Anaesthesia reports最新文献

Pulmonary embolism of haemostatic material during paediatric neurosurgery 小儿神经外科中止血材料的肺栓塞

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Anaesthesia reports Pub Date : 2025-04-27 DOI: 10.1002/anr3.70010

M. L. Katsin, M. Glebov, T. Nir, Y. Portnoy, M. J. Katsin, H. Berkenstadt, D. Orkin

引用次数: 0

Gastric ultrasound to assess the prokinetic efficacy of erythromycin in a patient taking glucagon-like peptide-1 receptor agonists 胃超声评估红霉素对服用胰高血糖素样肽-1受体激动剂患者的促动力学作用

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Anaesthesia reports Pub Date : 2025-04-15 DOI: 10.1002/anr3.70008

N. S. Sidhu

{"title":"Gastric ultrasound to assess the prokinetic efficacy of erythromycin in a patient taking glucagon-like peptide-1 receptor agonists","authors":"N. S. Sidhu","doi":"10.1002/anr3.70008","DOIUrl":"https://doi.org/10.1002/anr3.70008","url":null,"abstract":"<p>Glucagon-like peptide-1 receptor agonists slow gastric emptying and may increase aspiration risk. Recent guidelines suggest using prokinetic agents pre-operatively, but no studies have assessed the efficacy of erythromycin for this purpose. We present a 53-year-old man (weight 110 kg) taking liraglutide and undergoing elective knee arthroscopy. Despite 19 h of fasting and withholding liraglutide, gastric ultrasound revealed a grade 3 antrum with solid content. Intravenous erythromycin 300 mg was administered, causing transient gastrointestinal symptoms. A repeat ultrasound 15 min later showed reduced solid content, although the antrum was not convincingly empty. As the patient declined neuraxial anaesthesia without sedation, a modified rapid sequence induction was performed. An ultrasound scan at the completion of surgery confirmed an empty stomach, and recovery was uneventful. This is the first documented case using gastric ultrasound to assess the effect of erythromycin on a patient taking a glucagon-like peptide-1 receptor agonist. While erythromycin achieved its desired effect within 100 min, the optimal timing for prokinetic administration and subsequent ultrasound assessment remains uncertain. Gastric ultrasound may refine risk stratification and guide prokinetic use for these patients. Further research is needed to determine optimal erythromycin dosing, time to desired effect and side effects to optimise peri-operative management.</p>","PeriodicalId":72186,"journal":{"name":"Anaesthesia reports","volume":"13 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/anr3.70008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143835869","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

Prolonged anaphylactic circulatory failure caused by blood transfusion during general anaesthesia 全身麻醉时输血引起的长时间过敏性循环衰竭

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Anaesthesia reports Pub Date : 2025-04-15 DOI: 10.1002/anr3.70009

M. Kuroki, A. Narisawa, Y. Yokoyama, T. Hayasaka, Y. Onodera, M. Okada, H. Toyama

{"title":"Prolonged anaphylactic circulatory failure caused by blood transfusion during general anaesthesia","authors":"M. Kuroki, A. Narisawa, Y. Yokoyama, T. Hayasaka, Y. Onodera, M. Okada, H. Toyama","doi":"10.1002/anr3.70009","DOIUrl":"https://doi.org/10.1002/anr3.70009","url":null,"abstract":"<p>Blood transfusion is one of the causes of anaphylaxis during general anaesthesia. In most cases, adrenaline administration quickly alleviates circulatory failure and its continuous administration for days is very rare. We present the case of a 79-year-old man who experienced prolonged anaphylactic circulatory failure with increased histamine and tryptase concentrations following laparoscopic total gastrectomy, during which he received a blood transfusion. He developed hypotension soon after the initiation of blood transfusion during surgery. We immediately administered intravenous adrenaline, followed by a continuous adrenaline infusion to stabilise the circulation. Circulatory failure recurred and itchy wheals appeared when the adrenaline dose was reduced necessitating continuous adrenaline administration for > 24 h. The histamine and tryptase serum concentrations increased when the adrenaline dose was reduced. The timing of anaphylaxis onset and skin test results excluded rocuronium, cefazolin, ropivacaine and propofol as causes of the anaphylaxis. Therefore, the blood transfusion was the most likely cause. For anaphylaxis due to common causes, boluses of adrenaline often restore the circulation shortly after onset. However, transfusion-induced anaphylaxis, as in this case, can require prolonged infusion of adrenaline because of the lack of allergen clearance. For such cases, careful follow-up is very important.</p>","PeriodicalId":72186,"journal":{"name":"Anaesthesia reports","volume":"13 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/anr3.70009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143835866","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

Fascial plane blocks and conscious sedation for a patient undergoing minimally invasive hemithyroidectomy 微创半甲状腺切除术患者的筋膜平面阻滞和意识镇静

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Anaesthesia reports Pub Date : 2025-04-07 DOI: 10.1002/anr3.70007

M. M. Alseoudy, I. A. Elzahaby, D. A. Elebedy

{"title":"Fascial plane blocks and conscious sedation for a patient undergoing minimally invasive hemithyroidectomy","authors":"M. M. Alseoudy, I. A. Elzahaby, D. A. Elebedy","doi":"10.1002/anr3.70007","DOIUrl":"https://doi.org/10.1002/anr3.70007","url":null,"abstract":"<div>\u0000 \u0000 <p>Fascial plane blocks for thoracic and neck surgery provide not only peri-operative analgesia but also serve as an effective alternative to general anaesthesia when combined with procedural sedation. Hemithyroidectomies are commonly performed by an open technique involving a transverse neck incision. Minimally invasive endoscopic approaches can offer cosmetic benefits, quicker recovery and reduced need for analgesia. Avoiding general anaesthesia may reduce complications, such as pulmonary atelectasis and cardiovascular instability, which may be of benefit to patients at increased risk. We describe the use of a combination of fascial plane blocks (superficial cervical plexus block, clavipectoral fascia plane block, interpectoral plane block and pectoserratus plane block) and dexmedetomidine sedation for a 65-year-old patient who had previously experienced accidental awareness under general anaesthesia and was very keen to avoid another general anaesthetic. The procedure was uneventful, with minimal bleeding and stable respiratory and haemodynamic parameters throughout. The patient was extremely satisfied with the anaesthetic technique and the cosmetic results of the surgery. We propose that fascial plane blocks along with dexmedetomidine sedation can be an effective alternative to general anaesthesia for endoscopic hemithyroidectomy in selected patients.</p>\u0000 </div>","PeriodicalId":72186,"journal":{"name":"Anaesthesia reports","volume":"13 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143793555","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: 0

Soft palate injury during attempted tracheal intubation using videolaryngoscopy 视频喉镜下气管插管时软腭损伤

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Anaesthesia reports Pub Date : 2025-03-20 DOI: 10.1002/anr3.70005

S. Heelan, T. Bhari, W. Smy

引用次数: 0

Managing post-reperfusion syndrome in domino liver transplantation for familial amyloidotic polyneuropathy 家族性淀粉样变性多发性神经病骨牌肝移植后再灌注综合征的处理

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Anaesthesia reports Pub Date : 2025-03-20 DOI: 10.1002/anr3.70006

G. Sindwani, S. L. Ronanki, A. Yadav, U. Dhingra, D. Tempe, V. Pamecha, N. Mohapatra

{"title":"Managing post-reperfusion syndrome in domino liver transplantation for familial amyloidotic polyneuropathy","authors":"G. Sindwani, S. L. Ronanki, A. Yadav, U. Dhingra, D. Tempe, V. Pamecha, N. Mohapatra","doi":"10.1002/anr3.70006","DOIUrl":"https://doi.org/10.1002/anr3.70006","url":null,"abstract":"<div>\u0000 \u0000 <p>Familial amyloidotic polyneuropathy is a rare genetic disorder caused by transthyretin mutations, leading to multi-organ dysfunction, with a significant impact on the nervous and cardiovascular systems. Domino liver transplantation is a unique strategy which increases donor organ availability by transplanting the explanted liver from a patient with familial amyloidotic polyneuropathy into another patient. This report describes a 37-year-old patient with familial amyloidotic polyneuropathy who underwent a living donor liver transplantation as part of a domino liver transplantation, emphasising the lessons learnt about the role of isoprenaline for managing the post-reperfusion syndrome and the considerations regarding prophylactic pacemaker insertion. She developed severe bradycardia following anaesthesia induction and again during graft reperfusion, which was refractory to atropine but successfully managed with isoprenaline. On postoperative day 20, she experienced severe bradycardia which was unresponsive to medical management, necessitating a temporary pacemaker, followed by a permanent pacemaker on postoperative day 26. This case highlights the role of isoprenaline as a preferred agent for managing bradyarrhythmia and conduction blocks during liver graft reperfusion. Additionally, it highlights the potential need for prophylactic pacemaker insertion in select patients with subclinical conduction abnormalities, as stressors, such as liver transplantation, can unmask life-threatening arrhythmias.</p>\u0000 </div>","PeriodicalId":72186,"journal":{"name":"Anaesthesia reports","volume":"13 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143688904","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: 0

Comment on ‘Peri-operative and anaesthetic considerations for gender-affirming vocal surgery’ 关于“性别确认声乐手术的围手术期和麻醉注意事项”的评论

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Anaesthesia reports Pub Date : 2025-03-03 DOI: 10.1002/anr3.70004

A. Muthukumar, A. Lakda, H. Allouch

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Hybrid closed loop technology in emergency surgery in a person with type 1 diabetes 混合闭环技术在1型糖尿病患者急诊手术中的应用

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Anaesthesia reports Pub Date : 2025-02-19 DOI: 10.1002/anr3.70003

H. Afridi, P. Olsen, N. Levy, K. Dhatariya

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Epidural spread of injectate from a costoclavicular catheter due to selective lodging in the middle trunk 由于选择性倒伏在中干，从肋锁骨导管注入的针剂在硬膜外扩散

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Anaesthesia reports Pub Date : 2025-02-14 DOI: 10.1002/anr3.70002

R. Sripriya, N. Jyotsna, S. Nelluri, P. Sona

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Ultrasonography guided modified Sellick manoeuvre in post-oesophagectomy patients – a case series* 超声引导改良Sellick手法在食管切除术后患者中的应用-一个病例系列*

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Anaesthesia reports Pub Date : 2025-02-14 DOI: 10.1002/anr3.70001

N. Reddivari, V. Naik, B. K. Rayani, S. Adda

{"title":"Ultrasonography guided modified Sellick manoeuvre in post-oesophagectomy patients – a case series*","authors":"N. Reddivari, V. Naik, B. K. Rayani, S. Adda","doi":"10.1002/anr3.70001","DOIUrl":"https://doi.org/10.1002/anr3.70001","url":null,"abstract":"<div>\u0000 \u0000 <p>Oesophagectomy is an established treatment option for the management of oesophageal carcinoma. This procedure results in loss of the lower oesophageal sphincter, which increases the risk of pulmonary aspiration in patients presenting for subsequent surgeries. Consequently, innovative strategies are needed to enhance safety during airway management. Although Sellick manoeuvre (cricoid pressure) is commonly used to mitigate the risk of aspiration, there is limited evidence to support its efficacy. Additionally, cricoid pressure may not be effective in patients who have undergone oesophagectomy because of the altered neck anatomy. In this case series, we present seven post-oesophagectomy patients who underwent ultrasound-guided modified Sellick manoeuvre for airway management. During tracheal intubation with a videolaryngoscope, the gastric conduit in the neck was visualised and compressed with the ultrasound probe, attempting to oppose both walls of the conduit and reduce the risk of regurgitation. This approach addresses the challenges posed by altered anatomy and the limitations of traditional cricoid pressure, potentially enhancing the safety of airway management in these patients. While ultrasound-guided oesophageal compression shows promise as a feasible technique, further studies are needed to validate its effectiveness.</p>\u0000 </div>","PeriodicalId":72186,"journal":{"name":"Anaesthesia reports","volume":"13 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143404357","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: 0