A&A Case Reports Pub Date : 2017-09-01DOI: 10.1213/XAA.0000000000000554
Stuart D Marshall, Jonathan Serpell
{"title":"Failed Vocalis Muscle Monitoring During Thyroid Surgery Resulting From Residual Muscle Relaxation.","authors":"Stuart D Marshall, Jonathan Serpell","doi":"10.1213/XAA.0000000000000554","DOIUrl":"https://doi.org/10.1213/XAA.0000000000000554","url":null,"abstract":"","PeriodicalId":6824,"journal":{"name":"A&A Case Reports ","volume":"9 5","pages":"158"},"PeriodicalIF":0.5,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1213/XAA.0000000000000554","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34999550","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}
A&A Case Reports Pub Date : 2017-09-01DOI: 10.1213/XAA.0000000000000546
Rodney A Gabriel, John J Finneran, Deepa Asokan, Andrea M Trescot, NavParkash S Sandhu, Brian M Ilfeld
{"title":"Ultrasound-Guided Percutaneous Cryoneurolysis for Acute Pain Management: A Case Report.","authors":"Rodney A Gabriel, John J Finneran, Deepa Asokan, Andrea M Trescot, NavParkash S Sandhu, Brian M Ilfeld","doi":"10.1213/XAA.0000000000000546","DOIUrl":"https://doi.org/10.1213/XAA.0000000000000546","url":null,"abstract":"<p><p>We report 3 different cases in which ultrasound-guided percutaneous cryoneurolysis was performed to treat acute pain: 1 patient with refractory incisional pain after percutaneous nephrolithotomy; 1 patient with burns to the foot; and 1 patient with pain from iliac crest grafting. Acute pain associated with surgery or injury is a challenge to treat with local anesthetic-based regional anesthesia techniques when the anticipated pain duration exceeds a few days. Cryoneurolysis is an alternative analgesic method that utilizes extremely cold temperatures to reversibly ablate peripheral nerves and is potentially a novel method for acute pain management.</p>","PeriodicalId":6824,"journal":{"name":"A&A Case Reports ","volume":"9 5","pages":"129-132"},"PeriodicalIF":0.5,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1213/XAA.0000000000000546","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34999449","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}
A&A Case Reports Pub Date : 2017-08-15DOI: 10.1213/XAA.0000000000000542
Veronika M Evers, Rogier V Immink, Willem J P van Boven, Mark I van Berge Henegouwen, Markus W Hollmann, Denise P Veelo
{"title":"Intraoperative Use of the Ventrain for Single Lung Ventilation After Iatrogenic Trauma to the Left Main Bronchus During Thoracoscopy: A Case Report.","authors":"Veronika M Evers, Rogier V Immink, Willem J P van Boven, Mark I van Berge Henegouwen, Markus W Hollmann, Denise P Veelo","doi":"10.1213/XAA.0000000000000542","DOIUrl":"https://doi.org/10.1213/XAA.0000000000000542","url":null,"abstract":"<p><p>In a patient undergoing thoracoscopic esophagectomy and concomitant wedge resection, an iatrogenic lesion in the left main bronchus was observed following deflation of the right lung. Because the bronchial cuff of the double-lumen tube was visible through the lesion, repair was only possible after deflation of the bulging cuff. Positive pressure ventilation would result in air leakage jeopardizing ventilation and oxygenation. This challenging situation was resolved using the Ventrain device to oxygenate the patient through a small-bore catheter placed through the lumen beyond the bronchial defect. With the use of this technique, oxygenation was maintained at an acceptable level during repair.</p>","PeriodicalId":6824,"journal":{"name":"A&A Case Reports ","volume":"9 4","pages":"116-118"},"PeriodicalIF":0.5,"publicationDate":"2017-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1213/XAA.0000000000000542","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34946029","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}
A&A Case Reports Pub Date : 2017-08-15DOI: 10.1213/XAA.0000000000000540
Rosemarie E Garcia Getting, Cynthia L Harris
{"title":"Sudden Increase in EtCO2 During Upper Endoscopy Under General Endotracheal Anesthesia Suggests the Presence of Tracheoesophageal Fistula: A Case Report.","authors":"Rosemarie E Garcia Getting, Cynthia L Harris","doi":"10.1213/XAA.0000000000000540","DOIUrl":"https://doi.org/10.1213/XAA.0000000000000540","url":null,"abstract":"<p><p>Acquired tracheoesophageal fistula is a rare and devastating complication of lung cancer. The diagnosis is typically confirmed on barium esophagram. We report a case of a patient with lung cancer status after palliative chemoradiotherapy and esophageal stenting for malignant stenosis who presented with signs and symptoms suggestive of tracheoesophageal fistula; however, no evidence of fistula was found on barium esophagram. During subsequent esophagogastroduodenoscopy, the presence of a fistula was verified by capnography, given extreme elevations in end-tidal CO2 concentrations during endoscopic CO2 insufflation.</p>","PeriodicalId":6824,"journal":{"name":"A&A Case Reports ","volume":"9 4","pages":"109-111"},"PeriodicalIF":0.5,"publicationDate":"2017-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1213/XAA.0000000000000540","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35157127","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}
A&A Case Reports Pub Date : 2017-08-15DOI: 10.1213/XAA.0000000000000537
W Jonathan Dunkman, Alina Nicoara, Jacob Schroder, Momen M Wahidi, Aimen El Manafi, Desiree Bonadonna, Coral X Giovacchini, Frederick W Lombard
{"title":"Elective Venovenous Extracorporeal Membrane Oxygenation for Resection of Endotracheal Tumor: A Case Report.","authors":"W Jonathan Dunkman, Alina Nicoara, Jacob Schroder, Momen M Wahidi, Aimen El Manafi, Desiree Bonadonna, Coral X Giovacchini, Frederick W Lombard","doi":"10.1213/XAA.0000000000000537","DOIUrl":"https://doi.org/10.1213/XAA.0000000000000537","url":null,"abstract":"<p><p>We present a case in which we electively used venovenous extracorporeal membrane oxygenation (VV-ECMO) to facilitate safe resection of a nearly obstructing airway tumor near the carina in a 37-year-old male. The patient was brought to the operating room and underwent bifemoral cannulation for VV-ECMO under light sedation while maintaining spontaneous ventilation. After VV-ECMO was initiated, general anesthesia was induced, and the tumor was resected via rigid bronchoscopy. After resection, the patient was intubated, weaned from ECMO, decannulated, awoken, extubated, and taken to the postanesthesia care unit for recovery.</p>","PeriodicalId":6824,"journal":{"name":"A&A Case Reports ","volume":"9 4","pages":"97-100"},"PeriodicalIF":0.5,"publicationDate":"2017-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1213/XAA.0000000000000537","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35025918","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}
A&A Case Reports Pub Date : 2017-08-15DOI: 10.1213/XAA.0000000000000538
Shin-E Lin, David B Auyong, Aaron B Dahl, Neil A Hanson
{"title":"Successful Continuous Adductor Canal Block Placement in a Patient With Absent Sartorius Muscle: A Case Report.","authors":"Shin-E Lin, David B Auyong, Aaron B Dahl, Neil A Hanson","doi":"10.1213/XAA.0000000000000538","DOIUrl":"https://doi.org/10.1213/XAA.0000000000000538","url":null,"abstract":"<p><p>We report a novel case of a patient who presented for elective total knee arthroplasty and had distorted adductor canal anatomy due to previous sartorius rotational flap surgery. Despite the lack of a sartorius muscle on the intended operative limb, we describe the successful placement of a continuous adductor canal block. This case is a clinically relevant example that highlights the importance of the vastoadductor membrane as the anatomical anteromedial boundary for the adductor canal, and that it remains intact even after sartorius muscle flap surgery.</p>","PeriodicalId":6824,"journal":{"name":"A&A Case Reports ","volume":"9 4","pages":"101-104"},"PeriodicalIF":0.5,"publicationDate":"2017-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1213/XAA.0000000000000538","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34913993","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}
A&A Case Reports Pub Date : 2017-08-15DOI: 10.1213/XAA.0000000000000541
Eugene Kim, Giovanni Cucchiaro
{"title":"Unique Considerations in Spinal Cord Stimulator Placement in Pediatrics: A Case Report.","authors":"Eugene Kim, Giovanni Cucchiaro","doi":"10.1213/XAA.0000000000000541","DOIUrl":"https://doi.org/10.1213/XAA.0000000000000541","url":null,"abstract":"<p><p>Spinal cord stimulation can be a valuable treatment option in the management of neuropathic pain in select pediatric patients. We present a unique case of a 16-year-old girl with Klippel-Trenaunay-Weber syndrome and scoliosis who required the placement of a spinal cord stimulator (SCS) for severe sciatic nerve neuropathic pain after a right above-knee amputation. Several attempts at lead placement were required before successful pain coverage was achieved because of late recognition of significant vertebral body rotation. This case highlights important considerations in pediatric SCS placement including a careful review of the spinal cord anatomy before the placement of an SCS.</p>","PeriodicalId":6824,"journal":{"name":"A&A Case Reports ","volume":"9 4","pages":"112-115"},"PeriodicalIF":0.5,"publicationDate":"2017-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1213/XAA.0000000000000541","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35081683","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}
A&A Case Reports Pub Date : 2017-08-15DOI: 10.1213/XAA.0000000000000544
Rakesh V Sondekoppam, Douglas Quan, Sugantha Ganapathy
{"title":"Temporary Decompression of Symptomatic Epidural Hematoma via an In Situ Epidural Catheter: A Case Report.","authors":"Rakesh V Sondekoppam, Douglas Quan, Sugantha Ganapathy","doi":"10.1213/XAA.0000000000000544","DOIUrl":"https://doi.org/10.1213/XAA.0000000000000544","url":null,"abstract":"<p><p>Spinal epidural hematoma (SEH) following neuraxial anesthesia needs prompt recognition and early decompressive measures to prevent long-term neurologic injury. We report a case of SEH presenting on the second postoperative day during an ongoing epidural infusion. Aspiration of blood through the epidural catheter and a subsequent improvement in the neurological symptoms made us suspect SEH, which was further confirmed by an MRI study. We describe the timeline of the presentation of SEH and the subsequent clinical course in our patient. Aspiration of blood through an in situ epidural catheter may not only point toward the possibility of SEH but may also temporarily decompress the spinal canal.</p>","PeriodicalId":6824,"journal":{"name":"A&A Case Reports ","volume":"9 4","pages":"123-126"},"PeriodicalIF":0.5,"publicationDate":"2017-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1213/XAA.0000000000000544","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34956972","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}
A&A Case Reports Pub Date : 2017-08-15DOI: 10.1213/XAA.0000000000000539
Daniel J Rosenkrans, Lavinia M Kolarczyk
{"title":"Intraoperative Hyperkalemia and Ventricular Arrhythmia During Parathyroidectomy: A Case Report.","authors":"Daniel J Rosenkrans, Lavinia M Kolarczyk","doi":"10.1213/XAA.0000000000000539","DOIUrl":"https://doi.org/10.1213/XAA.0000000000000539","url":null,"abstract":"<p><p>We present a case of acute hyperkalemia and ventricular arrhythmia during parathyroidectomy in a patient with end-stage renal disease. This case highlights the under-recognized alterations in potassium homeostasis associated with parathyroidectomy and underscores the importance of preoperative optimization.</p>","PeriodicalId":6824,"journal":{"name":"A&A Case Reports ","volume":"9 4","pages":"105-108"},"PeriodicalIF":0.5,"publicationDate":"2017-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1213/XAA.0000000000000539","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35096342","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}
A&A Case Reports Pub Date : 2017-08-15DOI: 10.1213/XAA.0000000000000545
Franklin Chiao, Karen Boretsky
{"title":"Dexmedetomidine as a Supplement to Spinal Anesthesia Block: A Case Report of Three Infants.","authors":"Franklin Chiao, Karen Boretsky","doi":"10.1213/XAA.0000000000000545","DOIUrl":"https://doi.org/10.1213/XAA.0000000000000545","url":null,"abstract":"<p><p>We report a novel use for dexmedetomidine as a supplemental intravenous or intranasal sedative for spinal anesthesia in infants. The children were 1, 2, and 9 months old having either inguinal hernia repair or circumcision. None of them experienced clinically relevant hemodynamic changes or apnea. Pain scores were zero throughout the postoperative period.</p>","PeriodicalId":6824,"journal":{"name":"A&A Case Reports ","volume":"9 4","pages":"127-128"},"PeriodicalIF":0.5,"publicationDate":"2017-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1213/XAA.0000000000000545","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34956973","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}