Anaesthesia reports最新文献

{"title":"Implementation of the American Society of Anesthesiologists 2022 paediatric guidelines in a child with mandibular metastasis","authors":"M. Larkins,&nbsp;J. Iasiello,&nbsp;K. Travia,&nbsp;M. Pasli,&nbsp;S. Cai,&nbsp;A. Hutton","doi":"10.1002/anr3.12274","DOIUrl":"https://doi.org/10.1002/anr3.12274","url":null,"abstract":"<p>The 2022 American Society of Anesthesiologists Practice Guidelines for Management of the Difficult Airway differ significantly from prior guidelines, particularly regarding paediatric patients. These guidelines place new emphasis on establishing a multidisciplinary team led by an anaesthetist trained in paediatric anaesthesia. Here, we demonstrate the clinical application of the new guidelines by presenting the case of a 16-month-old girl with a rapidly growing mandibular mass. The new guidelines stipulated the need for multidisciplinary team assembly; planning with indirect laryngoscopy; the availability of surgical tracheostomy and extracorporeal membrane oxygenation; and multiple ‘time out’ stops to confirm team members and plans. The patient tolerated induction of general anaesthesia and mask-ventilation and tracheal intubation was achieved uneventfully on the first attempt. Her trachea was extubated uneventfully 5 days later. We emphasise the importance of paediatric anaesthesia training and videolaryngoscopy and discuss components of the 2022 American Society of Anesthesiologists Practice Guidelines for Management of the Difficult Airway with reference to a successful outcome in a paediatric difficult airway scenario.</p>","PeriodicalId":72186,"journal":{"name":"Anaesthesia reports","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/anr3.12274","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139109793","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":"Thrombolysis and mechanical cardiopulmonary resuscitation for pulmonary embolism complicated by hepatic and splenic lacerations resulting in major haemorrhage","authors":"L. Flower,&nbsp;P. Extremera-Navas,&nbsp;J. Mackenney","doi":"10.1002/anr3.12270","DOIUrl":"https://doi.org/10.1002/anr3.12270","url":null,"abstract":"<div>\u0000 \u0000 <p>Thrombolysis with prolonged cardiopulmonary resuscitation may be required for the successful resuscitation of patients presenting with massive pulmonary embolism leading to cardiac arrest. A rare, recognised complication of cardiopulmonary resuscitation is traumatic hepatic and splenic laceration. The incidence of complications is believed to be increased in those who receive automated mechanical cardiopulmonary resuscitation, compared to those who receive standard chest compressions. We present a case of a patient with massive pulmonary embolism leading to cardiac arrest which was successfully treated with thrombolysis and mechanical automated cardiopulmonary resuscitation. The patient suffered hepatic and splenic lacerations resulting in major haemorrhage. This required emergency resuscitation with blood products and splenic embolisation. This case highlights the importance of continual re-assessment of patients, the early recognition of complications and an awareness of the potential complications of treatments we deliver.</p>\u0000 </div>","PeriodicalId":72186,"journal":{"name":"Anaesthesia reports","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139109976","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":"Unilateral sacral erector spinae plane block for hip fracture surgery","authors":"F. Marrone,&nbsp;S. Paventi,&nbsp;M. Tomei,&nbsp;S. Failli,&nbsp;S. Crecco,&nbsp;C. Pullano","doi":"10.1002/anr3.12269","DOIUrl":"https://doi.org/10.1002/anr3.12269","url":null,"abstract":"<div>\u0000 \u0000 <p>The provision of anaesthesia for hip fracture surgery in elderly and frail patients can be challenging, with potentially significant risks associated with both general and neuraxial techniques. Here, we report the use of a sacral erector spinae plane block as an alternative to conventional anaesthetic approaches for a frail 89-year-old woman with significant cardiovascular and respiratory comorbidity who underwent intramedullary nailing for a proximal femoral fracture. A unilateral injection of local anaesthetic at the intermediate crest of the second sacral vertebra resulted in bilateral sensory block of the T12 to S2 dermatomes. The technique did not result in hypotension or motor block of the limbs, and the surgery was completed uneventfully. Sacral erector spinae plane block warrants further investigation as an alternative to spinal and general anaesthesia for hip and lower limb surgery.</p>\u0000 </div>","PeriodicalId":72186,"journal":{"name":"Anaesthesia reports","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139101108","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":"Relief of laryngospasm with gentle chest compressions during direct laryngotracheobronchoscopy","authors":"N. Wilson-Baig,&nbsp;R. Walker","doi":"10.1002/anr3.12268","DOIUrl":"10.1002/anr3.12268","url":null,"abstract":"","PeriodicalId":72186,"journal":{"name":"Anaesthesia reports","volume":"11 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139032843","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":"Quality improvement in paediatric preoperative screening: a Japanese perspective","authors":"A. Sueda,&nbsp;T. Kagawa,&nbsp;T. Kojima","doi":"10.1002/anr3.12267","DOIUrl":"10.1002/anr3.12267","url":null,"abstract":"","PeriodicalId":72186,"journal":{"name":"Anaesthesia reports","volume":"11 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139032842","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 Heister jaw opener: a novel solution for tracheal intubation in patients with temporomandibular joint ankylosis","authors":"A. Hazarika,&nbsp;V. Rattan,&nbsp;S. Arora,&nbsp;A. Ray,&nbsp;P. Banga","doi":"10.1002/anr3.12260","DOIUrl":"https://doi.org/10.1002/anr3.12260","url":null,"abstract":"","PeriodicalId":72186,"journal":{"name":"Anaesthesia reports","volume":"11 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138570905","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":"Awake tracheal intubation in a patient with a post-burn contracture performed via direct laryngoscopy in a resource-limited setting","authors":"S. Silwal,&nbsp;D. Shrestha,&nbsp;G. Neupane,&nbsp;R. Rana,&nbsp;S. Bhurtel,&nbsp;P. Adhikari,&nbsp;N. Khadka","doi":"10.1002/anr3.12265","DOIUrl":"https://doi.org/10.1002/anr3.12265","url":null,"abstract":"","PeriodicalId":72186,"journal":{"name":"Anaesthesia reports","volume":"11 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138485163","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":"Incorrect community dosing leading to high apixaban levels in a patient with a hip fracture","authors":"M. A. Clayton-Smith,&nbsp;R. Brown","doi":"10.1002/anr3.12266","DOIUrl":"https://doi.org/10.1002/anr3.12266","url":null,"abstract":"","PeriodicalId":72186,"journal":{"name":"Anaesthesia reports","volume":"11 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138473385","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":"Spinal anaesthesia with intravenous sedation for total hip arthroplasty in two patients with a history of orthotopic heart transplantation","authors":"L. Tseng,&nbsp;I. Al-Saidi,&nbsp;V. Channagiri","doi":"10.1002/anr3.12263","DOIUrl":"https://doi.org/10.1002/anr3.12263","url":null,"abstract":"<div>\u0000 \u0000 <p>Many patients with orthotopic heart transplantation later undergo non-cardiac surgery. Historically, neuraxial anaesthesia has been avoided in these patients because the denervated heart is unable to compensate for hypotension via the baroreceptor reflex. Here, we present the cases of two patients with prior heart transplantation who underwent total hip arthroplasty under spinal anaesthesia with intravenous sedation. In both cases, this technique was well-tolerated haemodynamically. We propose that spinal anaesthesia with intravenous sedation can be a safe and efficacious anaesthetic technique for selected patients with a history of orthotopic heart transplantation, with careful intraoperative fluid and pharmacological management.</p>\u0000 </div>","PeriodicalId":72186,"journal":{"name":"Anaesthesia reports","volume":"11 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138449404","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":"Challenges in confirming the position of a central venous catheter in the presence of an arterio-venous haemodialysis fistula","authors":"C. R. Evans,&nbsp;T. M. Hall","doi":"10.1002/anr3.12264","DOIUrl":"https://doi.org/10.1002/anr3.12264","url":null,"abstract":"&lt;p&gt;A 71-year-old man was admitted to the Cardiothoracic Intensive Care Unit following implantation of a left ventricular assist device (LVAD) (Impella, Abiomed, Danvers, MA, USA) and percutaneous coronary intervention (PCI) procedure. His medical history included coronary artery disease and end-stage chronic kidney disease requiring haemodialysis via an arteriovenous (AV) fistula on his right arm. He was transferred to our centre with new onset heart failure and was found to have a left ventricular ejection fraction of 22% on transthoracic echo. Percutaneous coronary intervention was deemed too high risk to undertake without LVAD support. During a protracted recovery, on day 46, he required a replacement central venous catheter (CVC) and dialysis catheter. The left internal jugular vein was chosen due to the presence of existing vascular access devices elsewhere. An 8.5 Fr, 20 cm quad-lumen CVC (Multicath 4expert, Vygon, Aachen, Germany) and a 13.5 Fr, 20 cm dual lumen dialysis catheter (Hemo-cath, Nikkiso Co Ltd, Tokyo, Japan) were sited at a depth of 18 cm and 17 cm respectively, with the dialysis catheter placed proximally.&lt;/p&gt;&lt;p&gt;Blood gas analysis from the distal lumen of the new CVC showed a pO&lt;sub&gt;2&lt;/sub&gt; of 10.8 kPa (F&lt;sub&gt;I&lt;/sub&gt;O&lt;sub&gt;2&lt;/sub&gt; of 0.28). A contemporaneous arterial line sample indicated an arterial pO&lt;sub&gt;2&lt;/sub&gt; of 10.5 kPa. A sample from the distal lumen of the dialysis catheter indicated a more reassuring pO&lt;sub&gt;2&lt;/sub&gt; of 4.24 kPa. Repeat CVC samples showed a pO&lt;sub&gt;2&lt;/sub&gt; of 10 kPa from the distal lumen whilst samples taken from proximal CVC lumens indicated a pO&lt;sub&gt;2&lt;/sub&gt; of 4.62 kPa, consistent with venous results. Because of these results, we were concerned that the CVC had punctured the left carotid artery. Neither line was transduced at this stage and a computed tomography (CT) angiogram was arranged urgently, which confirmed an appropriate position for both lines (Fig. 1).&lt;/p&gt;&lt;p&gt;This case highlights the difficulty of interpreting blood gas samples taken from a CVC in a patient with an AV fistula. The presence of a high pO&lt;sub&gt;2&lt;/sub&gt; cannot be interpreted accurately because of abnormal flow of arterial blood from the fistula. However, results compatible with venous samples were taken from the proximal lumens of the CVC which complicated the interpretation of results. Although rare, cases of patients with AV fistulae in whom CVC location is unclear due to unexpected blood gas analysis data have been previously reported [&lt;span&gt;1, 2&lt;/span&gt;]. It is well established that the central veins demonstrate laminar flow and that laminae vary in their oxygenation, indicating that mixing of content between the laminae does not necessarily occur [&lt;span&gt;3&lt;/span&gt;]. It seems most likely in our case that the distal CVC lumen was situated sufficiently close to the fistula to allow aspiration from an arterial, well-oxygenated stream of blood.&lt;/p&gt;&lt;p&gt;As per Association of Anaesthetists guidance [&lt;span&gt;4&lt;/span&gt;], pressure transduction","PeriodicalId":72186,"journal":{"name":"Anaesthesia reports","volume":"11 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/epdf/10.1002/anr3.12264","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138449403","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}