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Anaesthesia case reports

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https://www.readbyqxmd.com/read/29334510/comparing-peri-operative-complications-of-paediatric-and-adult-anaesthesia-a-retrospective-cohort-study-of-81%C3%A2-267-cases
#1
Andrie C Westerkamp, A Fred de Geus, Bouwe Molenbuur, Peter Meyer, J K Götz Wietasch, Michel M R F Struys, Herman G D Hendriks
BACKGROUND: Comparisons of peri-operative complications associated with paediatric (≤16 years) and adult anaesthesia are poorly available, especially in which cardiac surgery, organ transplantation and neurosurgery are involved. OBJECTIVE: The aim of this study was to evaluate the nature and incidence of peri-operative complications that might be due to anaesthesia and to identify independent risk factors for complications in children and adults, including those undergoing cardiac surgery, organ transplantation and neurosurgery...
January 13, 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29330080/use-of-a-pulsed-radiofrequency-energy-device-peak-plasmablade%C3%A2-in-neuromodulation-implant-revisions
#2
I Ughratdar, K A Kawsar, R Mitchell, R Selway, K Ashkan
BACKGROUND: Battery replacement or revision surgery for neuromodulation implants is conventionally performed using sharp dissection. Meticulous dissection within thick scar tissue is vital to avoid damage to surrounding lead(s) which could result in more extensive revision surgery. Traditional electrosurgery devices are contraindicated as the emitted energy can be transferred to the hardware resulting in implant or tissue damage with severe consequent complications. OBJECTIVE: We report our experience and potential applications of a novel, pulsed monopolar radiofrequency energy device (PEAK PlasmaBlade™, Medtronic plc) which facilitates dissection around implants without the risk of damaging or transmitting energy through the system...
January 9, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29328847/an-anaesthesia-perspective-on-carotid-body-tumour-cbt-excision-a-twenty-year-case-series-at-the-singapore-general-hospital
#3
Deanna Wj Ng, Chris I Yam, Loong T Wong, Darren Lk Koh
Carotid body tumours (CBT) are extremely rare neoplasms that arise from chemoreceptor cells at the bifurcation of the carotid artery. This rarity poses a challenge for the anaesthetist when dealing with surgeries for the removal of CBT. Reports of associated perioperative morbidity range from twenty to forty percent. This paper reviews the perioperative anaesthetic management of CBT patients and challenges in our institution's 20 year experience on 13 surgical CBT resections.
October 2017: Journal of Perioperative Practice
https://www.readbyqxmd.com/read/29327341/combined-thoracic-paravertebral-and-pectoral-nerve-blocks-for-breast-surgery-under-sedation-a-prospective-observational-case-series
#4
A Pawa, J Wight, D N Onwochei, R Vargulescu, I Reed, L Chrisman, E Pushpanathan, A Kothari, K El-Boghdadly
Avoidance of general anaesthesia for breast surgery may be because of clinical reasons or patient choice. There is emerging evidence that the use of regional anaesthesia and the avoidance of volatile anaesthetics and opioid analgesia may have beneficial effects on oncological outcomes. We conducted a prospective observational case series of 16 breast cancer surgeries performed under thoracic paravertebral plus pectoral nerve block with propofol sedation to demonstrate feasibility of technique, patient acceptability and surgeon satisfaction...
January 12, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29326765/pneumocephalus-following-combined-spinal-epidural-anaesthesia-for-total-knee-arthroplasty-a-case-report
#5
Y W Chew, V K Suppan, S R Ashutosh, M M Tew, J H Jimmy-Tan
The authors describe a case of pneumocephalus following epidural anaesthesia for total knee arthroplasty. Multiple attempts in locating the epidural space for the anaesthesia and the use of loss of resistance to air (LORA) technique were identified as the source of air entry. Supportive management was given including high flow oxygenation therapy and spontaneous reabsorption of air was noted five days after surgery. The presence of pneumocephalus should be kept in mind if patient develops neurological complications postoperatively following epidural anaesthesia...
November 2017: Malaysian Orthopaedic Journal
https://www.readbyqxmd.com/read/29313907/adverse-drug-reactions
#6
REVIEW
K Patton, D C Borshoff
Adverse drug reactions are a cause of significant morbidity and mortality to patients and a source of financial burden to the healthcare system. Of the wide spectrum of adverse drug reactions, the most concerning to the anaesthetist remain anaphylaxis and malignant hyperthermia. Although the incidence of anaphylaxis under anaesthesia is difficult to ascertain, it occurs commonly enough that most anaesthetists will manage at least one case in their career. The wide range of drugs given in the peri-operative period and the variable presentation in the anaesthetised patient can delay diagnosis and treatment, and adversely affect outcome...
January 2018: Anaesthesia
https://www.readbyqxmd.com/read/29299503/massive-emphysema-and-pneumothorax-following-shoulder-arthroscopy-under-general-anaesthesia-a-case-report
#7
Mohammad J Shariyate, Amir R Kachooei, Mohammad H Ebrahimzadeh
The patient was a 61-year-old female with massive rotator cuff tear who had no history of smoking, COPD, asthma, or other pulmonary diseases. Four hours following shoulder arthroscopy, the patient developed progressive dyspnea, which was diagnosed as pneumothorax with subcutaneous emphysema extending to the neck and face. Chest tube was inserted promptly. The patient was discharged with a good condition after 7 days. Follow up of the patient for the next 3 months was uneventful.
November 2017: Archives of Bone and Joint Surgery
https://www.readbyqxmd.com/read/29298785/secondary-stone-formation-over-a-suture-material-after-partial-nephrectomy
#8
Kumar Prem, Somesh Janoria, Pankaj Kumar
We hereby present the treatment of renal pelvic and lower pole stones of sizes 2.74×1 cm and 1.38×0.92 cm, respectively, forming over a nidus of non-absorbable suture, in a 50-year-old female patient with a history of open partial nephrectomy done for renal angiomyolipoma around 10 years back. She was successfully treated with percutaneous nephrolithotomy technique under spinal anaesthesia. There was complete stone clearance, and she was discharged in stable condition within 40 hours of surgery without any stent...
January 3, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29295777/hereditary-haemorrhagic-telangiectasia-in-pregnancy-regional-and-general-anaesthesia
#9
M Crawford, R Burns, S Cooper, T Mackay
Hereditary haemorrhagic telangiectasia, also known as Osler-Weber-Rendu disease, is a rare autosomal dominant multisystem disorder, characterised by mucocutaneous telangiectases and arteriovenous malformations affecting any organ. The physiological changes in pregnancy pose significant obstetric and anaesthetic challenges for women affected by the disease. The optimal timing and mode of delivery requires careful consideration; and the benefits and risks of both regional and general anaesthetic techniques must be carefully considered, depending on the organs affected...
November 13, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/29249272/successful-spinal-anaesthesia-in-a-patient-with-a-tarlov-cyst
#10
N Pfund, A Oh, A Cyna
Perineural (Tarlov) cysts are cerebrospinal fluid-containing perineural sacs that are usually located in the sacral spine. While often asymptomatic, they can cause progressive neurological symptoms including pain, paraesthesia and weakness. We present a case of a 24-year-old patient who had uneventful spinal anaesthesia at the L3-4 level for an elective caesarean section. Prior to her procedure, she had reported a two-year history of intermittent back pain and lower-limb paraesthesia, secondary to an S1 segment perineural cyst...
December 14, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/29246395/cardiac-arrest-related-to-anaesthesia-in-williams-beuren-syndrome
#11
J Lucena Delgado, P Sanabria Carretero, P Durán la Fuente, A Gónzalez Rocafort, L Castro Parga, F Reinoso Barbero
Williams-Beuren syndrome is the clinical manifestation of a congenital genetic disorder in the elastin gene, among others. There is a history of cardiac arrest refractory to resuscitation manoeuvres in anaesthesia. The incidence of myocardial ischaemia is high during anaesthetic induction, but there are patients who do not have this condition yet also have had very serious cardiac events, and issues that are still to be resolved. Case descriptions will enable the common pathophysiological factors to be defined, and decrease morbidity and mortality...
December 12, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/29242658/quadratus-lumborum-block-for-post-operative-pain-relief-in-patient-with-prune-belly-syndrome
#12
Chitra Garg, Sangeeta Khanna, Yatin Mehta
Abdominal field blocks are commonly used as part of multimodal analgesia for post-operative pain relief in patients undergoing abdominal surgery. Conventionally, transversus abdominis plane block is used, but has the disadvantage of limited spread only to T10-T12 segments, providing only partial pain relief. The new quadratus lumborum (QL) block has the advantage of providing wider sensory block from T6 to L1 and thus has an evolving role in opioid-free anaesthesia. Opioid-induced cough depression, urinary retention, and drowsiness can be problematic in patients with Prune belly syndrome, who have deficient abdominal muscles and myriad of genitourinary problems...
October 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29231979/otitis-media-with-effusion-in-the-boxer-a-report-of-seven-cases
#13
S Paterson
The aim of this study was to describe otitis media with effusion in seven boxers. All dogs presented with a range of clinical signs, which included head shaking, neurological dysfunction, pain on opening of the mouth and reduction in hearing ability. Otitis media was confirmed under general anaesthesia in each case by video-otoscopic identification of a bulging pars tensa and subsequent myringotomy, which revealed a tenacious mucus plug within the middle ear. Brainstem auditory evoked response thresholds were elevated in all affected ears...
December 12, 2017: Journal of Small Animal Practice
https://www.readbyqxmd.com/read/29210043/accidental-awareness-during-general-anaesthesia-a-narrative-review
#14
REVIEW
S R Tasbihgou, M F Vogels, A R Absalom
Unintended accidental awareness during general anaesthesia represents failure of successful anaesthesia, and so has been the subject of numerous studies during the past decades. As return to consciousness is both difficult to describe and identify, the reported incidence rates vary widely. Similarly, a wide range of techniques have been employed to identify cases of accidental awareness. Studies which have used the isolated forearm technique to identify responsiveness to command during intended anaesthesia have shown remarkably high incidences of awareness...
January 2018: Anaesthesia
https://www.readbyqxmd.com/read/29208583/challenging-anaesthetic-management-of-captive-reindeer-rangifer-tarandus-report-of-4-cases
#15
P Monticelli, A McSloy, U Morath, C Adami
Four captive reindeer underwent anaesthesia to allow dehorning or drainage of lymph nodes abscessation. Premedication was based on xylazine (dose range: 0.075- 0.5 mg/kg, IM or IV), with or without ketamine (dose range: 1-2 mg/kg, IM or IV), all of which failed to produce effective sedation without side effects. During anaesthesia, 2 reindeer experienced severe hypoxaemia and hypoventilation. Recovery was smooth in 3 out 4 animals, but delayed in one reindeer sedated with 0.5 mg/kg of xylazine IV; this patient required repeated atipamezole administrations (0...
December 2017: Schweizer Archiv Für Tierheilkunde
https://www.readbyqxmd.com/read/29207813/anaesthetic-considerations-for-balloon-mitral-valvuloplasty-in-pregnant-patient-with-severe-mitral-stenosis-a-case-report-and-review-of-literature
#16
Hemlata, Puneet Goyal, Satyendra Tewari, Arindam Chatterjee
Even though, the incidence of Mitral Stenosis (MS) has reduced grossly, it still remains a health problem in developing countries and is the most common rheumatic valvular lesion encountered in pregnant patients. The already compromised cardiac status of a pregnant female deteriorates further by the presence of MS. So, pregnancy is a common situation during which untreated and frequently poorly tolerated MS are first diagnosed. Percutaneous Balloon Mitral Valvuloplasty (BMV) may be life saving in such a setting and a multidisciplinary approach in the management reduces the mortality and morbidity during the procedure...
September 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/29207775/axial-torsion-of-meckel-s-diverticulum-a-rare-case-report
#17
Sandesh Vithal Parab, Pramod Govindrao Salve, Aruna Dahiphale, Rupesh Thakare, Amit Aiwale
Meckel's Diverticulum (MD) is the most common congenital anomaly of gastrointestinal tract, occurring in 2% of the population. It is a true diverticulum and histologically all four intestinal layers are present within MD. There are various complications related to a Meckel's diverticulum, including haemorrhage, intestinal obstruction, inflammation and perforation. Axial torsion followed by gangrene of MD is the rarest of the complications that have been reported. The exact mechanism for torsion is unclear. Preoperative diagnosis of torsion of MD is difficult and often confused with appendicitis as pain is usually localized to right lower quadrant...
September 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/29203759/-right-hemicolectomy-under-spinal-anesthesia-due-to-cancer-of-ascending-large-bowel-case-report
#18
Gniewomir Ćwiertnia, Michał Dyaczyński
Surgery procedures of the abdomen cavity are commonly performed in general anaesthesia. Patients from high risk group with circulatory insufficiency, respiratory failure pose a problem. They undergo surgical procedures for life indications and emergency cases. Regional anaesthesia can be an alternative for general anaesthesia, and makes planned surgical treatment possible for this group of patients. The study presents the case of 79-year-old male with chronic obstructive pulmonary disease, after left lung upper lobectomy, arterial hypertension, who underwent operation due to ascending large bowel cancer under spinal anaesthesia as planned...
2017: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29170175/schizophrenia-and-anaesthesia
#19
Liew Sat Lin Constance, Meryl Grace Lansing, Foo Kiang Khor, Rajesh Kumar Muniandy
Administering anaesthesia for elderly patients with chronic schizophrenia has always been a great challenge to anaesthetists. These patients will usually be on multiple antipsychotic drugs for many years and may lead to delayed awakening, cardiovascular instability, arrhythmias and sudden cardiac death during general anaesthesia. This case report is about the perioperative anaesthetic management of an elderly schizophrenic patient undergoing removal of femur implant. This article will explore important drug interactions and available options for a successful anaesthesia...
November 23, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29169839/cardiopulmonary-effects-of-anaesthesia-maintained-by-propofol-infusion-versus-isoflurane-inhalation-in-cheetahs-acinonyx-jubatus
#20
Roxanne K Buck, Adrian Sw Tordiffe, Gareth E Zeiler
OBJECTIVE: To compare the cardiopulmonary effects of propofol total intravenous anaesthesia (TIVA) with isoflurane in cheetahs (Acinonyx jubatus) to evaluate feasibility for field use. STUDY DESIGN: Prospective clinical study. ANIMALS: A group of 24 adult cheetahs, 12 per group. METHODS: Cheetahs were immobilized with zolazepam/tiletamine (1.2 mg kg-1) and medetomidine [40 μg kg-1, both intramuscular (IM)] by darting...
June 23, 2017: Veterinary Anaesthesia and Analgesia
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