Bedside Diagnosis of Pulmonary Embolism Using Electrical Impedance Tomography: A Case Report: Erratum
No abstract available (Source: A&A Case Reports)
Source: A&A Case Reports - November 1, 2022 Category: Anesthesiology Tags: Erratum Source Type: research
Erector Spinae Plane Catheters for Analgesia for Cytoreduction Surgery With Hyperthermic Intraperitoneal Chemotherapy: A Case Series
We present a case series of 6 patients who had erector spinae plane catheters for cytoreduction surgery with hyperthermic intraperitoneal chemotherapy. They remained stable intraoperatively and had adequate pain control postoperatively. Erector spinae plane catheters may be a suitable alternative for epidural analgesia for these patients. (Source: A&A Case Reports)
Source: A&A Case Reports - November 1, 2022 Category: Anesthesiology Tags: Case Series Source Type: research
Transnasal Humidified Rapid-Insufflation Ventilatory Exchange for Difficult Airway Management in Adults With Recessive Dystrophic Epidermolysis Bullosa: A Case Series
Airway management of adult patients with recessive dystrophic epidermolysis bullosa presents significant challenges associated with tissue fragility and distortion of airway anatomy. This retrospective case series describes 11 adult patients with recessive dystrophic epidermolysis bullosa and difficult airways undergoing 24 general anesthetics in which transnasal humidified rapid-insufflation ventilatory exchange was used for preoxygenation and apneic oxygenation. Despite an average time to intubation of over 6 minutes, transnasal humidified rapid-insufflation ventilatory exchange provided oxygenation before endotracheal i...
Source: A&A Case Reports - November 1, 2022 Category: Anesthesiology Tags: Airway Management Source Type: research
Infection of a Retained Peripheral Nerve Stimulation Lead: A Case Report
Percutaneous peripheral nerve stimulation is used to provide analgesia for weeks or even months. While infection of any percutaneously implanted object is a concern, it is exceedingly rare for helically coiled leads, with a reported incidence of less than 1 infection for every 32,000 indwelling days. We now report an infected helically coiled lead requiring sedation for extraction and complicated by lead fracture during removal, leaving a remnant in situ. The infection was successfully treated with oral antibiotics. We speculate on the cause of this infection and propose steps to prevent this complication, including the av...
Source: A&A Case Reports - November 1, 2022 Category: Anesthesiology Tags: Acute Pain Medicine Source Type: research
Aphonia Following Bilateral Cervical Plexus Blocks for an Awake Hemithyroidectomy: A Case Report
A 35-year-old female patient was scheduled for a left hemithyroidectomy. We performed bilateral cervical plexus blocks with ultrasound guidance for an awake thyroidectomy. Soon after the blocks, she developed a weak voice, which gradually progressed to complete aphonia. Due to her apprehension, general anesthesia was administered. After an uneventful surgery, the patient spontaneously regained her normal voice in the postoperative period. The case report describes a previously unreported complication of aphonia presumably due to bilateral recurrent laryngeal nerve blocks, which might have occurred from the infiltrated loca...
Source: A&A Case Reports - November 1, 2022 Category: Anesthesiology Tags: Case Report Source Type: research
Perioperative Management and Considerations for Patients With Voltage-Gated Sodium Channel Mutations: A Pediatric Case Report
A 13-year-old girl with a voltage-gated sodium channel mutation (SCN8A)-associated intractable epilepsy presented for bilateral mastectomy for painful juvenile fibroadenomatosis. Sodium channel mutations are more frequently diagnosed with continued advances in genetic testing. Understanding the effects of sodium channel mutations is important to provide safe anesthetic care to these patients. In this article, we discuss what is known regarding the physiology of SCN8A channels and the anesthetic considerations when caring for patients with an SCN8A mutation. (Source: A&A Case Reports)
Source: A&A Case Reports - November 1, 2022 Category: Anesthesiology Tags: Case Report Source Type: research
Heparin Insensitivity and Thrombotic Risk Associated With Sequential Uses of Prothrombin Complex Concentrate and Andexanet Alfa for Apixaban Reversal During Acute Type A Aortic Dissection Repair: A Case Report
We report 2 patients on DOAC treatment who required emergency cardiac surgery. Both received perioperative andexanet alfa together with prothrombin complex concentrate (PCC) at some time during 6 hours before operative management. Heparin resistance was noted in each instance, and pump thrombosis developed in 1 case. (Source: A&A Case Reports)
Source: A&A Case Reports - November 1, 2022 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: Erratum
No abstract available (Source: A&A Case Reports)
Source: A&A Case Reports - October 1, 2022 Category: Anesthesiology Tags: Erratum Source Type: research
Percutaneous Auricular Nerve Stimulation (Neuromodulation) for Analgesia and Opioid-Sparing Following Knee and Hip Arthroplasty: A Proof-of-Concept Case Series
We present a case series to demonstrate proof-of-concept for the off-label use of an auricular neuromodulation device—originally developed to treat symptoms associated with opioid withdrawal—to instead provide analgesia and opioid-sparing following knee and hip arthroplasties. Within the recovery room, an auricular neuromodulation device (near-field stimulator system 2 [NSS-2] Bridge, Masimo) was applied to 5 patients. Average daily pain at rest and while moving was a median of 0 to 2 as measured on the 0 to 10 numeric rating scale, while median daily oxycodone use was 0 to 2.5 mg until device removal at home on post...
Source: A&A Case Reports - October 1, 2022 Category: Anesthesiology Tags: Acute Pain Medicine Source Type: research
Unrepaired Maternal Vein of Galen Malformation in Pregnancy: A Case Report
We present a case of a pregnant patient with an unrepaired vein of Galen malformation (VGAM) and left ventricular (LV) dilation. Patients with VGAM lesions typically present during childhood with cardiac failure or developmental delay prompting embolization. Therefore, it is highly unusual for an adult to present with an unrepaired lesion.1 It poses challenges for obstetric and anesthetic management during pregnancy and delivery to reduce the risk of heart failure, arrhythmia, and intracranial hemorrhage. Our patient safely delivered a term neonate by cesarean delivery with neuraxial analgesia at a Level IV Maternal Care C...
Source: A&A Case Reports - October 1, 2022 Category: Anesthesiology Tags: Case Report Source Type: research
A Case Report of Hypotension and Methemoglobinemia Associated With Gunshot Residue Poisoning: Nitrite-Induced Methemoglobinemia
A patient with gunshots within inches of the skin developed intraoperative vasodilatory hypotension and methemoglobinemia, both recognized consequences of nitrite poisoning. A 1- mg/kg dose of methylene blue transiently and partially reversed methemoglobinemia, but the color of the methylene blue faded rapidly, consistent with bleaching of methylene blue by nitrite in vivo. Methylene blue did not raise blood pressure, consistent with inhibition of nitric oxide (NO) synthase. Because NO production from nitrite uses an NO synthase (NOS)-independent pathway, methylene blue is expected to have little effect on reversing hypote...
Source: A&A Case Reports - October 1, 2022 Category: Anesthesiology Tags: Cardiovascular Anesthesiology Source Type: research
Serial Peripheral Nerve Blocks to Aid in Salvage of a Compromised Limb: A Case Report
We describe a case of a congenital heart disease patient with multiple risk factors for thrombosis with a compromised limb immediately after heart transplant who received serial daily peripheral nerve blocks (PNBs) resulting in limb salvage. The analgesic effects of the blocks allowed for clinical progression and participation in rehabilitation therapy, and the vasodilatory effects of the blocks helped prevent a below the knee amputation (BKA) in this devitalized and congested extremity. (Source: A&A Case Reports)
Source: A&A Case Reports - October 1, 2022 Category: Anesthesiology Tags: Case Report Source Type: research
General Anesthesia in a Patient With Neuronal Intranuclear Inclusion Disease: A Case Report
Neuronal intranuclear inclusion disease (NIID) is a progressive neurodegenerative disease with diverse clinical manifestations, including dementia and muscle weakness. We summarize anesthetic considerations in reporting general anesthesia for a 58-year-old man with bladder dysfunction and cerebellar ataxia who was diagnosed with NIID. The patient developed postinduction hypotension relevant to autonomic neuropathy. The potential risks, such as prolonged reaction to neuromuscular blocking agent, postoperative delirium, and worsening of NIID-related symptoms, were also considered. The responsiveness to anesthetics may vary w...
Source: A&A Case Reports - October 1, 2022 Category: Anesthesiology Tags: Perioperative Management/Medicine Source Type: research
Case Report: Anesthesia for a Neonate With Cutis Aplasia
This report highlights the challenges in temperature and fluid management as well as intraoperative positioning in a neonate with cutis aplasia. (Source: A&A Case Reports)
Source: A&A Case Reports - October 1, 2022 Category: Anesthesiology Tags: Burn Care Source Type: research
Pulsatile Femoral Vein Doppler and Congestive Delirium, What Is the Relationship?: A Case Report
We report a 69-year-old patient who developed postoperative delirium in the intensive care unit following aortic valve replacement surgery. The postoperative course was complicated by delirium for which echographic signs of venous congestion on the portal and the renal but also the femoral veins and their resolution correlated with the course of delirium. The use of common femoral vein Doppler as a simple bedside technique to predict and identify congestive delirium has not been reported before. (Source: A&A Case Reports)
Source: A&A Case Reports - October 1, 2022 Category: Anesthesiology Tags: Case Report Source Type: research
