Case Reports in Anesthesiology最新文献_第8页

Anesthesia in a Patient with Potocki-Lupski Syndrome. Potocki-Lupski综合征患者的麻醉。

Case Reports in Anesthesiology Pub Date : 2021-12-04 eCollection Date: 2021-01-01 DOI: 10.1155/2021/3313904

Songhyun Kim, Yunhee Lim, In-Jung Jun, Byunghoon Yoo, Kye-Min Kim

{"title":"Anesthesia in a Patient with Potocki-Lupski Syndrome.","authors":"Songhyun Kim, Yunhee Lim, In-Jung Jun, Byunghoon Yoo, Kye-Min Kim","doi":"10.1155/2021/3313904","DOIUrl":"https://doi.org/10.1155/2021/3313904","url":null,"abstract":"Introduction: Potocki-Lupski syndrome (PTLS) is a rare disease caused by the duplication of a small segment of chromosome 17 (17p11.2). The clinical presentation of this syndrome is quite variable and includes hypotonia, failure to thrive, oropharyngeal dysphagia, developmental delay, and behavioral abnormalities. In addition, congenital heart disease, sleep apnea, and mildly dysmorphic features are common and should be considered during anesthetic management. However, because of the rarity and newness of the syndrome, there are few reports on the anesthetic care of patients with PTLS. Case Report. We report a case of a 4-year-old girl diagnosed with this syndrome who underwent general anesthesia for exotropia surgery. The patient exhibited micrognathia; a mild decrease in muscle tone; and a developmental delay in motor, speech, and cognition. She had a history of swallowing incoordination and gastroesophageal reflux. No abnormalities were found on a preoperative echocardiography. A videolaryngoscope was used for tracheal intubation, and the state of neuromuscular blockade was monitored in addition to standard monitoring. Anesthesia was maintained with sevoflurane and remifentanil. The patient recovered without any adverse events.Conclusion: As PTLS patients may have several malformations, preanesthetic evaluation is important. Preoperative echocardiography and cardiologic consultations are required. It is desirable to prepare for the risk of difficult airway and pulmonary aspiration. Postoperatively, close monitoring is needed to prevent airway compromise.","PeriodicalId":36504,"journal":{"name":"Case Reports in Anesthesiology","volume":"2021 ","pages":"3313904"},"PeriodicalIF":0.0,"publicationDate":"2021-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8665889/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39722947","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

A Case Report of Femoral Hematoma following Obturator Nerve Block. 闭孔神经阻滞致股血肿1例。

Case Reports in Anesthesiology Pub Date : 2021-11-13 eCollection Date: 2021-01-01 DOI: 10.1155/2021/2556645

Kiyoshi Moriyama, Kumi Moriyama, Tomoki Kohyama, Kunitaro Watanabe, Mieko Chinzei, Tomoko Yorozu

{"title":"A Case Report of Femoral Hematoma following Obturator Nerve Block.","authors":"Kiyoshi Moriyama, Kumi Moriyama, Tomoki Kohyama, Kunitaro Watanabe, Mieko Chinzei, Tomoko Yorozu","doi":"10.1155/2021/2556645","DOIUrl":"https://doi.org/10.1155/2021/2556645","url":null,"abstract":"Background: When an obturator nerve block (ONB) is performed, the conventional landmark method or ultrasound-guided method is used. The major complications of this block are hematoma, but there are very few reports of its complications. We encountered massive bleeding and a huge hematoma after ONB. Case Presentation. A 95-year-old female underwent transurethral resection of the bladder tumor. Induction of anesthesia was accomplished via spinal anesthesia and right ONB using the landmark method. Postoperatively, subcutaneous bleeding was detected in the lower right interior thigh. Concentrated red cell transfusion was conducted to address the anemia. There was no subsequent expansion of the hematoma. It resolved on postoperative day (POD) 53. The hematoma was deemed to be inadvertently introduced due to an obturator artery puncture during the obturator nerve block.Conclusions: Close attention is necessary to avoid advancing the needle too deep into the obturator during obturator nerve block.","PeriodicalId":36504,"journal":{"name":"Case Reports in Anesthesiology","volume":"2021 ","pages":"2556645"},"PeriodicalIF":0.0,"publicationDate":"2021-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8605914/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39761886","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

ECMO for Metabolic Crisis in a Patient with Mitochondrial Disease. ECMO治疗线粒体疾病患者的代谢危像

Case Reports in Anesthesiology Pub Date : 2021-11-01 eCollection Date: 2021-01-01 DOI: 10.1155/2021/9914311

Sonal Sharma, Clifford Deerman, Michael H Andreae, Conrad Myler

引用次数: 2

Bedside Transcatheter Patent Ductus Arteriosus Device Occlusion in an Extremely Low Birth Weight Neonate: A Novel Approach in a High-Risk Population. 床边经导管动脉导管未闭装置闭塞治疗极低出生体重新生儿:一种高危人群的新方法。

Case Reports in Anesthesiology Pub Date : 2021-10-27 eCollection Date: 2021-01-01 DOI: 10.1155/2021/4716997

Tiffany M Pouldar, Robert Wong, Myriam Almeida-Jones, Evan Zahn, Lorraine Lubin

引用次数: 7

Anticoagulation with Argatroban in a Patient with Heparin-Induced Thrombocytopenia and Renal Insufficiency Undergoing Orthotopic Heart Transplantation. 阿加曲班抗凝治疗肝素性血小板减少和肾功能不全患者原位心脏移植。

Case Reports in Anesthesiology Pub Date : 2021-10-13 eCollection Date: 2021-01-01 DOI: 10.1155/2021/9945225

Michael Stuart Green, Johann Mathew, Christopher Ryan Hoffman, Henry Liu

{"title":"Anticoagulation with Argatroban in a Patient with Heparin-Induced Thrombocytopenia and Renal Insufficiency Undergoing Orthotopic Heart Transplantation.","authors":"Michael Stuart Green, Johann Mathew, Christopher Ryan Hoffman, Henry Liu","doi":"10.1155/2021/9945225","DOIUrl":"https://doi.org/10.1155/2021/9945225","url":null,"abstract":"Unfractionated heparin is the anticoagulant of choice for cardiac surgery that requires cardiopulmonary bypass. However, it can cause serious side effects like heparin-induced thrombocytopenia (HIT), an immune-mediated process where antibodies are directed against heparin and platelet 4 complexes. In such cases, alternative pharmacologic strategies are implemented to facilitate safe bypass conditions. A woman with severe decompensated heart failure was heparinized for intra-aortic balloon pump and subsequent LVAD placement. On day 6, a fall in platelets from 113,000 to 26,000 was noted. She was diagnosed with HIT. Heparin was discontinued and replaced with an argatroban infusion for the duration of her care until heart transplantation was completed. We review the mechanism, diagnosis, and complications of HIT. We discuss cardiopulmonary bypass and its relation to heparin, HIT, and heparin alternatives. We discuss argatroban's relevant pharmacology, clinical use, advantages, and disadvantages.","PeriodicalId":36504,"journal":{"name":"Case Reports in Anesthesiology","volume":"2021 ","pages":"9945225"},"PeriodicalIF":0.0,"publicationDate":"2021-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8528599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39552461","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

Managing Known Difficult Airways in Obstetric Patients Using a Flexible Bronchoscope and IRRIS: A Case-Illustrated Guide for Nonexpert Anesthesiologists, without Surgical Backup. 使用柔性支气管镜和IRRIS管理产科患者已知的困难气道:一个没有手术支持的非专业麻醉师的案例说明指南。

Case Reports in Anesthesiology Pub Date : 2021-10-08 eCollection Date: 2021-01-01 DOI: 10.1155/2021/6778805

Kjartan E Hannig, Rasmus W Hauritz, Christian Jessen, Jan Herzog, Anders M Grejs, Michael S Kristensen

引用次数: 3

Diagnosis and Management of Obesity Hypoventilation Syndrome during Labor. 分娩时肥胖低通气综合征的诊断和处理。

Case Reports in Anesthesiology Pub Date : 2021-08-25 eCollection Date: 2021-01-01 DOI: 10.1155/2021/8096212

Brandon M Togioka, Sarah S McConville, Rachael M Penchoen-Lind, Katie J Schenning

{"title":"Diagnosis and Management of Obesity Hypoventilation Syndrome during Labor.","authors":"Brandon M Togioka, Sarah S McConville, Rachael M Penchoen-Lind, Katie J Schenning","doi":"10.1155/2021/8096212","DOIUrl":"https://doi.org/10.1155/2021/8096212","url":null,"abstract":"Obesity hypoventilation syndrome (OHS) is a disorder in which patients with a body mass index ≥30 kg/m2 develop awake hypercapnia with a partial pressure of carbon dioxide ≥45 mm Hg, in the absence of other diseases that may produce alveolar hypoventilation. Additional clinical features include sleep disordered breathing, restrictive lung disease, polycythemia, hypoxemia, and an increased serum bicarbonate concentration (≥27 mEq/L). Anesthesia providers should be familiar with OHS because it is often undiagnosed, it is associated with a higher mortality rate than obstructive sleep apnea, and it is projected to increase in prevalence along with the obesity epidemic. In this case, a 33-year-old obese woman with presumed OHS developed respiratory acidosis during induction of labor. Continuous positive airway pressure treatment was initiated, but the patient continued to have hypercapnia. A cesarean delivery was recommended. The patient had baseline orthopnea due to her body habitus; thus, despite adequate labor analgesia, a cesarean delivery was completed with general endotracheal anesthesia. We believe this patient had OHS despite a serum bicarbonate <27 mEq/L, a partial pressure of oxygen >70 mm Hg, and a hemoglobin <16 g/dL, which would typically rule out OHS. Pregnant women experience a decrease in serum bicarbonate concentration due to progesterone-mediated hyperventilation, an increase in arterial oxygenation from increased minute ventilation and higher cardiac output, and a decrease in hemoglobin due to the physiologic anemia of pregnancy. Thus, OHS may be defined differently in pregnant than in non-pregnant patients.","PeriodicalId":36504,"journal":{"name":"Case Reports in Anesthesiology","volume":"2021 ","pages":"8096212"},"PeriodicalIF":0.0,"publicationDate":"2021-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8413020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39404014","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

Suspected Sugammadex Hypersensitivity following Repeated Administration in the Setting of Multiple Flap Takebacks in a Brief Timespan. 在短时间内多次皮瓣收回的情况下，反复给药后疑似糖胺酮过敏。

Case Reports in Anesthesiology Pub Date : 2021-08-23 eCollection Date: 2021-01-01 DOI: 10.1155/2021/5716159

Elizabeth G Zolper, Alan H Kim, Kevin G Kim, Paige K Dekker, Jenna C Bekeny, David H Song, Kenneth L Fan

{"title":"Suspected Sugammadex Hypersensitivity following Repeated Administration in the Setting of Multiple Flap Takebacks in a Brief Timespan.","authors":"Elizabeth G Zolper, Alan H Kim, Kevin G Kim, Paige K Dekker, Jenna C Bekeny, David H Song, Kenneth L Fan","doi":"10.1155/2021/5716159","DOIUrl":"https://doi.org/10.1155/2021/5716159","url":null,"abstract":"Sugammadex hypersensitivity is an uncommon event that typically occurs at higher doses. We report a case of suspected sugammadex hypersensitivity in a patient who developed hypoxia and bronchospasm following three administrations of the standard 2 mg/kg doses of sugammadex within 26 hours due to flap takebacks. Hypersensitivity to sugammadex was not initially suspected given that the patient had previous exposures. Diagnoses of pneumothorax, hemothorax, mucus plug, and tracheal tube malposition were immediately ruled out. Furthermore, the onset of hypoxia with sudden loss of tidal volume, development of high peak airway pressures, and temporal correlation with sugammadex administration all supported bronchospasm secondary to a hypersensitivity reaction. Sugammadex is a useful agent for neuromuscular blockade reversal; however, it is critical to carefully examine all adverse reactions. This case report highlights the importance of considering hypersensitivity reactions in the setting of repeat sugammadex administrations in a limited timeframe, such as in free flap reconstruction requiring multiple takebacks to the operating room in the setting of flap compromise.","PeriodicalId":36504,"journal":{"name":"Case Reports in Anesthesiology","volume":"2021 ","pages":"5716159"},"PeriodicalIF":0.0,"publicationDate":"2021-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8405312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39377103","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

Use of Liposomal Bupivacaine in Pediatric Peripheral Nerve Blocks after Traumatic Amputation. 布比卡因脂质体在小儿外伤性截肢后周围神经阻滞中的应用。

Case Reports in Anesthesiology Pub Date : 2021-08-16 eCollection Date: 2021-01-01 DOI: 10.1155/2021/8092204

Gregory M Halenda, Stylianos Voulgarelis

引用次数: 2

Uncommon Occurrence of an Air Embolism during the Preanhepatic Phase of an Orthotopic Liver Transplant. 原位肝移植肝前期空气栓塞的罕见发生。

Case Reports in Anesthesiology Pub Date : 2021-08-09 eCollection Date: 2021-01-01 DOI: 10.1155/2021/6628961

Klint J Smart, Saman Yaghoubian

引用次数: 0