setting: A Case Report
Split cord malformations are rare spinal dysraphisms in which 2 separate spinal cords are present. Despite its diagnosis in all age groups, split cord malformations are not well described. The clinical presentation and symptom severity are highly variable. Anesthesiologists may encounter patients with known or unknown split cord malformations without much information to guide clinical decision-making and procedural risks of neuraxial anesthesia. This is the first case to the authors’ knowledge of utilizing a caudal epidural injection for pain management in a patient with a diagnosed split cord malformation. (Source: A&A Case Reports)
Source: A&A Case Reports - August 1, 2021 Category: Anesthesiology Tags: Case Report Source Type: research
Regional Anesthetic Approaches for Postoperative Analgesia Following Vertebral Body Tethering: A Case Series
Vertebral body tethering (VBT) is an innovative surgical technique used to treat juvenile and adolescent idiopathic scoliosis. The optimal anesthetic technique, including the preferred management of postoperative pain, is not known. In this case series, we describe 3 patients with adolescent idiopathic scoliosis who received either continuous erector spinae plane block (ESPB) catheters or intercostal liposomal bupivacaine for postoperative pain management after bilateral VBT via minithoracotomy. (Source: A&A Case Reports)
Source: A&A Case Reports - August 1, 2021 Category: Anesthesiology Tags: Case Report Source Type: research
Liposomal Bupivacaine for Pediatric Celiac Plexus Block: A Case Report of Refractory Constipation Management
We present the use of liposomal bupivacaine for pediatric celiac plexus block in a 12-year-old boy suffering from gastrointestinal complications (eg, pain, constipation, and ileus) after bone marrow transplantation. Celiac plexus block utilizing liposomal bupivacaine was successfully used to palliate his pain and to normalize bowel function. (Source: A&A Case Reports)
Source: A&A Case Reports - August 1, 2021 Category: Anesthesiology Tags: Case Report Source Type: research
Development of Upper Extremity Complex Regional Pain Syndrome After Prolonged Surgery in Lithotomy Position: A Case Report
We describe a 45-year-old man with no known preexisting injury or neuropathy to his upper extremities who developed CRPS of his right wrist and hand after prolonged colorectal surgery. (Source: A&A Case Reports)
Source: A&A Case Reports - August 1, 2021 Category: Anesthesiology Tags: Case Report Source Type: research
Combined Spinal-Epidural Anesthesia for Subtotal Colectomy in a Patient With Hamman Syndrome and Epidural Pneumatosis: A Case Report
We present a 19-year-old patient with Hamman syndrome and epidural pneumatosis who required emergency laparotomy. Effective analgesia was obtained using neuraxial anesthesia with a combined spinal-epidural anesthesia technique. (Source: A&A Case Reports)
Source: A&A Case Reports - August 1, 2021 Category: Anesthesiology Tags: Case Report Source Type: research
Use of Ultrasound-Guided Selective Sensory Nerve Blocks to Provide Satisfactory Postoperative Analgesia Without Motor Paralysis in Bilateral Distal Radius Fracture Fixation: A Case Report
Peripheral nerve blocks for postoperative pain management in distal radius fracture fixation with volar locking plates can cause undesirable motor paralysis. We performed bilateral ultrasound-guided selective sensory nerve blocks to the lateral cutaneous nerve of the forearm, superficial branch of the radial nerve, and anterior interosseous nerve for a patient undergoing bilateral distal radius fracture fixation with volar locking plates. This case report describes the first successful use of this ultrasound-guided selective sensory nerve block, which provided satisfactory postoperative analgesia and preserved the patientâ...
Source: A&A Case Reports - August 1, 2021 Category: Anesthesiology Tags: Case Report Source Type: research
Opioid-Free Postoperative Pain Management After Adenotonsillectomy With Nasal Turbinate Reduction Using Bilateral Suprazygomatic Infratemporal-Pterygopalatine Fossa Injections: A Case Report
We present a case utilizing bilateral suprazygomatic maxillary nerve (SZMN) blocks or, more accurately, suprazygomatic infratemporal-pterygopalatine fossa injections to achieve opioid-free perioperative analgesia for pediatric adenotonsillectomy with nasal turbinate reduction. (Source: A&A Case Reports)
Source: A&A Case Reports - August 1, 2021 Category: Anesthesiology Tags: Case Report Source Type: research
Treatment of Steroid-Induced Lipoatrophy Following Transverse Abdominis Plane Block With Serial Intralesional Isotonic Saline Injections: A Case Report
A transverse abdominis plane (TAP) block is one option in the management of chronic groin pain after inguinal hernia repair. Steroid-induced lipoatrophy following local injection is an infrequent complication of this procedure, but can be distressing to patients when it does occur. A 36-year-old male patient of ours sustained this rare procedural complication and underwent successful reversal of the lipoatrophy through serial intralesional isotonic saline injections. The serial intralesional injection of isotonic saline is technically simple and may be an effective means of treating lipoatrophy. Pain specialists may opt to...
Source: A&A Case Reports - August 1, 2021 Category: Anesthesiology Tags: Case Report Source Type: research
