Case Reports in Anesthesiology最新文献

{"title":"Alternative Approaches to Bilateral Stellate Ganglion Block for Treatment of Refractory Ventricular Arrhythmia.","authors":"Chelsea Skinner, Mohamad Ayoub, Elie Geara, Adeeb Oweidat, Ismat Mrad, Loran Mounir Soliman, Husien Taleb","doi":"10.1155/cria/2691681","DOIUrl":"10.1155/cria/2691681","url":null,"abstract":"<p><strong>Introduction and importance: </strong>Patients with ventricular arrhythmias (VAs) refractory to medical treatment suffer high morbidity and mortality. The stellate ganglion block is an effective diagnostic and therapeutic tool for refractory VAs.</p><p><strong>Case presentation: </strong>After obtaining an informed consent, we describe a case of a 62-year-old female who suffered ventricular tachycardia refractory to pharmacologic and electrical management, resulting in pulseless ventricular tachycardia (pVT) arrest. The regional anesthesia team was unable to expose the neck and obtain adequate ultrasound visualization using the classic approach and therefore used alternative ultrasound-guided approaches with success.</p><p><strong>Discussion: </strong>We describe the performance of the stellate ganglion blocks with an out-of-plane needle approach on the left and a medial in-plane approach on the right. These approaches allowed us to successfully block the stellate ganglia bilaterally.</p><p><strong>Conclusion: </strong>Refractory VA is associated with an increased cardiac sympathetic tone and has high morbidity and mortality. Stellate ganglion blocks can be used for diagnostic and therapeutic purposes. In-plane and out-of-plane techniques can be utilized.</p>","PeriodicalId":36504,"journal":{"name":"Case Reports in Anesthesiology","volume":"2025 ","pages":"2691681"},"PeriodicalIF":0.0,"publicationDate":"2025-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12719393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145821311","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":"Erector Spinae Plane Block With Liposomal Bupivacaine for Cervical Spine Surgery.","authors":"Hali Peterson, Ahmad Nassr, Mitchell Kerfeld","doi":"10.1155/cria/5687388","DOIUrl":"10.1155/cria/5687388","url":null,"abstract":"<p><p>Regional anesthesia for spine surgery is a relatively new and evolving area. Erector spinae plane blocks (ESPB) are a type of regional technique that has successfully managed acute postoperative pain in thoracic and lumbar spine surgeries. Using ESPB in cervical spine surgeries has shown to reduce intraoperative opioid needs and improve postoperative pain control, among other benefits. Liposomal bupivacaine has been shown potential in managing acute postoperative pain when injected at the surgical incision site. There is limited research on using liposomal bupivacaine in cervical spine surgery, especially with ESPB. We present a case of ESPB for cervical spine surgery performed successfully with liposomal bupivacaine.</p>","PeriodicalId":36504,"journal":{"name":"Case Reports in Anesthesiology","volume":"2025 ","pages":"5687388"},"PeriodicalIF":0.0,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12686824/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145726420","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":"Retrograde Migration of a Retained Radial Arterial Catheter Fragment: A Rare Perioperative Complication.","authors":"Lotfi Rebai, Sarra Sammari, Olfa Faten, Firas Kalai, Sabrine Ben Brahem, Ichraf Ardhaoui","doi":"10.1155/cria/8704664","DOIUrl":"10.1155/cria/8704664","url":null,"abstract":"<p><p>We report a rare case of inadvertent transection and retrograde intravascular migration of a radial arterial catheter fragment in a 52-year-old woman undergoing transcranial resection of a recurrent pituitary macroadenoma. The catheter had been inserted using the Seldinger technique and secured with three sutures. During catheter removal in the postoperative ward, an unexpected movement by the patient led to accidental transection and retention of the catheter's distal portion within the radial artery. Initial bedside exploration was inconclusive. A computed tomography angiography (CTA) confirmed the presence of the retained catheter fragment approximately 3 cm proximal to the radial styloid. Surgical removal under general anesthesia was successful without complications. We review this rare complication in light of previously published cases and highlight preventative strategies.</p>","PeriodicalId":36504,"journal":{"name":"Case Reports in Anesthesiology","volume":"2025 ","pages":"8704664"},"PeriodicalIF":0.0,"publicationDate":"2025-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12683067/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145716155","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":"Clinical Experience With Thoracic Segmental Spinal Anesthesia in High-Risk Surgical Patients.","authors":"Alhareth M Amro, Tasnim S Kurdiahirbawi, Islam Frijat, Sufian M Alrajabi, Mohammad A Abudayyeh, Yahya M Aljuba, Majde G Hamamdh","doi":"10.1155/cria/7430380","DOIUrl":"10.1155/cria/7430380","url":null,"abstract":"<p><strong>Background: </strong>General anesthesia (GA) can pose significant risks in patients with advanced comorbidities. Thoracic segmental spinal anesthesia (TSSA) is an underutilized alternative that offers hemodynamic stability and enhanced postoperative recovery. This case series highlights the application of TSSA in three high-risk surgical patients with complex cardiovascular, renal, or oncologic conditions.</p><p><strong>Case presentation: </strong>We describe three patients (ASA Classes III-IV) undergoing laparoscopic or endourological procedures who received TSSA instead of GA due to high anesthetic risk. Each patient received isobaric levobupivacaine combined with dexmedetomidine via thoracic or thoracolumbar spinal injection. All patients remained awake, hemodynamically stable, and spontaneously breathing throughout their procedures. No sedation, vasopressor support, airway intervention, or ICU admission was required. Postoperative pain was minimal, with early ambulation and no reported complications.</p><p><strong>Conclusion: </strong>TSSA is a safe and effective anesthetic technique for selecting high-risk patients undergoing abdominal or urological surgery. It provides excellent intraoperative conditions, avoids the systemic effects of GA, and facilitates rapid recovery. With proper technique and patient selection, TSSA offers a valuable alternative to GA in complex surgical cases.</p>","PeriodicalId":36504,"journal":{"name":"Case Reports in Anesthesiology","volume":"2025 ","pages":"7430380"},"PeriodicalIF":0.0,"publicationDate":"2025-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12664820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145655839","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":"Rocuronium for Treatment of Sugammadex Anaphylaxis: A Case Report.","authors":"Logan H Cone, Lauren M Walden, Neal W Fleming","doi":"10.1155/cria/5741904","DOIUrl":"10.1155/cria/5741904","url":null,"abstract":"<p><p>Anaphylaxis presents as a complex and unpredictable intraoperative emergency. Rocuronium is among the most common triggering agents for intraoperative anaphylaxis. Sugammadex has been suggested as a therapeutic option for the treatment of anaphylaxis triggered by rocuronium. With increased use, the incidence of anaphylaxis triggered by sugammadex may approach that of rocuronium. We present a case suggesting the converse might also be efficacious. In a critically ill patient with refractory anaphylaxis apparently triggered by sugammadex, administration of rocuronium rapidly restored hemodynamic stability.</p>","PeriodicalId":36504,"journal":{"name":"Case Reports in Anesthesiology","volume":"2025 ","pages":"5741904"},"PeriodicalIF":0.0,"publicationDate":"2025-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12663690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145649607","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":"Anesthetic Challenges of Caring for an Adult With Moebius Syndrome: A Case Report.","authors":"Geetasravya Vegunta, Giovanna Patafio, Swata Gade, Kwame Awuku, Evelyne Kalyoussef, Shridevi Pandya Shah","doi":"10.1155/cria/1908098","DOIUrl":"10.1155/cria/1908098","url":null,"abstract":"<p><strong>Background: </strong>Moebius syndrome (MBS) is a rare congenital disorder with facial nerve palsies and craniofacial malformations, increasing the risk of a difficult airway during anesthesia. We report a difficult airway in an adult with MBS during an elective procedure, which is unique as most reports of MBS are in children.</p><p><strong>Case presentation: </strong>Our patient was a 30-year-old male diagnosed with MBS at birth and presented with craniofacial and orthopedic malformations, intellectual disability, and facial nerve palsies. Although our patient had prior successful intubations, their airway exam deteriorated from Mallampati Classes II to IV after many surgeries. After fiberoptic intubation with nebulized lidocaine to maintain spontaneous ventilation failed, an attempt with dexmedetomidine and video laryngoscopy was successful.</p><p><strong>Conclusion: </strong>Our case demonstrates the necessity of preparing for a difficult airway and strategies for airway management in an adult with MBS.</p>","PeriodicalId":36504,"journal":{"name":"Case Reports in Anesthesiology","volume":"2025 ","pages":"1908098"},"PeriodicalIF":0.0,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12636042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145588846","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":"Hypnosis as an Adjunct to Topical Anesthesia for Awake Intubation in a Patient With Difficult Airway: A Case Report.","authors":"Stefan Torlakovic, Corinne Grandjean-Progin, Florence Nikles, Olivia Stiennon","doi":"10.1155/cria/9699223","DOIUrl":"10.1155/cria/9699223","url":null,"abstract":"<p><strong>Background: </strong>Awake intubation is often distressing for patients, particularly in cases of difficult airway anatomy.</p><p><strong>Case presentation: </strong>We report a case of successful awake fiber-optic intubation in a 69-year-old male with limited mouth opening due to previous ENT surgeries. Hypnosis was used alongside topical anesthesia and low-dose dexmedetomidine. The patient entered a relaxed state, and the intubation proceeded without pain, discomfort, or complications.</p><p><strong>Conclusion: </strong>This case demonstrates the feasibility of using hypnosis as a noninvasive adjunct to improve comfort during awake intubation. Further studies are warranted.</p>","PeriodicalId":36504,"journal":{"name":"Case Reports in Anesthesiology","volume":"2025 ","pages":"9699223"},"PeriodicalIF":0.0,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12634462/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145589036","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":"Ultrasound-Guided External Trigger Point Injections for Female Patients With Myofascial Pelvic Pain: A Report of Two Cases.","authors":"Sophie E Smith, Alopi Patel","doi":"10.1155/cria/7853542","DOIUrl":"10.1155/cria/7853542","url":null,"abstract":"<p><p>Trigger point injections (TPIs) are used to relieve myofascial pain via injection with local anesthetics. External TPIs are commonly used to treat surface muscle groups such as the trapezius, while internal transvaginal or external pelvic TPIs may be used for pelvic pain in female patients. This case series discusses two female patients with histories of myofascial pelvic pain due to high-tone pelvic floor disorder (HTPFD) who received ultrasound-guided external TPIs for pain relief. Patient 1 had previously received internal TPIs with no relief, while Patient 2 had previously tried botulinum toxin injections and a pudendal nerve block with some relief. In both cases, ultrasound-guided external TPIs provided pain relief for a period of time and were repeated. This case highlights the importance of ultrasound-guided external TPIs as part of the arsenal of treatment options for pelvic floor dysfunction treatment.</p>","PeriodicalId":36504,"journal":{"name":"Case Reports in Anesthesiology","volume":"2025 ","pages":"7853542"},"PeriodicalIF":0.0,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12618178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145543064","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":"Anesthetic Management of a Pregnant Patient With a Large Anterior Mediastinal Mass Undergoing Diagnostic Bronchoscopy: A Case Report.","authors":"Rei Ndoni, Aariya Srinivasan, Ryan Dougherty, Colin Nahrstedt, Jia Liu, Sabry Ayad","doi":"10.1155/cria/2053701","DOIUrl":"10.1155/cria/2053701","url":null,"abstract":"<p><p>This case report details the successful use of awake fiberoptic intubation in a 28-year-old pregnant patient at 21 weeks gestation, who presented for diagnostic mediastinoscopy with biopsy secondary to a large anterior mediastinal mass suspected to be lymphoma. MRI displayed encasement of the superior mediastinal vasculature and 13.0 cm × 7.6 cm coalescence in the anterior mediastinum. Given the size of the mass and potential for airway and vascular complications, awake fiberoptic intubation was chosen to ensure safety for both mother and fetus. The case underscores the efficacy of awake fiberoptic intubation in complex airway management scenarios in pregnant patients, highlighting the importance of a multidisciplinary approach to optimize patient care and outcomes.</p>","PeriodicalId":36504,"journal":{"name":"Case Reports in Anesthesiology","volume":"2025 ","pages":"2053701"},"PeriodicalIF":0.0,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12547615/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145378872","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":"Anesthetic Management of Progressive Deformity of Tracheal Cartilaginous Sleeve in a Pediatric Patient With Beare-Stevenson Syndrome: A Case Report.","authors":"Yumi Doi, Atsuko Harada, Jiro Tsugawa, Nayuta Higa, Tatsuki Oyoshi, Ryosuke Hanaya","doi":"10.1155/cria/6267230","DOIUrl":"10.1155/cria/6267230","url":null,"abstract":"<p><p>Beare-Stevenson syndrome is a rare fibroblast growth factor receptor 2-related disorder characterized by craniosynostosis, midface hypoplasia, cutis gyrata, and developmental delay, with upper airway obstruction being a critical concern in early infancy. Tracheal cartilaginous sleeve is a congenital anomaly associated with fibroblast growth factor receptor 2-related syndromes, which often necessitates tracheostomy because of the potential for significant airway complications. However, serial airway imaging in patients with Beare-Stevenson syndrome with tracheal cartilaginous sleeve has not yet been documented. Our pediatric patient with Beare-Stevenson syndrome underwent airway evaluations using a rigid bronchoscope under general anesthesia at 33 days, 62 days, and then at 3 years of age. The initial rigid bronchoscopy demonstrated tracheal cartilaginous sleeve, and tracheostomy was performed. At 3 years of age, rigid bronchoscopy revealed progressive tracheal cartilage deformity with inward protrusion. This pouch-like structural change greatly affected anesthesia management because it posed a risk for airway obstruction due to potential tube misplacement. The image resolution of a rigid bronchoscope is superior to that of a flexible bronchoscope, allowing for more precise assessment. Despite the absence of abnormalities on routine flexible bronchoscopy, rigid bronchoscopy provided critical insights into airway changes. Precise imaging allowed multidisciplinary planning, and it highlighted tube malposition as a cause of intraoperative respiratory failure. Tracheal cartilaginous sleeve is a life-threatening condition that may occur in children with Beare-Stevenson syndrome. This case demonstrated progressive tracheal deformity over time, increasing the risk of sudden airway obstruction and presenting significant anesthetic challenges. Our findings highlight the clinical importance of repeated rigid bronchoscopic evaluations, which provide essential information for safe airway management.</p>","PeriodicalId":36504,"journal":{"name":"Case Reports in Anesthesiology","volume":"2025 ","pages":"6267230"},"PeriodicalIF":0.0,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12531426/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145330275","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}