Case Reports in Anesthesiology最新文献_第4页

Postoperative Heart Failure with Preserved Ejection Fraction Induced by Flumazenil Administered for Remimazolam Antagonism. 氟马西尼抗雷马唑仑致保留射血分数的术后心力衰竭。

Case Reports in Anesthesiology Pub Date : 2022-11-12 eCollection Date: 2022-01-01 DOI: 10.1155/2022/8923008

Keito Koh, Takeshi Omae, Sonoko Sakuraba, Masateru Kumemura, Sho Yamazaki, Hiroshi Yunoki

{"title":"Postoperative Heart Failure with Preserved Ejection Fraction Induced by Flumazenil Administered for Remimazolam Antagonism.","authors":"Keito Koh, Takeshi Omae, Sonoko Sakuraba, Masateru Kumemura, Sho Yamazaki, Hiroshi Yunoki","doi":"10.1155/2022/8923008","DOIUrl":"https://doi.org/10.1155/2022/8923008","url":null,"abstract":"Remimazolam is an ultrashort-acting benzodiazepine intravenous anesthetic characterized by rapid awakening after anesthesia. However, the method for administering remimazolam in clinical practice remains unclear. Here, we report a case of postoperative heart failure with preserved ejection fraction (HFpEF) after antagonizing remimazolam with flumazenil. An 82-year-old woman was scheduled to undergo lumbar laminectomy for lumbar spinal canal stenosis. Preoperative echocardiography revealed normal left ventricular systolic function, left atrial enlargement, and impaired left ventricular diastolic function. General anesthesia was induced with 10 mg/kg/h remimazolam and maintained with 0.8 mg/kg/h remimazolam intraoperatively. Before extubation, a total of 1.0 mg of flumazenil was administered. After extubation, the patient developed pulmonary edema due to HFpEF. When remimazolam is administered in elderly patients with cardiac dysfunction, the maintenance dose should be customized according to the patient's general condition to minimize the dosage of flumazenil.","PeriodicalId":36504,"journal":{"name":"Case Reports in Anesthesiology","volume":" ","pages":"8923008"},"PeriodicalIF":0.0,"publicationDate":"2022-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9675602/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40718989","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

Orthotopic Liver Transplantation in a Patient with Acutely Decompensated Liver Disease and Personal History of Malignant Hyperthermia. 急性失代偿性肝病及个人恶性高热史患者的原位肝移植。

Case Reports in Anesthesiology Pub Date : 2022-09-17 eCollection Date: 2022-01-01 DOI: 10.1155/2022/4996977

Elizabeth A Townsend, Manuchehr Habibi, Molly Groose, Thomas McDowell

{"title":"Orthotopic Liver Transplantation in a Patient with Acutely Decompensated Liver Disease and Personal History of Malignant Hyperthermia.","authors":"Elizabeth A Townsend, Manuchehr Habibi, Molly Groose, Thomas McDowell","doi":"10.1155/2022/4996977","DOIUrl":"https://doi.org/10.1155/2022/4996977","url":null,"abstract":"Introduction: Orthotopic liver transplants are characterized by sudden changes in hemodynamics, intraoperative hemorrhage, metabolic and electrolyte derangements, and arrhythmias. Many of these features are also hallmarks of malignant hyperthermia episodes and make differentiation difficult intraoperatively. Additionally, the treatment for malignant hyperthermia, dantrolene, can cause hepatotoxicity in already damaged native livers and newly reperfused organ allografts. Thus, it is imperative to avoid a triggering anesthetic in these patients. Here we report on a successful total intravenous anesthetic in a malignant hyperthermia susceptible individual undergoing an orthotopic liver transplant for acutely decompensated end-stage liver disease. Case Presentation. A 49-year-old male with a past medical history significant for malignant hyperthermia episodes as a child was admitted with decompensated alcoholic cirrhosis. He underwent uneventful total intravenous general anesthesia with propofol and sufentanil continuous infusions for an orthotopic liver transplant. He required minimal vasoactive agents to maintain a mean arterial blood pressure >65 mmHg and was extubated on postoperative day 1.Conclusions: Total intravenous anesthesia is necessary for patients with a personal history of malignant hyperthermia. However, this type of general anesthesia is difficult in the setting of fluctuating hemodynamics, hemorrhage, and changes in drug metabolism and clearance during the anhepatic and reperfusion phases of an orthotopic liver transplant. Propofol and sufentanil continuous infusions provided stable hemodynamics and an excellent plane of anesthesia throughout the case and should be considered in other individuals undergoing this procedure who require a total intravenous anesthetic.","PeriodicalId":36504,"journal":{"name":"Case Reports in Anesthesiology","volume":" ","pages":"4996977"},"PeriodicalIF":0.0,"publicationDate":"2022-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9509212/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40377410","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

Airway Management of Esophageal Atresia and Tracheoesophageal Fistula Combined with Anal Atresia. 食管闭锁、气管食管瘘合并肛门闭锁的气道管理。

Case Reports in Anesthesiology Pub Date : 2022-09-05 eCollection Date: 2022-01-01 DOI: 10.1155/2022/3775140

Jieshu Zhou, Hao Li, Xuemei Lin

引用次数: 0

Diagnosis and Management of a Unique Iatrogenic Biatrial Gerbode Defect. 一种独特的医源性双房Gerbode缺陷的诊断和治疗。

Case Reports in Anesthesiology Pub Date : 2022-07-18 eCollection Date: 2022-01-01 DOI: 10.1155/2022/6998632

Karim Shuaib, Giacomo Scorsese, Christopher Seiter, Eric Zabirowicz, Jeremy Poppers

引用次数: 0

Labor Analgesia in Brugada Syndrome and the Importance of Contingency Planning. Brugada 综合征的分娩镇痛和应急计划的重要性。

Case Reports in Anesthesiology Pub Date : 2022-07-15 eCollection Date: 2022-01-01 DOI: 10.1155/2022/8940704

Shayla Mena, Ana Costa, Michelle DeLemos, Joy Schabel, Morgane Factor

引用次数: 0

The Successful Anesthetic Management of a Cesarean Delivery in a Patient with Fanconi-Bickel Syndrome. Fanconi-Bickel综合征患者剖宫产的成功麻醉处理。

Case Reports in Anesthesiology Pub Date : 2022-07-08 eCollection Date: 2022-01-01 DOI: 10.1155/2022/3220486

Alexander M DeLeon, Rishi D Gaiha, Feyce M Peralta

{"title":"The Successful Anesthetic Management of a Cesarean Delivery in a Patient with Fanconi-Bickel Syndrome.","authors":"Alexander M DeLeon, Rishi D Gaiha, Feyce M Peralta","doi":"10.1155/2022/3220486","DOIUrl":"https://doi.org/10.1155/2022/3220486","url":null,"abstract":"Introduction: Fanconi-Bickel syndrome (FBS) is a rare genetic condition characterized by extremely short stature, renal tubular dysfunction, osteoporosis, and rickets. The literature is scant regarding the successful reproduction of women with FBS. Cesarean delivery is indicated due to the risk of pelvic fracture from vaginal delivery in a patient with FBS and rickets, yet no case describing the anesthetic has been reported. Clinical Findings. We present a 39-inch-tall, 46.47 kg/m2 BMI woman with FBS who was scheduled for cesarean delivery and requesting neuraxial anesthesia. A low-dose, combined spinal-epidural technique (CSE) was employed to account for her extreme short stature yet allow for additional dosing if needed. The cesarean delivery, hospital course, and follow-up were all uneventful.Conclusion: A single case of an FBS patient's successful pregnancy was previously reported in the literature without describing the anesthetic technique. Our case is unique in that it is the first case in the literature that we are aware of describing the anesthetic technique. This case may provide a template for clinicians treating FBS patients and patients with extremely short stature.","PeriodicalId":36504,"journal":{"name":"Case Reports in Anesthesiology","volume":" ","pages":"3220486"},"PeriodicalIF":0.0,"publicationDate":"2022-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9286953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40600217","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

When Left Is Right and Right Is Wrong: A Case Report of Two Near-Miss Wrong-Sided Peripheral Nerve Blocks. 当左为右，右为错:两例险些脱险的错误侧周围神经阻滞。

Case Reports in Anesthesiology Pub Date : 2022-06-15 eCollection Date: 2022-01-01 DOI: 10.1155/2022/1541827

Alexander M DeLeon, Alexander G Samworth, Bashar F Kazanji

引用次数: 0

Cardiac Transplantation following Cobalt Cardiomyopathy from Bilateral Metal-on-Metal Hip Replacements. 双侧金属对金属髋关节置换术后钴性心肌病的心脏移植。

Case Reports in Anesthesiology Pub Date : 2022-06-08 eCollection Date: 2022-01-01 DOI: 10.1155/2022/3373363

Peter Szedlak, Amrik Virdi, Paul Cacciottolo, Stephen Shepherd, Stephen Pettit, Florian Falter

引用次数: 2

Reexpansion Pulmonary Edema following Tube Thoracostomy in a Pediatric Patient with Anterior Mediastinal Mass 小儿前纵隔肿块插管造胸术后再扩张肺水肿一例

Case Reports in Anesthesiology Pub Date : 2022-05-19 DOI: 10.1155/2022/8547611

S. Choi, Deborah A. Romeo, David A Gutman, Jennifer V. Smith

{"title":"Reexpansion Pulmonary Edema following Tube Thoracostomy in a Pediatric Patient with Anterior Mediastinal Mass","authors":"S. Choi, Deborah A. Romeo, David A Gutman, Jennifer V. Smith","doi":"10.1155/2022/8547611","DOIUrl":"https://doi.org/10.1155/2022/8547611","url":null,"abstract":"Reexpansion pulmonary edema (RPE) is an exceedingly rare and potentially fatal complication of a rapidly reexpanded lung following evacuation of air or fluid from the pleural space secondary to conditions such as a mediastinal mass, pleural effusion, or pneumothorax. Clinical presentations can range from mild radiographic changes to acute respiratory failure and hemodynamic instability. The rapidly progressive nature of the disease makes it important for clinicians to appropriately diagnose and manage patients who develop RPE. We present a case of a child with a large malignant pleural effusion who developed severe RPE after tube thoracostomy and ultimately required venoarterial extracorporeal membrane oxygenation (VA-ECMO). The patient was 7-year-old Caucasian male with newly diagnosed ambiguous T cell myeloid leukemia. A chest computerized tomography (CT) demonstrated a large pleural effusion causing tracheal shift and left bronchus compression as well as an anterior mediastinal mass causing compression of the right atria and right ventricle. Tube thoracostomy was performed in the operating room (OR) with deep sedation. The procedure was complicated with hypoxemia, bradycardia, and pulseless cardiac arrest. After return of spontaneous circulation, the child continued to have refractory hypoxemia, profound hypotension, and frothy secretions. Endotracheal intubation was performed with a size 5.0 cuffed endotracheal tube. Chest radiograph demonstrated opacification of the left hemithorax with chest infiltrates. Patient required VA-ECMO for circulatory support. Supportive therapy of RPE was continued and decannulation was done on day three. Tracheal extubation was performed on day five.","PeriodicalId":36504,"journal":{"name":"Case Reports in Anesthesiology","volume":"51 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83960987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

A New Anesthetic, Remimazolam, Is Useful in the Management of Anesthesia in Patients with Liver Cirrhosis 一种新的麻醉剂雷马唑仑在肝硬化患者麻醉管理中的应用

Case Reports in Anesthesiology Pub Date : 2022-05-07 DOI: 10.1155/2022/9268454

A. Onoda, Yasuyuki Suzuki

引用次数: 6