Case Reports in Anesthesiology最新文献

{"title":"Retracted: Intrathecal Pump Implantation in the Cisterna Magna for Treating Intractable Cancer Pain.","authors":"Case Reports In Anesthesiology","doi":"10.1155/2021/9814903","DOIUrl":"https://doi.org/10.1155/2021/9814903","url":null,"abstract":"<p><p>[This retracts the article DOI: 10.1155/2018/5287150.].</p>","PeriodicalId":36504,"journal":{"name":"Case Reports in Anesthesiology","volume":"2021 ","pages":"9814903"},"PeriodicalIF":0.0,"publicationDate":"2021-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8373483/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39334831","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 Patient with Harlequin Ichthyosis.","authors":"Klint J Smart,&nbsp;Catherine A Gruffi,&nbsp;Tara M Doherty","doi":"10.1155/2021/9953320","DOIUrl":"https://doi.org/10.1155/2021/9953320","url":null,"abstract":"<p><p>Harlequin ichthyosis is a severe and often fatal form of congenital ichthyosis caused by defective lipid transport which results in a dysfunctional skin barrier. Patients who survive the neonatal period are predisposed to skin infections, sepsis, impaired thermoregulation, and dehydration. The unique skin characteristics can present significant anesthetic challenges. We highlight the relevant anesthetic considerations in a 3-year-old presenting for syndactyly release of the right second and fourth digits. We describe the steps to ensure protection of the fragile skin barrier during establishment of intravenous access and airway management, therefore providing guidance for care of this vulnerable patient population.</p>","PeriodicalId":36504,"journal":{"name":"Case Reports in Anesthesiology","volume":"2021 ","pages":"9953320"},"PeriodicalIF":0.0,"publicationDate":"2021-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8328734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39277119","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":"Antisynthetase Syndrome with Severe Interstitial Lung Disease in Pregnancy.","authors":"Catalina I Dumitrascu,&nbsp;David A Olsen,&nbsp;Katherine W Arendt,&nbsp;Carl H Rose,&nbsp;Emily E Sharpe","doi":"10.1155/2021/1150394","DOIUrl":"https://doi.org/10.1155/2021/1150394","url":null,"abstract":"<p><p>Antisynthetase syndrome is a rare multisystem autoimmune disorder which clinically manifests with myositis, arthritis, interstitial lung disease, Raynaud phenomenon, and skin hyperkeratosis. Lung involvement represents the most severe form of disease and has rarely been reported in pregnancy. We present the case of a 22-year-old woman with antisynthetase syndrome and severe restrictive pulmonary disease who experienced a successful pregnancy and delivery. We discuss anesthetic considerations and highlight the importance of a multidisciplinary team approach in caring for parturients with multifactorial medical conditions.</p>","PeriodicalId":36504,"journal":{"name":"Case Reports in Anesthesiology","volume":"2021 ","pages":"1150394"},"PeriodicalIF":0.0,"publicationDate":"2021-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8328709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39276709","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":"Axonal Injury with Persistent Neuropathy following Popliteal Nerve Block for Cheilectomy Surgery.","authors":"Y A M Kuijpers,&nbsp;J M Setz,&nbsp;K Khemlani-Houthoff","doi":"10.1155/2021/9942195","DOIUrl":"https://doi.org/10.1155/2021/9942195","url":null,"abstract":"<p><p>Peripheral nerve blocks are often used for foot and ankle surgery. The occurrence of persistent neurological symptoms thereafter is very rare. Preventive strategies pose no guarantee and uncovering true etiology is often complicated. We discuss a case in which a young, healthy patient developed nerve damage after an uneventful popliteal block and cheilectomy. Nerve conduction studies revealed axonal injury in the distribution area of the sciatic nerve. The neurological symptoms persisted for more than 12 months, emotionally affecting the patient greatly. Patients will primarily report to the orthopedic surgeon, for whom cooperation with anaesthesia and neurology is of importance. Anesthetic involvement probably improves patient satisfaction during complication management.</p>","PeriodicalId":36504,"journal":{"name":"Case Reports in Anesthesiology","volume":"2021 ","pages":"9942195"},"PeriodicalIF":0.0,"publicationDate":"2021-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8275396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39203010","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":"Tricuspid Valve Replacement in a Patient with a Leadless Cardiac Pacemaker: Current Guidelines and Recommendations for Perioperative Management.","authors":"River Hames,&nbsp;J W Awori Hayanga,&nbsp;Diane Schmidt-Krings,&nbsp;Timothy Goldhardt,&nbsp;John Bozek,&nbsp;Donald Siddoway,&nbsp;Stanley Schmidt,&nbsp;John Lobban,&nbsp;Heather K Hayanga","doi":"10.1155/2021/5559830","DOIUrl":"https://doi.org/10.1155/2021/5559830","url":null,"abstract":"<p><p>Leadless cardiac pacemakers were developed to reduce complications associated with conventional transvenous pacemakers. While this technology is still relatively new, devices are increasingly being implanted. The perioperative management of patients with these devices has been underreported; we thus seek to add to the limited body of knowledge of perioperative management of patients with leadless cardiac pacemakers. An elderly female patient with a Micra VR transcatheter pacing system leadless cardiac pacemaker placed for tachycardia-bradycardia syndrome with intermittent complete heart block was scheduled for elective tricuspid valve replacement for severe tricuspid regurgitation. Pacemaker interrogation was performed several hours prior to the scheduled surgery based on the electrophysiologist's availability; the device was kept in its programmed VVIR mode, and the base rate was increased from 60 to 80 beats per minute in anticipation of the upcoming surgery. Upon preoperative evaluation, the anesthesiologist asked that the electrophysiology team be placed on standby intraoperatively due to the concern that either oversensing in the setting of pacemaker dependence and/or undesirable tachycardia from rate-responsive pacing could occur. The surgeon used monopolar electrocautery for the duration of the cardiac surgery. Despite the patient having evidence of pacemaker dependence in the intensive care unit preoperatively, no electromagnetic interference leading to oversensing nor rate modulation was detected during intraoperative electrocardiographic and intraarterial invasive monitoring. Evidence-based guidelines regarding perioperative management specifically of leadless cardiac pacemakers do not exist. As these devices become more prevalent, further evaluation will be paramount to determine whether existing guidelines for perioperative management of conventional transvenous pacemakers apply.</p>","PeriodicalId":36504,"journal":{"name":"Case Reports in Anesthesiology","volume":"2021 ","pages":"5559830"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8266474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39219983","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 \"Rash\" Decision in Anesthetic Management: Benzyl Alcohol Allergy in the Perioperative Period.","authors":"Michael Tripp,&nbsp;Matthew Ribeiro,&nbsp;Susanna Kmiecik,&nbsp;Ramon Go","doi":"10.1155/2021/8859823","DOIUrl":"https://doi.org/10.1155/2021/8859823","url":null,"abstract":"<p><p>Here, we present the case of a 54-year-old female presenting for outpatient ankle hardware removal who experienced severe total body pruritus along with a maculopapular rash persisting four days after the procedure. Patch testing demonstrated a sensitivity to benzyl alcohol, a preservative in propofol and several other anesthetics. The patient returned for left ankle arthroscopy a year later, and during that procedure, the anesthetic team avoided medications containing benzyl alcohol. This resulted in no pruritus or rash. Hypersensitivity reactions, ranging from contact dermatitis to anaphylaxis, are critical events in the perioperative period. Induction of general anesthesia has been implicated as the inciting event for perioperative hypersensitivity reactions. Benzyl alcohol is among a few excipients found in common anesthetic agents known to cause hypersensitivity reactions in susceptible patients. While reports of adult death are rare, infantile death due to benzyl alcohol has been described.</p>","PeriodicalId":36504,"journal":{"name":"Case Reports in Anesthesiology","volume":"2021 ","pages":"8859823"},"PeriodicalIF":0.0,"publicationDate":"2021-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8249123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39180796","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 Use of Methylene Blue during Liver Transplantation for Vasoplegia.","authors":"Paul Harding,&nbsp;Thomas Nicholas,&nbsp;Cale Kassel","doi":"10.1155/2021/6610754","DOIUrl":"https://doi.org/10.1155/2021/6610754","url":null,"abstract":"<p><p>The use of methylene blue for vasoplegia in cardiac cases with cardiopulmonary bypass, septic shock, and acute liver failure is well documented. Use of MB for liver transplantation has been largely limited to case reports. We describe three separate liver transplantation patients with significant hypotension following reperfusion. Administration of methylene blue to each patient resulted in a significant decrease in vasopressor medication and two patients weaned completely. We argue that the use of MB should be considered as a treatment option for refractory hypotension.</p>","PeriodicalId":36504,"journal":{"name":"Case Reports in Anesthesiology","volume":"2021 ","pages":"6610754"},"PeriodicalIF":0.0,"publicationDate":"2021-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8245233/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39180795","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":"Intraoperative Transesophageal Echocardiography to Monitor for Pulmonary Emboli in a Pediatric Patient Undergoing Undifferentiated Embryonal Sarcoma of the Liver Resection.","authors":"Irim Salik,&nbsp;Nicolas Lamper,&nbsp;Bhupen Mehta,&nbsp;Kar-Mei Chan","doi":"10.1155/2021/5532028","DOIUrl":"https://doi.org/10.1155/2021/5532028","url":null,"abstract":"<p><p>A minimally invasive monitoring technique, intraoperative transesophageal echocardiography (TEE), has been utilized to provide real-time data on volume status and ventricular function in patients undergoing liver transplantation. In this case, TEE was utilized in an 8-year-old female undergoing undifferentiated embryonal sarcoma of the liver resection to monitor for pulmonary emboli, particularly a saddle embolus. In addition to visualization of cardiac structures, TEE can also be utilized to monitor the liver, lungs, spleen, and kidneys. Monitoring for echocardiographic findings of pulmonary embolism in this high-risk patient was an integral part of effective intraoperative management.</p>","PeriodicalId":36504,"journal":{"name":"Case Reports in Anesthesiology","volume":"2021 ","pages":"5532028"},"PeriodicalIF":0.0,"publicationDate":"2021-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8238612/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39166297","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":"Two Endotracheal Tubes in One Trachea with a Traumatic Injury.","authors":"Andrew Winegarner,&nbsp;Harish Lecamwasam,&nbsp;Mark C Kendall,&nbsp;Shyamal Asher","doi":"10.1155/2021/9912553","DOIUrl":"https://doi.org/10.1155/2021/9912553","url":null,"abstract":"<p><strong>Background: </strong>Traumatic airway injuries often require improvising solutions to altered anatomy under strict time constraints. We describe here the use of two endotracheal tubes simultaneously in the trachea to facilitate securing an airway which has been severely compromised by a self-inflicted wound to the trachea. <i>Case Presentation</i>: A 71-year-old male presented with a self-inflicted incision to his neck, cutting deep into the trachea itself. An endotracheal tube was emergently placed through the self-inflicted hole in the trachea in the ED. The patient was bleeding profusely, severely somnolent, and desaturating upon arrival to the operating room. Preservation of the tenuous airway was a priority while seeking to establish a more secure one. A video laryngoscope was used to gain a wide view of the posterior oropharynx and assist with oral intubation using a fiberoptic scope loaded with a second endotracheal tube. The initial tube's cuff was deflated as the second tube was advanced over the fiberoptic scope, thereby securing the airway while a completion tracheostomy was performed.</p><p><strong>Conclusions: </strong>Direct penetrating airway trauma may necessitate early, albeit less secure, intubations though the neck wounds prior to operating room arrival. The conundrum is weighing the risk of losing a temporary airway while attempting to establish a more secure airway. Here, we demonstrate the versatility of common anesthesia tools such as a video laryngoscope and a fiberoptic bronchoscope and the welcome discovery of the trachea's ability to accommodate two endotracheal tubes simultaneously so as to ensure a patent airway at all points throughout resuscitation.</p>","PeriodicalId":36504,"journal":{"name":"Case Reports in Anesthesiology","volume":"2021 ","pages":"9912553"},"PeriodicalIF":0.0,"publicationDate":"2021-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8131148/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39032809","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":"Acute Airway Obstruction from Megaoesophagus Secondary to Achalasia Evaluated with Flexible Bronchoscope.","authors":"Jun D Parker","doi":"10.1155/2021/8815376","DOIUrl":"https://doi.org/10.1155/2021/8815376","url":null,"abstract":"<p><p>A 94-year-old female presented to the emergency department with acute expiratory stridor. In the absence of an otorhinolaryngologist, an urgent laryngoscopy was performed using a flexible bronchoscope by an anaesthesiologist in the emergency department leading to a change in management. Subsequent radiographs confirmed severe tracheal compression from megaoesophagus secondary to achalasia as the cause of acute airway obstruction. Use of flexible bronchoscope as a diagnostic tool by an anaesthesiologist to evaluate a patient presenting with signs of acute airway obstruction may lead to a safer and more careful airway management planning. Suggestions are also made regarding establishment of emergency surgical airways when conventional approaches fail.</p>","PeriodicalId":36504,"journal":{"name":"Case Reports in Anesthesiology","volume":"2021 ","pages":"8815376"},"PeriodicalIF":0.0,"publicationDate":"2021-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8128534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39026949","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}