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Transient Dexmedetomidine Bolus-Induced Excessive Urination Intraoperatively in a 68-Year-Old Male. 68岁男性术中一过性右美托咪定过量排尿一例。
Case Reports in Anesthesiology Pub Date : 2020-12-02 eCollection Date: 2020-01-01 DOI: 10.1155/2020/6660611
Joseph A McGuire, Summer A Niazi, Daniel C Sizemore
{"title":"Transient Dexmedetomidine Bolus-Induced Excessive Urination Intraoperatively in a 68-Year-Old Male.","authors":"Joseph A McGuire,&nbsp;Summer A Niazi,&nbsp;Daniel C Sizemore","doi":"10.1155/2020/6660611","DOIUrl":"https://doi.org/10.1155/2020/6660611","url":null,"abstract":"<p><p>Excessive urination can be a perioperative challenge for providers due to the possibility of secondary hypernatremia. Dexmedetomidine has previously been reported by several groups to induce a polyuric-like syndrome; however, the exact mechanism in humans remains unclear. In this report, we discuss a case of intraoperative, transient dexmedetomidine bolus-induced excessive urination and suggest a potential mechanism by which this may occur in a subset of the population.</p>","PeriodicalId":36504,"journal":{"name":"Case Reports in Anesthesiology","volume":"2020 ","pages":"6660611"},"PeriodicalIF":0.0,"publicationDate":"2020-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7725579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38731610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Management of Total Transection of Nasoendotracheal Tube during LeFort I Osteotomy. LeFort I型截骨术中鼻气管管全截断的处理。
Case Reports in Anesthesiology Pub Date : 2020-11-17 eCollection Date: 2020-01-01 DOI: 10.1155/2020/2097240
Miles Somers, Peter Tsakiris, Peter Isert, Samuel Kim
{"title":"Management of Total Transection of Nasoendotracheal Tube during LeFort I Osteotomy.","authors":"Miles Somers,&nbsp;Peter Tsakiris,&nbsp;Peter Isert,&nbsp;Samuel Kim","doi":"10.1155/2020/2097240","DOIUrl":"https://doi.org/10.1155/2020/2097240","url":null,"abstract":"<p><p>Transection of the nasoendotracheal tube during orthognathic surgery is a rare, but life-threatening complication. We present a case of complete nasoendotracheal tube transection during a LeFort 1 osteotomy and discuss appropriate preventative and management techniques.</p>","PeriodicalId":36504,"journal":{"name":"Case Reports in Anesthesiology","volume":"2020 ","pages":"2097240"},"PeriodicalIF":0.0,"publicationDate":"2020-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/2097240","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38341020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
It Is Just a Blood Patch: Considerations for Patients with Preexisting Intracranial Hypertension. 这只是一块血贴：颅内高血压患者的注意事项。
Case Reports in Anesthesiology Pub Date : 2020-11-10 eCollection Date: 2020-01-01 DOI: 10.1155/2020/8365296
Devina Shiwlochan, Sargis Ohanyan, Kanishka Rajput
{"title":"It Is Just a Blood Patch: Considerations for Patients with Preexisting Intracranial Hypertension.","authors":"Devina Shiwlochan, Sargis Ohanyan, Kanishka Rajput","doi":"10.1155/2020/8365296","DOIUrl":"10.1155/2020/8365296","url":null,"abstract":"<p><p>Epidural blood patches are routine procedures interventional pain physicians perform for postdural puncture headaches (PDPH), whether it be due to the inadvertent wet tap from an epidural or a diagnostic lumbar puncture. Typically, these patients are relatively healthy and an epidural is relatively straightforward. However, there are cases complicated by a neurologic history such as benign intracranial hypertension. Here, we present a case of a patient with benign intracranial hypertension (BIH) that suffered a postdural puncture headache after a diagnostic lumbar puncture, with no documented opening pressure, continued on acetazolamide. There have only been a small number of documented cases of BIH complicated by PDPH. We discuss the medical management of BIH, how it can exacerbate a postdural puncture headache, our definitive management with an epidural blood patch, and our concerns of rebound intracranial hypertension. We demonstrate that treatment of PDPH in BIH is best managed with image-guided blood patches, with smaller volume of autologous blood, and at a slower rate.</p>","PeriodicalId":36504,"journal":{"name":"Case Reports in Anesthesiology","volume":"2020 ","pages":"8365296"},"PeriodicalIF":0.0,"publicationDate":"2020-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7676938/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38333788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Aortic Cannulation around Grade 5 Aortic Arch Atheroma Utilizing Transesophageal Echocardiography. 经食管超声心动图应用于5级主动脉弓动脉粥样硬化周围的主动脉插管。
Case Reports in Anesthesiology Pub Date : 2020-11-05 eCollection Date: 2020-01-01 DOI: 10.1155/2020/8820948
Trey W Vanek, Jeremiah Hayanga, Matthew Ellison, Jeffrey Puette, Lawrence Wei, Heather K Hayanga
{"title":"Aortic Cannulation around Grade 5 Aortic Arch Atheroma Utilizing Transesophageal Echocardiography.","authors":"Trey W Vanek, Jeremiah Hayanga, Matthew Ellison, Jeffrey Puette, Lawrence Wei, Heather K Hayanga","doi":"10.1155/2020/8820948","DOIUrl":"10.1155/2020/8820948","url":null,"abstract":"<p><p>A 61-year-old male with severe aortic valve stenosis was scheduled for a minimally invasive bioprosthetic aortic valve replacement. Intraoperative transesophageal echocardiography (TEE) showed a unicuspid aortic valve and extensive aortic atheromatous disease. A large atheroma with mobile components existed near the distal aortic arch. A 17-French aortic cannula was successfully placed using TEE guidance with the tip proximal to the mobile atheroma to avoid inadvertent disruption and subsequent embolic sequelae. The patient had no evidence of perioperative stroke or other complications postoperatively. This case demonstrates one strategy to manage severe atheromatous disease intraoperatively. We also review additional management options.</p>","PeriodicalId":36504,"journal":{"name":"Case Reports in Anesthesiology","volume":"2020 ","pages":"8820948"},"PeriodicalIF":0.0,"publicationDate":"2020-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/8820948","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38720778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Effectiveness of Ketamine in Pediatric Acute Deafferentation Pain after Spinal Cord Injury. 氯胺酮治疗小儿脊髓损伤后急性脱神经痛的疗效观察。
Case Reports in Anesthesiology Pub Date : 2020-10-19 eCollection Date: 2020-01-01 DOI: 10.1155/2020/8835292
Devina G Shiwlochan, Misty Shah, Khushboo Baldev, Donna-Ann Thomas, Maxime Debrosse
{"title":"The Effectiveness of Ketamine in Pediatric Acute Deafferentation Pain after Spinal Cord Injury.","authors":"Devina G Shiwlochan,&nbsp;Misty Shah,&nbsp;Khushboo Baldev,&nbsp;Donna-Ann Thomas,&nbsp;Maxime Debrosse","doi":"10.1155/2020/8835292","DOIUrl":"https://doi.org/10.1155/2020/8835292","url":null,"abstract":"<p><p>Deafferentation pain and allodynia commonly occur after spinal cord trauma, but its treatment is often challenging. The literature on effective therapies for pediatric deafferentation pain, especially in the setting of spinal cord injury, is scarce. We report the case of a 12-year-old patient with acute allodynia after a gunshot injury to the spine. The pain was refractory to multiple analgesics, but resolved with ketamine, which also improved the patient's physical function and quality of life, a trend that continued many months after the injury. We suggest that early initiation of ketamine may be effective for acute pediatric deafferentation pain secondary to spinal cord injury, as well as preventing chronic pain states in that population.</p>","PeriodicalId":36504,"journal":{"name":"Case Reports in Anesthesiology","volume":"2020 ","pages":"8835292"},"PeriodicalIF":0.0,"publicationDate":"2020-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/8835292","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38554086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Ultrasound-Guided Interscalene Brachial Plexus Block for Pathological Humerus Fracture due to Multiple Myeloma with Systemic Manifestation: Useful Option for Management in Low-Income Countries. 超声引导下斜角肌间臂丛阻滞治疗系统性多发性骨髓瘤引起的病理性肱骨骨折:低收入国家治疗的有效选择。
Case Reports in Anesthesiology Pub Date : 2020-10-17 eCollection Date: 2020-01-01 DOI: 10.1155/2020/9892580
Pawan Kumar Hamal, Bibena Lamichhane, Nabin Pokhrel, Janith Singh, Rupesh Kumar Yadav
{"title":"Ultrasound-Guided Interscalene Brachial Plexus Block for Pathological Humerus Fracture due to Multiple Myeloma with Systemic Manifestation: Useful Option for Management in Low-Income Countries.","authors":"Pawan Kumar Hamal,&nbsp;Bibena Lamichhane,&nbsp;Nabin Pokhrel,&nbsp;Janith Singh,&nbsp;Rupesh Kumar Yadav","doi":"10.1155/2020/9892580","DOIUrl":"https://doi.org/10.1155/2020/9892580","url":null,"abstract":"<p><p>Anesthetic management of pathological fracture due to multiple myeloma with systemic manifestation poses a perioperative challenge especially in low-resource setups like Nepal. Regional anesthesia using ultrasound-guided block can improve the accuracy, reduce complications, and improve overall perioperative management of pathological fractures due to malignancy with systemic spread in resource-deprived setups. We present a case of a 53-year-old lady with pathological fracture of left humerus shaft, a diagnosed case of multiple myeloma with compression fracture of multiple lumbar spine with chest wall metastasis with resolving acute kidney injury with chest infections. Ultrasound-guided interscalene brachial plexus block with sedation was done for open reduction internal fixation of humerus shaft fracture taking in consideration the overall high perioperative risk of patient. Intraoperative hemodynamic was uneventful, with no neurological sequelae and good recovery status perioperatively. Ultrasound-guided interscalene brachial plexus block if done cautiously can be a very useful alternative technique for better perioperative outcome in patients with malignancy with systemic spread in areas where expertise is scarce and resource is limited.</p>","PeriodicalId":36504,"journal":{"name":"Case Reports in Anesthesiology","volume":"2020 ","pages":"9892580"},"PeriodicalIF":0.0,"publicationDate":"2020-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/9892580","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38545073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
Intermediate-High Risk Pulmonary Embolism: The Use of Riociguat and Inferior Vena Cava Filter in a Situation of Recurrent Embolism following Insufficient Anticoagulation and Fibrinolytic Therapy. 中高危险肺栓塞:使用利奥西格特和下腔静脉过滤器在抗凝和纤溶治疗不足后复发栓塞的情况下。
Case Reports in Anesthesiology Pub Date : 2020-10-15 eCollection Date: 2020-01-01 DOI: 10.1155/2020/4219616
Anh Khoi Vo, Håkon Reikvam, Helga Midtbø, Jan Ludvig Wirsching, Øyvind Bruserud, Øystein Wendelbo
{"title":"Intermediate-High Risk Pulmonary Embolism: The Use of Riociguat and Inferior Vena Cava Filter in a Situation of Recurrent Embolism following Insufficient Anticoagulation and Fibrinolytic Therapy.","authors":"Anh Khoi Vo,&nbsp;Håkon Reikvam,&nbsp;Helga Midtbø,&nbsp;Jan Ludvig Wirsching,&nbsp;Øyvind Bruserud,&nbsp;Øystein Wendelbo","doi":"10.1155/2020/4219616","DOIUrl":"https://doi.org/10.1155/2020/4219616","url":null,"abstract":"<p><p>Pulmonary embolism (PE) is associated with serious morbidity and mortality. In this case report, we describe a hemodynamically stable patient with submassive PE and a large thrombus in the inferior vena cava (IVC) protruding into the right atrium (RA), complicated by severe respiratory failure, elevated troponin T (TnT), and right ventricular (RV) dysfunction. The patient was stratified as intermediate-high risk of early death. Important issues regarding the initial choice of anticoagulation, rescue thrombolytic therapy, and benefits of adding riociguat to stimulate the nitric oxide-soluble guanylate cyclase-cyclic guanosine monophosphate (NO-sGC-cGMP) pathway to improve the RV function are discussed. Finally, we address appropriate timing and the use of IVC filter in a situation of recurrent PE following anticoagulation and fibrinolytic therapy.</p>","PeriodicalId":36504,"journal":{"name":"Case Reports in Anesthesiology","volume":"2020 ","pages":"4219616"},"PeriodicalIF":0.0,"publicationDate":"2020-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/4219616","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38569396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Corrigendum to "Iatrogenic Superior Vena Cava Syndrome after Cardiopulmonary Bypass Diagnosed by Intraoperative Echocardiography". “术中超声心动图诊断体外循环后医源性上腔静脉综合征”的更正。
Case Reports in Anesthesiology Pub Date : 2020-10-13 eCollection Date: 2020-01-01 DOI: 10.1155/2020/8179176
Matthew B Ellison, Alec Statler, Roy E Henrickson, Julia Graff, Daniel Sloyer, Mir Ali Abbas Khan, Heather K Hayanga, Pavithra R Ellison
{"title":"Corrigendum to \"Iatrogenic Superior Vena Cava Syndrome after Cardiopulmonary Bypass Diagnosed by Intraoperative Echocardiography\".","authors":"Matthew B Ellison,&nbsp;Alec Statler,&nbsp;Roy E Henrickson,&nbsp;Julia Graff,&nbsp;Daniel Sloyer,&nbsp;Mir Ali Abbas Khan,&nbsp;Heather K Hayanga,&nbsp;Pavithra R Ellison","doi":"10.1155/2020/8179176","DOIUrl":"https://doi.org/10.1155/2020/8179176","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1155/2020/8813065.].</p>","PeriodicalId":36504,"journal":{"name":"Case Reports in Anesthesiology","volume":"2020 ","pages":"8179176"},"PeriodicalIF":0.0,"publicationDate":"2020-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/8179176","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38545072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Broken Spinal Needle in a Morbidly Obese Parturient Presenting for Urgent Cesarean Section. 一例病态肥胖产妇脊柱断针急诊剖宫产。
Case Reports in Anesthesiology Pub Date : 2020-09-30 eCollection Date: 2020-01-01 DOI: 10.1155/2020/8880464
Saurin J Shah, Kristen Vanderhoef, Michael Ibrahim
{"title":"Broken Spinal Needle in a Morbidly Obese Parturient Presenting for Urgent Cesarean Section.","authors":"Saurin J Shah,&nbsp;Kristen Vanderhoef,&nbsp;Michael Ibrahim","doi":"10.1155/2020/8880464","DOIUrl":"https://doi.org/10.1155/2020/8880464","url":null,"abstract":"<p><p>Neuraxial anesthesia has become the preferred method of anesthesia for nonemergent cesarean delivery and cases where regional anesthesia is not contraindicated. Multiple cases of broken spinal and epidural needles have been reported in the literature over the last several years; however, the specific incidence of needle breakage is still unknown. Less reliance on general anesthesia and increasing parturient body mass index (BMI) has likely contributed to more reports of broken needles during regional anesthesia for obstetric surgery. We describe a case of a broken spinal needle after attempted spinal anesthetic placement for cesarean delivery in a morbidly obese parturient, subsequent postoperative management, and current treatment recommendations.</p>","PeriodicalId":36504,"journal":{"name":"Case Reports in Anesthesiology","volume":"2020 ","pages":"8880464"},"PeriodicalIF":0.0,"publicationDate":"2020-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/8880464","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38596084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 8
Break the Spasm with Succinylcholine, but Risk Intraoperative Awareness with Undiagnosed Pseudocholinesterase Deficiency. 用琥珀胆碱打破痉挛，但未确诊的假胆碱酯酶缺乏风险术中意识。
Case Reports in Anesthesiology Pub Date : 2020-09-18 eCollection Date: 2020-01-01 DOI: 10.1155/2020/8874617
Danny D Bui, Shyamal R Asher
{"title":"Break the Spasm with Succinylcholine, but Risk Intraoperative Awareness with Undiagnosed Pseudocholinesterase Deficiency.","authors":"Danny D Bui,&nbsp;Shyamal R Asher","doi":"10.1155/2020/8874617","DOIUrl":"https://doi.org/10.1155/2020/8874617","url":null,"abstract":"<p><p>Succinylcholine is a commonly used medication in all aspects of anesthetic care, and there are a number of known side effects and complications associated with its use. However, when succinylcholine is used emergently, anesthesia providers must remain vigilant to undiagnosed conditions that pose additional risks to patients. We report the use of succinylcholine to treat acute, refractory laryngospasm after extubation leading to prolonged neuromuscular paralysis. There are unique challenges presented by this case including the risk of anesthesia awareness with recall due to the cognitive biases that prevent the clinical diagnosis of pseudocholinesterase deficiency.</p>","PeriodicalId":36504,"journal":{"name":"Case Reports in Anesthesiology","volume":"2020 ","pages":"8874617"},"PeriodicalIF":0.0,"publicationDate":"2020-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/8874617","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38452355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
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