Anaesthesia reports最新文献

{"title":"Rebound methaemoglobinaemia secondary to intentional sodium nitrite ingestion","authors":"J. Dalziel,&nbsp;D. Urwin,&nbsp;G. Band,&nbsp;S. Dey,&nbsp;T. Barker,&nbsp;R. Frank","doi":"10.1002/anr3.12320","DOIUrl":"https://doi.org/10.1002/anr3.12320","url":null,"abstract":"<div>\u0000 \u0000 <p>We report a case of rebounding severe methaemoglobinaemia secondary to sodium nitrite ingestion, despite several administrations of methylene blue. The patient's clinical course was characterised by a series of alternating improvements and deteriorations and proved challenging for treating clinicians. On discussion with poisoning experts, it was hypothesised that a small amount of sodium nitrite remained in the gastrointestinal tract leading to prolonged absorption of the causative agent. Methaemoglobin levels returned to normal following the administration of multi-dose activated charcoal via a nasogastric tube 30 h after the initial presentation to hospital.</p>\u0000 </div>","PeriodicalId":72186,"journal":{"name":"Anaesthesia reports","volume":"12 2","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142123287","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}

{"title":"Sternal haematoma infusion catheter: a novel technique for pain management in manubriosternal fractures in the emergency department","authors":"K. Frowde,&nbsp;S. Naeem,&nbsp;A. Alzarrad,&nbsp;D. Abdel-Aziz,&nbsp;O.W. Schofield","doi":"10.1002/anr3.12322","DOIUrl":"https://doi.org/10.1002/anr3.12322","url":null,"abstract":"<div>\u0000 \u0000 <p>Sternal fractures are associated with significant morbidity and mortality, with some patients requiring admission for pain management, often through systemic analgesia, which may be ineffective. Regional anaesthetic techniques are more challenging for sternal fractures than rib fractures and require experienced clinicians. Local anaesthetic techniques are becoming recognised as a modality to improve pain control and to reduce complications from opioid use, especially in the elderly. We delivered local anaesthetic via a sternal haematoma infusion catheter for an elderly patient with uncontrolled pain despite the provision of intravenous patient-controlled analgesia. This technique enabled an improvement in pain scores, better engagement with physiotherapy and reduced opioid use. Local anaesthesia has been used previously to manage pain after coronary artery bypass graft surgery. Our experience demonstrated the safety, efficacy and tolerability of this approach to analgesia in sternal fractures.</p>\u0000 </div>","PeriodicalId":72186,"journal":{"name":"Anaesthesia reports","volume":"12 2","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142100428","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}

{"title":"Recurrent laryngeal nerve block to facilitate rigid bronchoscopy for tracheal stenosis in a patient with extensive burns","authors":"S. Shokohi,&nbsp;M. M. Aghdashi","doi":"10.1002/anr3.12319","DOIUrl":"https://doi.org/10.1002/anr3.12319","url":null,"abstract":"","PeriodicalId":72186,"journal":{"name":"Anaesthesia reports","volume":"12 2","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141986034","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}

{"title":"Modified external oblique intercostal plane nerve block for female patients undergoing open donor hepatectomy","authors":"G. Sindwani,&nbsp;R. Nair,&nbsp;G. Manikandan","doi":"10.1002/anr3.12317","DOIUrl":"10.1002/anr3.12317","url":null,"abstract":"","PeriodicalId":72186,"journal":{"name":"Anaesthesia reports","volume":"12 2","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141908428","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}

{"title":"Thiopentone-based total intravenous anaesthesia for a patient with carnitine palmitoyltransferase II deficiency and malignant hyperthermia susceptibility","authors":"Z. Essackjee,&nbsp;G. Sloan","doi":"10.1002/anr3.12318","DOIUrl":"10.1002/anr3.12318","url":null,"abstract":"<div>\u0000 \u0000 <p>In this case report, we discuss the use of a thiopentone infusion for the maintenance of anaesthesia in a patient with confirmed malignant hyperthermia susceptibility and carnitine palmitoyltransferase 2 deficiency. The concurrence of both diagnoses precluded the use of both propofol-based total intravenous anaesthesia and volatile inhalational anaesthesia. This patient had been anaesthetised previously with a triple infusion regimen of thiopentone, midazolam and remifentanil and this was a unique opportunity to compare the two instances. Electroencephalogram-based depth of anaesthesia monitoring was in routine use by the time of the second anaesthetic, and thus, the thiopentone infusion could be adjusted accordingly, resulting in a more rapid emergence time. We hope that this case may serve as an example of suitable anaesthetic alternative should both propofol infusion and inhalational anaesthesia not be an option.</p>\u0000 </div>","PeriodicalId":72186,"journal":{"name":"Anaesthesia reports","volume":"12 2","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141908429","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}

{"title":"The utility of virtual reality and manikin crisis scenario simulations for anaesthesia trainee education: a randomised crossover pilot study","authors":"L. W. Babus,&nbsp;H. Gurnaney,&nbsp;A. K. Doshi,&nbsp;H. Liu,&nbsp;A. Nishisaki,&nbsp;D. Singh,&nbsp;R. J. Daly Guris,&nbsp;the CHOP Virtual Reality Group","doi":"10.1002/anr3.12316","DOIUrl":"10.1002/anr3.12316","url":null,"abstract":"<div>\u0000 \u0000 <p>Simulation education for anaesthesia trainees is essential to build clinical skills and virtual reality can provide a reproducible, high-fidelity intra-operative training environment. Compared to in-situ manikin-based simulation, this modality has yet to be thoroughly evaluated. Twenty-six second post-graduate year anaesthesiology residents were randomly divided into two groups and participated in both virtual reality and manikin crisis scenarios at sessions six months apart. The exposure order was group A virtual reality followed by manikin and group B manikin followed by virtual reality. Clinical assessments were performed using a standardised checklist. Knowledge assessments were conducted. National Aeronautics and Space Administration Task Load Index and System Usability Scale scores were collected immediately after participation. Clinical scores between groups A and B were not significantly different. Group A had improved post-simulation knowledge scores after both sessions. Task load index scores were lower in mental demand for virtual reality. System usability scores showed less ease of use and more need for support in virtual reality.</p>\u0000 </div>","PeriodicalId":72186,"journal":{"name":"Anaesthesia reports","volume":"12 2","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141891098","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}

{"title":"Universal C-MAC® videolaryngoscope use in adult patients: a single-centre experience","authors":"R. Penders,&nbsp;F. E. Kelly,&nbsp;T. M. Cook","doi":"10.1002/anr3.12314","DOIUrl":"10.1002/anr3.12314","url":null,"abstract":"<div>\u0000 \u0000 <p>Universal use of Storz C-MAC® videolaryngoscopes was implemented for adult tracheal intubations in the operating theatres, intensive care unit and emergency department at Royal United Hospitals Bath NHS Foundation Trust in 2017. We report data from 1099 intubations from March 2020 to March 2022, collected contemporaneously and anonymously using a smartphone app, representing an estimated 18% of intubations in operating theatres and 30% of intubations in other locations during this period. Intubation success was 100%. The first-pass success rate was 87.3% overall: 87% with a Macintosh videolaryngoscope, 92% with a hyperangulated videolaryngoscope and 81% for users with ≤ 20 previous uses. First-pass success without complications was 87% overall: 87% in operating theatres (836/962), 93% in the emergency department (38/41) and 83% in the intensive care unit (73/88). Complications occurred during 0.6% of intubations: 0/962 in operating theatres and 7/137 in non-theatre locations. The rate of complications was unaltered by blade type (Macintosh 5/994 vs. hyperangulated 2/105, p = 0.14); intubator experience with the device (≤ 20 previous clinical uses 2/260 vs. &gt; 20 previous uses 5/832, p = 0.67) and use of airborne personal protective equipment (PPE 6/683 vs. no-PPE 1/410, p = 0.27). Complication rates increased outside theatres (theatres 0/963 vs. non-theatre 7/136, p &lt; 0.001) and during rapid sequence induction (RSI 6/379 (1.6%) vs. non-RSI 1/720 (0.1%), p = 0.008).</p>\u0000 </div>","PeriodicalId":72186,"journal":{"name":"Anaesthesia reports","volume":"12 2","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141891099","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}

{"title":"Transient recurrence of chemotherapy-induced peripheral neuropathy in the immediate postoperative period following gynaecological surgery under general anaesthesia","authors":"O. H. Ra,&nbsp;J. C. Tan,&nbsp;C. W. Zhao,&nbsp;S. L. Burns","doi":"10.1002/anr3.12315","DOIUrl":"10.1002/anr3.12315","url":null,"abstract":"<div>\u0000 \u0000 <p>Peripheral neuropathy is a well-described side effect of certain chemotherapeutic agents, including taxanes, and often improves in the weeks following treatment. The recurrence of motor and sensory neuropathies after anaesthesia has not yet been described to our knowledge. We present a case of transient recurrence of chemotherapy-induced peripheral neuropathy following general anaesthesia. Although an exact mechanism has not yet been described and is likely multifactorial in nature, anaesthetists should be prepared to address this phenomenon in the growing population of patients on chemotherapeutic agents.</p>\u0000 </div>","PeriodicalId":72186,"journal":{"name":"Anaesthesia reports","volume":"12 2","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141790160","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}

{"title":"Right trace wrong place: a normal capnography trace despite the tip of the tracheal tube existing outside the airway","authors":"A. Karmakar,&nbsp;M. J. Khan,&nbsp;N. A. H. Shallik,&nbsp;A. H. M. N. Moustafa,&nbsp;Y. M. R. A. Toble,&nbsp;G. F. Strandvik","doi":"10.1002/anr3.12313","DOIUrl":"10.1002/anr3.12313","url":null,"abstract":"<p>Head and neck trauma can result in difficult airway management. A 25-year-old male required emergency tracheal intubation on arrival to the emergency department following a motorbike accident. Despite the presence of a normal capnography a computed tomography scan demonstrated a tracheal opening, an extra-tracheal position of the distal end of the tracheal tube, and extensive subcutaneous emphysema. The tube was re-directed into the trachea and the tracheal injury was surgically repaired. This case highlights that the presence of a normal capnograph does not necessarily mean that the distal end of the tracheal tube resides within the airway.</p>","PeriodicalId":72186,"journal":{"name":"Anaesthesia reports","volume":"12 2","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11237171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141592253","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":"Unilateral arm weakness following retroperitoneal lymph node dissection for testicular germ cell tumour","authors":"S. Gaikwad,&nbsp;B. Trivedi,&nbsp;S. Gholap","doi":"10.1002/anr3.12312","DOIUrl":"10.1002/anr3.12312","url":null,"abstract":"<p>A 26-year-old man underwent retroperitoneal lymph node dissection following diagnosis of non-seminomatous testicular germ cell tumour. He had previously undergone an inguinal orchidectomy. The surgery was performed under general anaesthesia with thoracic epidural for analgesia. Four hours after the start of surgery, tachycardia and hypotension developed which did not respond to fluid therapy. Therefore, intravenous noradrenaline infusion was started at a rate of 0.01–0.07 μg.kg⁻¹.min⁻¹ which was discontinued 2 h after surgery. During the operation, both arms were abducted to 90 degrees. At the end of the surgery, the patients' trachea was extubated and he was transferred to the intensive care unit. On the first postoperative day, the patient developed a left upper limb monoparesis without sensory deficit. Magnetic resonance imaging (MRI) of the brain and brachial plexus were undertaken. The MRI brain revealed a haemorrhagic lesion with surrounding oedema, leading to a diagnosis of symptomatic intratumoural bleed with raised intracranial pressure (Fig. 1). This was suspected to be a metastatic lesion as it was well-defined and solitary. Testicular tumours can metastasise to the brain, although this is rare. The patient was treated with intravenous dexamethasone and received targeted radiotherapy which led to complete recovery of the arm weakness by postoperative day 21.</p><p>Brain metastases in non-seminomatous testicular germ cell tumours are uncommon, but more likely to occur in those over 40, with elevated levels of β-human chorionic gonadotropin (≥ 5000 IU.l⁻¹) and alpha-fetoprotein (&gt; 10,000 ng.ml⁻¹), pulmonary or bone metastases, and neurological symptoms. Due to the absence of these symptoms and low tumour marker levels, pre-operative brain imaging was not performed in this case [<span>1, 2</span>]. The tumour markers were repeated and were within normal range.</p><p>In non-seminomatous testicular germ cell tumours, spontaneous tumour bleed is rare, and while the patient's coagulation profile and platelets were normal, systemic immune response syndrome and immune suppression may have contributed to the bleeding risk. Systemic immune response syndrome may lead to increased metabolism and vascular complications, possibly influencing the occurrence of intratumoural bleeding [<span>3, 4</span>].</p><p>For us, the key point is that brain metastases can mimic anaesthetic complications, such as brachial plexus injury or a cerebrovascular accident. This highlights the need for a comprehensive differential diagnosis in the postoperative period to ensure accurate identification and management of underlying conditions.</p>","PeriodicalId":72186,"journal":{"name":"Anaesthesia reports","volume":"12 2","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11234445/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141581706","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}