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Management of Hemorrhage During Cesarean Delivery in a Patient With Vascular Ehlers-Danlos Syndrome: A Case Report. 血管性埃勒-丹洛斯综合征患者剖宫产术中出血的处理:1例报告。
IF 0.5
A&A Practice Pub Date : 2023-01-11 eCollection Date: 2023-01-01 DOI: 10.1213/XAA.0000000000001655
Orna Grant, Karen Mulligan, Jennifer Donnelly, Fionnuala Ní Áinle, Róisín Ní Mhuircheartaigh
{"title":"Management of Hemorrhage During Cesarean Delivery in a Patient With Vascular Ehlers-Danlos Syndrome: A Case Report.","authors":"Orna Grant, Karen Mulligan, Jennifer Donnelly, Fionnuala Ní Áinle, Róisín Ní Mhuircheartaigh","doi":"10.1213/XAA.0000000000001655","DOIUrl":"10.1213/XAA.0000000000001655","url":null,"abstract":"<p><p>Parturients with vascular Ehlers-Danlos syndrome are at particular risk of hemorrhage, and there is little evidence to guide prevention or management of hemorrhage in these patients. We present the case of a patient with vascular Ehlers-Danlos syndrome who had a cesarean delivery complicated by an intraoperative hemorrhage. Administration of desmopressin and tranexamic acid appeared to be of marked benefit in achieving hemostasis. To the best of our knowledge, this is the first report of the use of desmopressin during major obstetric hemorrhage in vascular Ehlers-Danlos syndrome.</p>","PeriodicalId":7307,"journal":{"name":"A&A Practice","volume":"17 1","pages":"e01655"},"PeriodicalIF":0.5,"publicationDate":"2023-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9149244","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
Ultrasound-Guided Zygomaticotemporal Nerve Block for Refractory Temporal Headaches: A Case Series. 超声引导颧颞神经阻滞治疗难治性颞部头痛:一个病例系列。
IF 0.5
A&A Practice Pub Date : 2023-01-01 DOI: 10.1213/XAA.0000000000001656
Rajesh Mahajan, Kulbhushan Gupta, Kajal Jain, Anju Jamwal, Summit Bloria, Gopika Kalsotra, Naine Bhadrala
{"title":"Ultrasound-Guided Zygomaticotemporal Nerve Block for Refractory Temporal Headaches: A Case Series.","authors":"Rajesh Mahajan,&nbsp;Kulbhushan Gupta,&nbsp;Kajal Jain,&nbsp;Anju Jamwal,&nbsp;Summit Bloria,&nbsp;Gopika Kalsotra,&nbsp;Naine Bhadrala","doi":"10.1213/XAA.0000000000001656","DOIUrl":"https://doi.org/10.1213/XAA.0000000000001656","url":null,"abstract":"<p><p>Landmark-guided zygomaticotemporal nerve blocks are a well-described modality to manage headaches in the temporal region. We report 3 cases in which ultrasound-guided zygomaticotemporal nerve blocks were performed for severe unilateral temporal headaches that failed to respond to standard treatment in the outpatient pain clinic. All the patients reported substantial and durable pain relief with no complications.</p>","PeriodicalId":7307,"journal":{"name":"A&A Practice","volume":"17 1","pages":"e01656"},"PeriodicalIF":0.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10629448","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
Long-Term Cangrelor Administration in Neurology Intensive Care: A Case Series. 神经内科重症监护长期使用康格乐:一个病例系列。
IF 0.5
A&A Practice Pub Date : 2023-01-01 DOI: 10.1213/XAA.0000000000001652
Olivier Duranteau, Lamine Abdennour, Mehdi Drir, Frederic Clarencon, Corinne Frère, Alice Jacquens, Vincent Degos
{"title":"Long-Term Cangrelor Administration in Neurology Intensive Care: A Case Series.","authors":"Olivier Duranteau,&nbsp;Lamine Abdennour,&nbsp;Mehdi Drir,&nbsp;Frederic Clarencon,&nbsp;Corinne Frère,&nbsp;Alice Jacquens,&nbsp;Vincent Degos","doi":"10.1213/XAA.0000000000001652","DOIUrl":"https://doi.org/10.1213/XAA.0000000000001652","url":null,"abstract":"<p><p>Cangrelor is a P2Y12 inhibitor antiplatelet agent, with a rapid onset and offset. The available literature only reviews short-term administration over a few hours. We describe 5 patients who received cangrelor for >1 month in a neurosurgical intensive care unit due to a very high likelihood of requiring emergency revision surgery. Despite multiple therapeutic interruptions for surgical procedures, no hemorrhagic events occurred, and there was only one transient ischemic event, which occurred during transition from cangrelor to ticagrelor. Cangrelor can be a therapeutic option for patients with a high likelihood of requiring revision neurosurgery after intracranial stenting.</p>","PeriodicalId":7307,"journal":{"name":"A&A Practice","volume":"17 1","pages":"e01652"},"PeriodicalIF":0.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9149246","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 Modified Approach to a Parasternal Block: A Case Report. 改良入路治疗胸骨旁阻滞1例报告。
IF 0.5
A&A Practice Pub Date : 2023-01-01 DOI: 10.1213/XAA.0000000000001644
Paolo Scimia, Luca Gentili, Mario Tedesco, Pierfrancesco Fusco, Giuseppe Sepolvere
{"title":"A Modified Approach to a Parasternal Block: A Case Report.","authors":"Paolo Scimia,&nbsp;Luca Gentili,&nbsp;Mario Tedesco,&nbsp;Pierfrancesco Fusco,&nbsp;Giuseppe Sepolvere","doi":"10.1213/XAA.0000000000001644","DOIUrl":"https://doi.org/10.1213/XAA.0000000000001644","url":null,"abstract":"<p><p>The parasternal block is an ultrasound-guided interfascial plane block that provides anesthesia of the medial quadrants of the breast. The original approach provided injections in the fascial plane between the pectoral major and external intercostal muscles. We observed that this technique might limit an adequate diffusion of the injectate due to the anatomical convexity of the ribs, which might hinder fascial hydrodissection. We suggest a modified approach by positioning the tip of the needle on the rib dome to reduce the local anesthetic volume and obtain a more homogeneous and longitudinal spread into the target fascial compartment.</p>","PeriodicalId":7307,"journal":{"name":"A&A Practice","volume":"17 1","pages":"e01644"},"PeriodicalIF":0.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10863285","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
Anesthetic Implications of Previously Undiagnosed Temporomandibular Joint Ankylosis: A Case Report. 先前未确诊的颞下颌关节强直的麻醉意义:1例报告。
IF 0.5
A&A Practice Pub Date : 2023-01-01 DOI: 10.1213/XAA.0000000000001640
Parisorn Thepmankorn, Mahir A Sufian, Omar Singer, Somdatta Gupta, Dennis Grech, Tomas Ballesteros, Shridevi Pandya Shah
{"title":"Anesthetic Implications of Previously Undiagnosed Temporomandibular Joint Ankylosis: A Case Report.","authors":"Parisorn Thepmankorn,&nbsp;Mahir A Sufian,&nbsp;Omar Singer,&nbsp;Somdatta Gupta,&nbsp;Dennis Grech,&nbsp;Tomas Ballesteros,&nbsp;Shridevi Pandya Shah","doi":"10.1213/XAA.0000000000001640","DOIUrl":"https://doi.org/10.1213/XAA.0000000000001640","url":null,"abstract":"<p><p>Temporomandibular joint (TMJ) ankylosis is characterized by bony fusion that limits TMJ mobility. We present the case of an elderly woman who was brought to the operating room for dental rehabilitation under general anesthesia. The patient had an undiagnosed TMJ ankylosis, which was discovered only after induction of anesthesia due to her nonverbal status and advanced dementia. The surgical team canceled the case due to limited access to the surgical field. We discuss the factors that suggest TMJ ankylosis and propose the perioperative management when TMJ ankylosis is suspected but unconfirmed.</p>","PeriodicalId":7307,"journal":{"name":"A&A Practice","volume":"17 1","pages":"e01640"},"PeriodicalIF":0.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9149247","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
Telescoping Nasal Intubation for Carotid Endarterectomy: A Case Series. 颈动脉内膜切除术的伸缩式鼻插管:一个病例系列。
IF 0.5
A&A Practice Pub Date : 2023-01-01 DOI: 10.1213/XAA.0000000000001657
Brittany J McDowell, Sonal Sharma
{"title":"Telescoping Nasal Intubation for Carotid Endarterectomy: A Case Series.","authors":"Brittany J McDowell,&nbsp;Sonal Sharma","doi":"10.1213/XAA.0000000000001657","DOIUrl":"https://doi.org/10.1213/XAA.0000000000001657","url":null,"abstract":"<p><p>Systemic anticoagulation is a relative contraindication for performing nasal intubation due to the risk of hazardous bleeding. However, nasal intubation may sometimes be the only way to facilitate surgical exposure. There are currently no recommendations in the literature to safely perform nasal intubation in anticoagulated patients. This case series describes 4 patients, all receiving systemic anticoagulation for carotid endarterectomy, who received nasal intubation using a telescoping approach. None of them had any epistaxis. Telescoping the endotracheal tube using a red rubber catheter may be an effective and safe method for nasal intubation when there is a high risk of epistaxis.</p>","PeriodicalId":7307,"journal":{"name":"A&A Practice","volume":"17 1","pages":"e01657"},"PeriodicalIF":0.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9149245","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
Co2 Rebreathing Observed While Using a Bag-Mask Resuscitator With Integrated Manometer: A Case Report. 使用带集成压力计的气囊面罩复苏器时观察到的二氧化碳再呼吸:1例报告。
IF 0.5
A&A Practice Pub Date : 2022-12-01 DOI: 10.1213/XAA.0000000000001648
Marianfeli C Landino-Delgado, Anh P Le, Alecia L Sabartinelli Stein, Juliana M Morales, Richard R McNeer, Joni M Maga
{"title":"Co2 Rebreathing Observed While Using a Bag-Mask Resuscitator With Integrated Manometer: A Case Report.","authors":"Marianfeli C Landino-Delgado,&nbsp;Anh P Le,&nbsp;Alecia L Sabartinelli Stein,&nbsp;Juliana M Morales,&nbsp;Richard R McNeer,&nbsp;Joni M Maga","doi":"10.1213/XAA.0000000000001648","DOIUrl":"https://doi.org/10.1213/XAA.0000000000001648","url":null,"abstract":"<p><p>Bag-mask resuscitators with integrated manometry help reduce the risk of pulmonary injury during manual ventilation. All such devices must function as intended while preventing carbon dioxide rebreathing, as unintended hypercapnia can be harmful in critically ill patients. We describe a case of carbon dioxide rebreathing in a patient suspected of having a brain injury after blunt trauma who was manually ventilated with a widely available bag-mask resuscitator with integrated manometry after emergent intubation. This case highlights the importance of vigilant monitoring of end-tidal carbon dioxide and appropriate troubleshooting and investigation of unexplained findings to mitigate and prevent adverse patient outcomes.</p>","PeriodicalId":7307,"journal":{"name":"A&A Practice","volume":"16 12","pages":"e01648"},"PeriodicalIF":0.5,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10487578","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
Anomalous Connection of Superior Vena Cava to Left Atrium-A Rare Congenital Cardiac Anomaly and Its Implications. 上腔静脉与左心房异常连接——一种罕见的先天性心脏异常及其意义。
IF 0.5
A&A Practice Pub Date : 2022-12-01 DOI: 10.1213/XAA.0000000000001645
Kartheek Hanumansetty, Don Jose Palamattam, Vipinraj V, Thomas Koshy
{"title":"Anomalous Connection of Superior Vena Cava to Left Atrium-A Rare Congenital Cardiac Anomaly and Its Implications.","authors":"Kartheek Hanumansetty,&nbsp;Don Jose Palamattam,&nbsp;Vipinraj V,&nbsp;Thomas Koshy","doi":"10.1213/XAA.0000000000001645","DOIUrl":"https://doi.org/10.1213/XAA.0000000000001645","url":null,"abstract":"<p><p>Exclusive drainage of superior vena cava (SVC) into the left atrium (LA) is one of the rare causes of right-to-left connection. Usually, this anomaly occurs in association with other cardiac defects, and is diagnosed in early childhood. But if it remains an isolated anomaly, this connection may be underdiagnosed and could lead to systemic manifestations. We describe a case of anomalous connection of SVC to LA with drainage of right upper pulmonary vein into SVC and its implications for the perioperative physician. The patient presented with dyspnea on exertion, cyanosis, and a past history of cerebral abscess.</p>","PeriodicalId":7307,"journal":{"name":"A&A Practice","volume":"16 12","pages":"e01645"},"PeriodicalIF":0.5,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10487577","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 Remimazolam and Remifentanil Anesthetic for a Pediatric Patient With a Medium-Chain Acyl-CoA Dehydrogenase Deficiency: A Case Report. 雷马唑仑和瑞芬太尼麻醉剂治疗中链酰基辅酶A脱氢酶缺乏症的儿科患者:1例报告。
IF 0.5
A&A Practice Pub Date : 2022-12-01 DOI: 10.1213/XAA.0000000000001646
Masayo Kiyokawa, Junichi Saito, Kishiko Nakai, Kazuyoshi Hirota
{"title":"A Remimazolam and Remifentanil Anesthetic for a Pediatric Patient With a Medium-Chain Acyl-CoA Dehydrogenase Deficiency: A Case Report.","authors":"Masayo Kiyokawa,&nbsp;Junichi Saito,&nbsp;Kishiko Nakai,&nbsp;Kazuyoshi Hirota","doi":"10.1213/XAA.0000000000001646","DOIUrl":"https://doi.org/10.1213/XAA.0000000000001646","url":null,"abstract":"<p><p>Medium-chain acyl-CoA dehydrogenase (MCAD) deficiency is one of the most common fatty acid oxidation disorders. The choice of anesthetics and blood glucose management are crucial to prevent metabolic decompensation. A 5-year-old Japanese boy with MCAD deficiency was scheduled to undergo surgery for an inguinal hernia. Glucose was continuously infused perioperatively, and his glucose concentrations were within the normal range. Anesthesia was induced and maintained with remimazolam, remifentanil, and intermittent rocuronium. No metabolic decompensation was observed. This case indicates the importance of a continuous intravenous glucose infusion, and that remimazolam can be the first-line anesthetic for a patient with MCAD deficiency.</p>","PeriodicalId":7307,"journal":{"name":"A&A Practice","volume":"16 12","pages":"e01646"},"PeriodicalIF":0.5,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9207437","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: 2
Surface Landmarks in the Lateral Decubitus Position Are Unreliable for Thoracic Epidural Catheter Placement: A Case Series. 侧卧位的体表标志对胸椎硬膜外导管放置不可靠:一个病例系列。
IF 0.5
A&A Practice Pub Date : 2022-12-01 DOI: 10.1213/XAA.0000000000001649
Sean W Dobson, Robert S Weller, James D Turner, Christopher M Lack, Daryl S Henshaw
{"title":"Surface Landmarks in the Lateral Decubitus Position Are Unreliable for Thoracic Epidural Catheter Placement: A Case Series.","authors":"Sean W Dobson,&nbsp;Robert S Weller,&nbsp;James D Turner,&nbsp;Christopher M Lack,&nbsp;Daryl S Henshaw","doi":"10.1213/XAA.0000000000001649","DOIUrl":"https://doi.org/10.1213/XAA.0000000000001649","url":null,"abstract":"<p><p>Thoracic epidurals remain the optimal method for providing postoperative analgesia after complex open abdominal and thoracic surgeries. However, they can be challenging to both place and maintain, as evidenced by a failure rate that exceeds 30%.1 Proper identification of the epidural space and accurate placement of the catheter are critical in order to deliver effective postoperative analgesia and avoid failure.2,3 This case series investigated the difficulty in correctly identifying the proper vertebral level for thoracic epidural catheter procedures when performed in the lateral decubitus position.</p>","PeriodicalId":7307,"journal":{"name":"A&A Practice","volume":"16 12","pages":"e01649"},"PeriodicalIF":0.5,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9207438","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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