Case Reports in Anesthesiology最新文献

{"title":"Quantitative Neuromuscular Blockade Monitoring During Surgical Manipulation of the Axillary Artery: A Case Report.","authors":"Valerie K Yu, Neal W Fleming","doi":"10.1155/cria/6042837","DOIUrl":"10.1155/cria/6042837","url":null,"abstract":"<p><p>Vascular surgery often involves the manipulation of major arteries that supply both the central and peripheral nervous systems. Here, we discuss the use of electromyography technology used for neuromuscular blockade monitoring in conjunction with intraoperative neuromonitoring to assess the function of the ulnar nerve during surgical manipulation of the axillary artery. This case highlights the importance of site selection for neuromuscular blockade monitoring as well as the dynamics of the neurovascular system and the resilience that the vasa nervorum may afford peripheral nerves.</p>","PeriodicalId":36504,"journal":{"name":"Case Reports in Anesthesiology","volume":"2025 ","pages":"6042837"},"PeriodicalIF":0.0,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11955257/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754937","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}

{"title":"Sevoflurane-Associated Acute Liver Injury in Renal Transplantation and Review of Literature.","authors":"Imran Gani, Nawal Moin, Jeffery Fallah, Ahmad Mirza","doi":"10.1155/cria/1303993","DOIUrl":"10.1155/cria/1303993","url":null,"abstract":"<p><p>Acute liver injury can be precipitated by several factors perioperatively. One of the rare factors identified intraoperatively is the use of sevoflurane, an inhalational anesthetic agent which can cause significant acute hepatotoxicity. The report presents a case of acute liver injury followed by graft loss in a patient who underwent kidney transplantation. The patient developed several complications which resulted in graft loss. Close postoperative monitoring of patients following kidney transplantation is crucial. The case supports the current literature describing sevoflurane as a hepatotoxic agent. Medication side effects should be closely monitored both intraoperatively and postoperatively in those with renal dysfunction.</p>","PeriodicalId":36504,"journal":{"name":"Case Reports in Anesthesiology","volume":"2025 ","pages":"1303993"},"PeriodicalIF":0.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11936524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711556","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}

{"title":"Suspected Somatosensory Evoked Potentials Pacing Atria During Cerebral Bypass Surgery: A Case Report.","authors":"Denise S Abdulahad, Justin Pachuski","doi":"10.1155/cria/2637445","DOIUrl":"10.1155/cria/2637445","url":null,"abstract":"<p><p>Somatosensory evoked potentials are commonly utilized during surgery to assess the function of the central nervous system. We present a case of a 48-year-old female patient undergoing cerebral bypass surgery who was noted to have reproducible, stimulation frequency-dependent heart rate changes that coincided with somatosensory evoked potentials stimulation. We hypothesize that the somatosensory evoked potential stimulation current was depolarizing a foci of atrial myocytes, resulting in the initiation of the cardiac cycle.</p>","PeriodicalId":36504,"journal":{"name":"Case Reports in Anesthesiology","volume":"2025 ","pages":"2637445"},"PeriodicalIF":0.0,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11928213/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693410","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}

{"title":"Treatment of Chronic Pain Due to Slipping Rib Syndrome Using Ultrasound-Guided Intercostal Cryoneurolysis: A Case Report.","authors":"Igor Filipovski, Freja Vesterdahl, Brian P Curran, Rodney A Gabriel","doi":"10.1155/cria/8800687","DOIUrl":"10.1155/cria/8800687","url":null,"abstract":"<p><p>Slipping rib syndrome (SRS) is an underdiagnosed condition, in which some ribs are not connected to the sternum, which may cause increased laxity of the interchondral ligament. This may result in pain in the lower chest and upper abdomen area. Treatment typically includes conservative measures, steroid injections, and surgery. Ultrasound-guided intercostal cryoneurolysis is a minimally-invasive procedure that may provide long-term analgesia in patients with SRS. This case report describes the procedure for a patient treated with right-sided ultrasound-guided cryoneurolysis of the intercostal nerves at the levels T7, T8, and T9.</p>","PeriodicalId":36504,"journal":{"name":"Case Reports in Anesthesiology","volume":"2025 ","pages":"8800687"},"PeriodicalIF":0.0,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11991757/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001469","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}

{"title":"Opioid-Free Perioperative Analgesia for Revision Total Hip Arthroplasty in a Patient With a History of Substance Use Disorder.","authors":"Robert L Owen, Mitchell J Kerfeld, Jason K Panchamia, David A Olsen, Adam W Amundson","doi":"10.1155/cria/5521332","DOIUrl":"https://doi.org/10.1155/cria/5521332","url":null,"abstract":"<p><p><b>Background:</b> Given the endemic opioid crisis in our communities, there is an important need for opioid-sparing analgesia alternatives for invasive surgical procedures that use multimodal analgesia to help reduce or avoid opioid consumption perioperatively. Unfortunately, a significant challenge exists in reducing opioid consumption with procedures that are known to cause a significant amount of postoperative discomfort. Regional anesthesia via peripheral nerve blockade is a modality that can take advantage of pertinent anatomy, greatly reduce a patient's postoperative pain, and minimize opioid consumption. Some anatomical locations, such as the hip joint, have complex innervation. For such anatomical locations, a single peripheral nerve block may fail to cover all the involved sensory nerves, and thus, incorporating additional regional blocks can synergistically provide sufficient analgesic coverage. <b>Case Presentation:</b> A 69-year-old man presented for revision total hip arthroplasty. Due to his previous history of opioid abuse, he requested an opioid-free perioperative experience. The patient's past medical history was complex, and he had suffered recurrent prosthetic joint infections. To accomplish opioid-free perioperative analgesia for his revision hip arthroplasty, we utilized both the suprainguinal fascia iliaca block and the pericapsular nerve group block, in combination with surgeon-administered local infiltration analgesia and oral and intravenous nonopioid systemic pain medications. The patient was successfully able to avoid opioids through the procedure and postoperative course, with the majority of his pain scores being zero out of 10 during his hospital admission. <b>Conclusions:</b> Complimentary regional nerve blocks, when combined with surgeon-administered local infiltration analgesia and multiple systemic nonopioid medications, can provide sufficient analgesia to cover the complexly innervated hip joint and accomplish an opioid-sparing revision total hip arthroplasty perioperative course.</p>","PeriodicalId":36504,"journal":{"name":"Case Reports in Anesthesiology","volume":"2025 ","pages":"5521332"},"PeriodicalIF":0.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11991800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031019","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}

{"title":"The Bezold-Jarisch Reflex Following an Endoscopic Endonasal Resection of an Intraosseous Clival Myxoma: A Case Report.","authors":"Abigail Peterson, Omar Hussain, Nathan Zwagerman, Harvey Woehlck","doi":"10.1155/cria/3336045","DOIUrl":"10.1155/cria/3336045","url":null,"abstract":"<p><p>In certain contexts, young and healthy patients with a strong heart and a history of vasovagal syncope are at increased risk of cardiac arrest. An increase in vagal tone results in the normal maintenance of arterial pressure shifting into parasympathetic activation and sympathetic suppression, amplifying afferent mechanoreceptors and, in rare instances, inducing asystole. We report the case of a 17-year-old patient with a past medical history of syncope who went into asystole while maintaining consciousness and protecting his airway when recovering from anesthesia in the postanesthesia care unit (PACU) following endoscopic endonasal resection of an intraosseous clival myxoma. Chest compressions were initiated and epinephrine was administered, allowing for return of spontaneous circulation to be quickly achieved. While being transferred to the intensive care unit, the patient's heart rate dropped to 20 bpm while sitting in Fowler's position, causing vasovagal syncope which was then resolved by laying the patient supine and 0.8 mg of glycopyrrolate administration. The altered sympathetic to parasympathetic tone resulting in asystole within this case and cardiac beta-agonist stimulation by epinephrine injection provide evidence that the Bezold-Jarisch reflex occurred. This case suggests that the intracranial internal carotid arteries can potentially display similar mechanical sensitivity as the carotid sinus and questions the validity of electrocardiogram readings during this reflex, as the patient remained conscious while in asystole.</p>","PeriodicalId":36504,"journal":{"name":"Case Reports in Anesthesiology","volume":"2025 ","pages":"3336045"},"PeriodicalIF":0.0,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11867714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524788","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}

{"title":"Profoundly Delayed Emergence due to Pulmonary Embolism.","authors":"Allison Steinauer, Whitney Marvin, Natalie R Barnett","doi":"10.1155/cria/6691273","DOIUrl":"10.1155/cria/6691273","url":null,"abstract":"<p><p>Pulmonary embolism is a rare, but serious, potential perioperative complication and crisis. We present a case of a 12-year-old female undergoing distal femoral and proximal tibial osteotomies with internal fixations who experienced acute onset hypercapnia, tachycardia, and prolonged minimal responsiveness following deflation of the tourniquet and cessation of inhaled sevoflurane. CT-chest demonstrated bilateral partially occlusive filling defects of the pulmonary vasculature. We concluded that the patient experienced a pulmonary embolism resulting in V/Q mismatch, retained sevoflurane, and ultimately delayed emergence.</p>","PeriodicalId":36504,"journal":{"name":"Case Reports in Anesthesiology","volume":"2025 ","pages":"6691273"},"PeriodicalIF":0.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11858700/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143504506","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}

{"title":"Awake Thoracotomy in an Obese Case of Cardiac Tamponade: A Case Report.","authors":"Malek Itmaiza, Peter Bael, Talha Isayed, Ali Abufarah, Islam Frijat, Majdi Hamamdeh","doi":"10.1155/cria/7867957","DOIUrl":"10.1155/cria/7867957","url":null,"abstract":"<p><p><b>Introduction:</b> Awake thoracic surgery is an old procedure still being used to this day for various indications, utilizing many different techniques for local analgesia. <b>Case Presentation:</b> We described the case of a 60-year-old obese heavy smoker, with significant respiratory and cardiac morbidity, who presented with signs of cardiac tamponade secondary to hypothyroidism. Our patient was treated with a pericardial window, using serratus anterior and parasternal blocks. <b>Discussion:</b> We presented the first case to our knowledge that employed parasternal and serratus anterior blocks as local analgesia for an awake thoracotomy, we also discussed different techniques, indications, benefits, and complications.</p>","PeriodicalId":36504,"journal":{"name":"Case Reports in Anesthesiology","volume":"2025 ","pages":"7867957"},"PeriodicalIF":0.0,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11835473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450502","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}

{"title":"A Rare Case of Intraoperative Anaphylaxis Secondary to Central Venous Catheter Placement: A Case Report.","authors":"Yusuf Ali, Andres Gonzalez, John Pallan, Emily Anne Smith Bergbower","doi":"10.1155/cria/1310392","DOIUrl":"10.1155/cria/1310392","url":null,"abstract":"<p><p>Central venous catheters (CVCs) are often used intraoperatively for large volume resuscitation and the administration of vasoactive medications. Many of these catheters are impregnated with antimicrobials to prevent infection but independent reports of anaphylaxis directly following catheter placement have been increasing. Here, we report the case of a severe episode of anaphylaxis attributed to a chlorhexidine-coated CVC in a middle-aged man who presented for an L5-S1 Anterior Lumbar Interbody Fusion (ALIF) revision due to hardware failure.</p>","PeriodicalId":36504,"journal":{"name":"Case Reports in Anesthesiology","volume":"2025 ","pages":"1310392"},"PeriodicalIF":0.0,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11835472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450501","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}

{"title":"Uniportal Robotic-Assisted Tracheal Resection and Reconstruction Under Spontaneous Ventilation.","authors":"Ricardo Eli Guido Guerra, Francina Valezka Bolaños Morales, Oscar Francisco Silva Gómez, Hector Olvera Prado, Sarahí Ibáñez Barzalobre, Mugurel Bosinceanu, Diego Gonzalez-Rivas","doi":"10.1155/cria/4991280","DOIUrl":"10.1155/cria/4991280","url":null,"abstract":"<p><p><b>Background:</b> Tracheal resection and reconstruction for airway tumors are traditionally performed using general anesthesia, tracheal intubation, and thoracotomy. Modern techniques, such as tubeless tracheal surgery and robotic uniportal approaches, offer several advantages including better surgical conditions, reduced postoperative complications, and faster recovery. <b>Case Report:</b> A 42-year-old woman with a tracheal neuroendocrine tumor underwent nonintubated uniportal robotically assisted tracheal resection and reconstruction. Thoracic epidural anesthesia, airway topicalization, and intravenous anesthesia with laryngeal mask airway allowed the procedure to be performed under nonintubated spontaneous ventilation, through a single 3-cm incision. Postoperative recovery was uneventful, with the patient experiencing minimal pain and no nausea or vomiting. <b>Conclusions:</b> Nonintubated uniportal robotically assisted tracheal resection and reconstruction is a feasible, less invasive technique that offers significant benefits in terms of recovery and patient comfort when performed by experienced surgeons.</p>","PeriodicalId":36504,"journal":{"name":"Case Reports in Anesthesiology","volume":"2025 ","pages":"4991280"},"PeriodicalIF":0.0,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11824845/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415486","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}