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Intraoperative Kounis Syndrome and Fixation Errors: A Case Report. 术中Kounis综合征与固定错误1例报告。
IF 0.5
A&A Practice Pub Date : 2023-03-01 DOI: 10.1213/XAA.0000000000001672
Trent A Ogaz, BobbieJean Sweitzer
{"title":"Intraoperative Kounis Syndrome and Fixation Errors: A Case Report.","authors":"Trent A Ogaz,&nbsp;BobbieJean Sweitzer","doi":"10.1213/XAA.0000000000001672","DOIUrl":"https://doi.org/10.1213/XAA.0000000000001672","url":null,"abstract":"<p><p>Postinduction hypotension, though frequently due to anesthetic medications, has a variety of causes. We present a case of presumed intraoperative Kounis syndrome, or anaphylaxis-induced coronary vasospasm, in which the patient's perioperative course was initially attributed to anesthesia-induced hypotension and iatrogenic rebound hypertension leading to Takotsubo cardiomyopathy. A second anesthetic event with immediate recurrence of hypotension after the patient received levetiracetam appears to confirm the diagnosis of Kounis syndrome. In this report, we discuss the fixation error that led to this patient's original misdiagnosis.</p>","PeriodicalId":7307,"journal":{"name":"A&A Practice","volume":"17 3","pages":"e01672"},"PeriodicalIF":0.5,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9163559","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: 1
Implementing Preoperative Penicillin Allergy Testing in Surgical Patients. 手术患者术前青霉素过敏试验的实施。
IF 0.5
A&A Practice Pub Date : 2023-02-03 eCollection Date: 2023-02-01 DOI: 10.1213/XAA.0000000000001659
Ravindra Alok Gupta, Howard Lee, Obianuju Okocha
{"title":"Implementing Preoperative Penicillin Allergy Testing in Surgical Patients.","authors":"Ravindra Alok Gupta, Howard Lee, Obianuju Okocha","doi":"10.1213/XAA.0000000000001659","DOIUrl":"10.1213/XAA.0000000000001659","url":null,"abstract":"<p><p>Penicillin allergy is the most reported immunoglobulin E (IgE)-mediated reaction. About 10% of the general population and 20% of hospitalized patients have a history of penicillin allergy. Unconfirmed penicillin allergy with subsequent administration of second-line antibiotics has been associated with increased morbidity. However, when penicillin allergy testing is performed, the incidence of IgE-mediated reactions is extremely low; in fact, the negative predictive value of penicillin allergy testing exceeds 99%. This article aims to briefly describe implementing safe penicillin allergy testing as a routine test during the preoperative evaluation of surgical patients.</p>","PeriodicalId":7307,"journal":{"name":"A&A Practice","volume":"17 2","pages":"e01659"},"PeriodicalIF":0.5,"publicationDate":"2023-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9212620","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
Harlequin Syndrome Related to Perioperative Intercostal Blockade: A Case Report. 围手术期肋间阻滞相关的丑角综合征1例报告。
IF 0.5
A&A Practice Pub Date : 2023-02-02 eCollection Date: 2023-02-01 DOI: 10.1213/XAA.0000000000001664
Phillip Sperling, Julie Læbel, Allan Vestergaard Danielsen, Jannie Bisgaard
{"title":"Harlequin Syndrome Related to Perioperative Intercostal Blockade: A Case Report.","authors":"Phillip Sperling, Julie Læbel, Allan Vestergaard Danielsen, Jannie Bisgaard","doi":"10.1213/XAA.0000000000001664","DOIUrl":"10.1213/XAA.0000000000001664","url":null,"abstract":"<p><p>Harlequin syndrome is a rare syndrome characterized by hemifacial flushing and altered facial sweating, with only a few case reports related to intercostal blockades. We present a case of Harlequin syndrome in a 65-year-old woman after intercostal blockade for video-assisted thoracoscopic lobectomy. One hour postoperatively, the patient became nauseated and presented with flushing of the right half of the face with a clear line of demarcation. Within 3 hours, the flushing disappeared. In this case report, we discuss Harlequin syndrome in relation to intercostal blockade and encourage clinicians to consider this syndrome in the differential diagnosis when encountering similar symptoms.</p>","PeriodicalId":7307,"journal":{"name":"A&A Practice","volume":"17 2","pages":"e01664"},"PeriodicalIF":0.5,"publicationDate":"2023-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9212618","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
Case Report of Cryo Nerve Block in a Patient Undergoing Full Sternotomy: A Novel Approach to Pain Control in Cardiac Surgery. 冷冻神经阻滞在全胸骨切开术患者中的病例报告:心脏手术中控制疼痛的新方法。
IF 0.5
A&A Practice Pub Date : 2023-02-02 eCollection Date: 2023-02-01 DOI: 10.1213/XAA.0000000000001654
David J Caparrelli
{"title":"Case Report of Cryo Nerve Block in a Patient Undergoing Full Sternotomy: A Novel Approach to Pain Control in Cardiac Surgery.","authors":"David J Caparrelli","doi":"10.1213/XAA.0000000000001654","DOIUrl":"10.1213/XAA.0000000000001654","url":null,"abstract":"<p><p>We present the case of a 65-year-old man undergoing open-heart surgery through a full sternotomy with the use of bilateral intercostal cryo nerve block (cryoNB) as adjunctive therapy for postoperative analgesia. CryoNB has been previously demonstrated as safe and effective for pain control in thoracotomy procedures as well as bilaterally in adolescent patients with pectus excavatum undergoing Nuss procedure. Herein, we describe for the first time, the cryoNB procedure for postoperative pain management in a patient undergoing full sternotomy.</p>","PeriodicalId":7307,"journal":{"name":"A&A Practice","volume":"17 2","pages":"e01654"},"PeriodicalIF":0.5,"publicationDate":"2023-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3c/86/acc-17-e01654.PMC9951789.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9321013","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
Endovascular Plug for Endobronchial Management of an Expectorated Pulmonary Artery Embolization Coil: A Case Report. 血管内栓塞治疗支气管内出痰的肺动脉栓塞线圈一例报告。
IF 0.5
A&A Practice Pub Date : 2023-02-01 DOI: 10.1213/XAA.0000000000001663
Jesse M Crawford, Priya P Patel, Aaron R DuCoffe, Michael Tsai, John A Hodgson
{"title":"Endovascular Plug for Endobronchial Management of an Expectorated Pulmonary Artery Embolization Coil: A Case Report.","authors":"Jesse M Crawford,&nbsp;Priya P Patel,&nbsp;Aaron R DuCoffe,&nbsp;Michael Tsai,&nbsp;John A Hodgson","doi":"10.1213/XAA.0000000000001663","DOIUrl":"https://doi.org/10.1213/XAA.0000000000001663","url":null,"abstract":"<p><p>Pulmonary artery aneurysms are frequently managed with endovascular embolization. Rare but serious complications of coil embolization are erosion and migration of the coils into the adjacent airways, posing a risk for massive hemoptysis. We report the case of a medically complex patient with a left main pulmonary artery aneurysm treated with coil embolization who ultimately experienced transbronchial migration and expectoration of the coil. We discuss the challenging anesthetic and surgical management of these serious complications, including the use of an endovascular plug to occlude the erosion site and distal airways.</p>","PeriodicalId":7307,"journal":{"name":"A&A Practice","volume":"17 2","pages":"e01663"},"PeriodicalIF":0.5,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9282759","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
Erector Spinae Plane Block for Scapulothoracic Arthrodesis for Facioscapulohumeral Dystrophy Patients: A Case Series. 肩胛骨-肱骨营养不良患者肩胛骨-胸椎关节融合术的竖脊椎平面阻滞:一个病例系列。
IF 0.5
A&A Practice Pub Date : 2023-02-01 DOI: 10.1213/XAA.0000000000001662
Yavuz Gürkan, Yasemin Sincer, Mete Manici, Cemil Cihad Gedik, İlker Eren, Mehmet Demirhan
{"title":"Erector Spinae Plane Block for Scapulothoracic Arthrodesis for Facioscapulohumeral Dystrophy Patients: A Case Series.","authors":"Yavuz Gürkan,&nbsp;Yasemin Sincer,&nbsp;Mete Manici,&nbsp;Cemil Cihad Gedik,&nbsp;İlker Eren,&nbsp;Mehmet Demirhan","doi":"10.1213/XAA.0000000000001662","DOIUrl":"https://doi.org/10.1213/XAA.0000000000001662","url":null,"abstract":"<p><p>Facioscapulohumeral dystrophy (FSHD) typically affects the periscapular muscles, resulting in scapular winging. Scapulothoracic arthrodesis (STA) stabilizes the scapula to provide better movement for these patients. Analgesia regimen for FSHD patients who received a single-shot erector spinae plane block (ESPB) and a catheter at the area were retrospectively analyzed in this study. Patients were asked to rate their pain postoperatively and only 5 of 10 patients needed rescue analgesic. No complications occurred. Our experience suggests that continuous ESPB may be helpful for providing analgesia in FSHD patients undergoing STA.</p>","PeriodicalId":7307,"journal":{"name":"A&A Practice","volume":"17 2","pages":"e01662"},"PeriodicalIF":0.5,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10705021","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
A Case Report of Rotational Thromboelastometry-Assisted Decision Analysis for Two Pregnant Patients With Platelet Storage Pool Disorder. 旋转血栓弹性测量辅助决策分析2例妊娠血小板储存池障碍患者报告。
IF 0.5
A&A Practice Pub Date : 2023-02-01 DOI: 10.1213/XAA.0000000000001658
John Hale, Gregory Galanti, Arielle Langer, Sarah Lassey, Emily Reiff, William Camann
{"title":"A Case Report of Rotational Thromboelastometry-Assisted Decision Analysis for Two Pregnant Patients With Platelet Storage Pool Disorder.","authors":"John Hale,&nbsp;Gregory Galanti,&nbsp;Arielle Langer,&nbsp;Sarah Lassey,&nbsp;Emily Reiff,&nbsp;William Camann","doi":"10.1213/XAA.0000000000001658","DOIUrl":"https://doi.org/10.1213/XAA.0000000000001658","url":null,"abstract":"<p><p>Platelet storage pool disorders (PSPDs) constitute a diverse group of hematologic abnormalities, which share the common feature of a deficiency in the ability of platelets to aggregate. Parturients with PSPD can present management challenges to their care team when they present for childbirth, especially with regard to neuraxial anesthesia. We report a series of 2 deliveries from unrelated patients affected by PSPD. In particular, we highlight the utility of rotational thromboelastometry (ROTEM) and the need for a multidisciplinary approach to the care of patients with this hematologic abnormality.</p>","PeriodicalId":7307,"journal":{"name":"A&A Practice","volume":"17 2","pages":"e01658"},"PeriodicalIF":0.5,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10757848","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
Left Stellate Ganglion Blockade for Refractory Ventricular Arrhythmias With Aconitine Poisoning: A Case Report. 左星状神经节阻滞治疗顽固性室性心律失常伴乌头碱中毒1例。
IF 0.5
A&A Practice Pub Date : 2023-02-01 DOI: 10.1213/XAA.0000000000001666
Yasuko Ichikawa, Shinsaku Matsumoto, Waso Fujinaka, Makoto Takatori, Kenji Nishioka, Akira Namera
{"title":"Left Stellate Ganglion Blockade for Refractory Ventricular Arrhythmias With Aconitine Poisoning: A Case Report.","authors":"Yasuko Ichikawa,&nbsp;Shinsaku Matsumoto,&nbsp;Waso Fujinaka,&nbsp;Makoto Takatori,&nbsp;Kenji Nishioka,&nbsp;Akira Namera","doi":"10.1213/XAA.0000000000001666","DOIUrl":"https://doi.org/10.1213/XAA.0000000000001666","url":null,"abstract":"<p><p>Aconitine poisoning causes refractory ventricular arrhythmias (VAs). In a 20-year-old man, VAs of unknown etiology did not respond to drugs and electrical defibrillation. However, left stellate ganglion blockade (SGB) dramatically decreased arrhythmias without complications. At a later date, we found that refractory VAs were caused by aconitine poisoning. Left SGB is effective for treating refractory VAs with aconitine poisoning and can be easily performed with few complications for VAs of unknown etiology even if patients are receiving anticoagulant therapy. Also, left SGB can be performed to diagnose refractory VAs.</p>","PeriodicalId":7307,"journal":{"name":"A&A Practice","volume":"17 2","pages":"e01666"},"PeriodicalIF":0.5,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10757951","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
Postpartum Acute Aortic Dissection in a Patient Without a Connective Tissue Disorder: A Case Report. 无结缔组织疾病的产后急性主动脉夹层1例报告。
IF 0.5
A&A Practice Pub Date : 2023-02-01 DOI: 10.1213/XAA.0000000000001629
Mercades A Meuli, Anne Shapiro, Brett H Cronin, Kelsey A Pinson, Erin I Martin
{"title":"Postpartum Acute Aortic Dissection in a Patient Without a Connective Tissue Disorder: A Case Report.","authors":"Mercades A Meuli,&nbsp;Anne Shapiro,&nbsp;Brett H Cronin,&nbsp;Kelsey A Pinson,&nbsp;Erin I Martin","doi":"10.1213/XAA.0000000000001629","DOIUrl":"https://doi.org/10.1213/XAA.0000000000001629","url":null,"abstract":"<p><p>Type A acute aortic dissection is a rare life-threatening event that occurs most commonly in the third trimester or early postpartum and in women with connective tissue disorders. However, this case describes a type A aortic dissection diagnosed on postpartum day 2 in a woman with preeclampsia without a history of a connective tissue disease. The case emphasizes the importance of considering dissection in any parturient complaining of chest pain, especially in the setting of hypertension and a new murmur. Emergent imaging must be considered to decrease delays in surgical repair and to minimize maternal morbidity and mortality.</p>","PeriodicalId":7307,"journal":{"name":"A&A Practice","volume":"17 2","pages":"e01629"},"PeriodicalIF":0.5,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9321566","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
Arterial Cannulation Near-Miss During Jugular Venous Catheterization With Carotid Artery Aneurysm: A Case Report. 颈动脉动脉瘤颈静脉置管术中动脉插管险些漏诊1例。
IF 0.5
A&A Practice Pub Date : 2023-02-01 DOI: 10.1213/XAA.0000000000001661
William C Culp, Michael Beitzel, Shawn Malan, Kelsea C Wright
{"title":"Arterial Cannulation Near-Miss During Jugular Venous Catheterization With Carotid Artery Aneurysm: A Case Report.","authors":"William C Culp,&nbsp;Michael Beitzel,&nbsp;Shawn Malan,&nbsp;Kelsea C Wright","doi":"10.1213/XAA.0000000000001661","DOIUrl":"https://doi.org/10.1213/XAA.0000000000001661","url":null,"abstract":"<p><p>Central venous catheterization is a common procedure that may lead to inadvertent arterial cannulation, potentially causing bleeding, hematoma, stroke or rarely, death. In this near-miss case presentation, an aneurysmal carotid artery was misidentified with ultrasound by a junior resident, nearly leading to placement of a sheath into the artery. This case highlights arterial punctures that still occur even with ultrasound guidance. Further, training inadequacies as well as anatomic, cultural, and production pressure factors led to this potentially highly morbid near-miss. Physician teachers should critically evaluate teaching methods to confirm that trainees are learning skills as intended. (A&A Practice. 2023;17:e01661.).</p>","PeriodicalId":7307,"journal":{"name":"A&A Practice","volume":"17 2","pages":"e01661"},"PeriodicalIF":0.5,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10764310","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
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