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Pain on arterial cannulation

Andreia Fernandes, Clara Gaio Lima, Nelson Paulo, Catarina Celestino, Ana Fonte Boa, Fátima Lima, Manuela Vieira
INTRODUCTION: Minimally invasive cardiac surgery (MICS), via minithoracotomy, is thought to be a fast track to extubation and recovery after surgery. Chronic pain, due to intercostal nerve injury, develops in up to 50% of postthoracotomy patients.A number of regional anaesthesia and analgesia techniques may be employed, and the anaesthesiologists play a key role in facilitating optimal outcomes after surgery. METHODS: We report a case of postoperative pain management with a local anesthetic infiltration for MICS...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
Won Ho Chang
Here we report a case of a 40-year-old man who visited the emergency room with severe chest pain. He showed a Stanford type B aortic dissection on chest-computed tomography. Despite medical treatment and malperfusion of lower extremities, acute renal failure developed; hence thoracic endovascular aortic repair (TEVAR) was considered under general anaesthesia. After endotracheal intubation, ventilation with low tidal volume required high inspiratory airway pressure. An arterial blood gas analysis showed PaCO2 of 61...
2018: Open Medicine (Warsaw, Poland)
Joseph Touma, Dorian Verscheure, Marek Majewski, Pascal Desgranges, Frederic Cochennec
OBJECTIVE: To evaluate the feasibility and early outcomes of complex aortic aneurysm repair in high risk patients with hostile anatomies using both parallel stents and physician-modified stent-graft (PMSG) techniques to address the renovisceral arteries METHODS: Consecutive patients with complex suprarenal (SRA) and thoracoabdominal aortic aneurysms (TAAA) undergoing endovascular repair using combined parallel stents technique and PMSG between September 2013 and November 2015 were evaluated...
July 21, 2017: Annals of Vascular Surgery
Ali Farooq, Waseem Amjad, Ata Ur Rahim Bajwa, Hassaan Yasin, Rizwan Ali, Muhammad Pervaiz
A 40-year-old female presented to a rural hospital with crushing substernal chest pain. An initial electrocardiogram showed ST elevation in lead II and aVF with elevated troponin I. She was immediately transferred to a tertiary care hospital. An emergent coronary angiogram did not show any significant coronary artery disease. On the second day, the patient experienced recurrence of severe chest pain with ST elevations in leads I, aVL, V5-V6, ST depressions in V1-V3, T-wave inversion over V2-V5. The troponin I level increased to > 40 ng/ml (normal 0...
May 23, 2017: Curēus
Pritam Sinharoy, Ian N Bratz, Sayantani Sinha, Loral E Showalter, Spencer R Andrei, Derek S Damron
BACKGROUND: Transient receptor potential (TRP) ion channels have emerged as key components contributing to vasoreactivity. Propofol, an anesthetic is associated with adverse side effects including hypotension and acute pain upon infusion. Our objective was to determine the extent to which TRPA1 and/or TRPV1 ion channels are involved in mediating propofol-induced vasorelaxation of mouse coronary arterioles in vitro and elucidate the potential cellular signal transduction pathway by which this occurs...
2017: PloS One
Dirk Rüsch, Tilo Koch, Florian Seel, Leopold Eberhart
OBJECTIVES: Local infiltration with lidocaine is a frequently used measure to prevent pain during arterial cannulation. Its administration is associated with pain. Vapocoolants like ethyl chloride or alkanes also affect rapid-onset anesthesia. However, their administration causes less discomfort compared with administration of lidocaine. The effectiveness of vapocoolants in mitigating discomfort associated with arterial cannulation never has been studied. The authors therefore compared vapocoolant with lidocaine for reducing discomfort caused by arterial cannulation...
February 2017: Journal of Cardiothoracic and Vascular Anesthesia
Kenji Yoshida, Eri Tanaka, Hiroyoshi Kawaai, Shinya Yamazaki
To obtain effective infiltration anesthesia in the jawbone, high concentrations of local anesthetic are needed. However, to reduce pain experienced by patients during local anesthetic administration, low-pressure injection is recommended for subperiosteal infiltration anesthesia. Currently, there are no studies regarding the effect of injection pressure on infiltration anesthesia, and a standard injection pressure has not been clearly determined. Hence, the effect of injection pressure of subperiosteal infiltration anesthesia on local anesthetic infiltration to the jawbone was considered by directly measuring lidocaine concentration in the jawbone...
December 0: Anesthesia Progress
Peter K Sculco, Lionel E Lazaro, Edwin P Su, Craig E Klinger, Jonathan P Dyke, David L Helfet, Dean G Lorich
BACKGROUND: Surgical hip dislocation allows circumferential access to the femoral head and acetabulum and is utilized in the treatment of intra-articular hip disorders. Surgical hip dislocation is currently performed with a trochanteric osteotomy that reliably preserves the femoral head arterial supply; however, trochanteric nonunion or painful hardware requiring removal may occur. In a cadaveric model, using gadolinium-enhanced magnetic resonance imaging (MRI) and gross dissection, we evaluated whether modifications to the posterior approach preserve the femoral head arterial supply after a posterior surgical hip dislocation...
March 16, 2016: Journal of Bone and Joint Surgery. American Volume
Ayumi Shirota, Tetsuya Nomura, Hiroshi Kubota, Shunta Taminishi, Ryota Urata, Takeshi Sugimoto, Yusuke Higuchi, Taku Kato, Natsuya Keira, Tetsuya Tatsumi
INTRODUCTION: Because of the unusual anatomy of an anomalous origin of the right coronary artery from the left sinus of Valsalva, selective cannulation of the guiding catheter in percutaneous coronary intervention for these cases is always challenging. CASE PRESENTATION: A 58-year-old Japanese man was admitted to our hospital complaining of worsening exertional chest pain. He was suspected of having unstable angina pectoris and underwent cardiac catheterization...
July 28, 2015: Journal of Medical Case Reports
Claudio Morselli, Paolo Chiari, Tiziana Aliberti, Guglielmo Celli, Silvia Catalani, Ignazia Miale, Vanessa Melandri, Lorenza Bianchi
BACKGROUND: Current protocols recommend the use of a blunt needle to access the arteriovenous fistula via a buttonhole. This study aims to demonstrate whether a sharp needle can be used at the same buttonhole site without causing complications. GOAL: To measure and compare fistula cannulation failures between the use of blunt and sharp needles. PLAN: Open-crossover randomised controlled trial. PARTICIPANTS: Adult out-patients who had provided consent and were on dialysis with a mature arteriovenous fistula and buttonhole cannulation...
December 2015: Journal of Renal Care
Koray Akkan, Emetullah Cindil, Koray Kilic, Erhan Ilgit, Baran Onal, Gonca Erbas
PURPOSE: We report on the endovascular management of hemorrhage with stent-graft due to a misplaced central venous catheter in the vertebral artery (VA) during percutaneous internal jugular vein catheterization in a child. METHODS: A 16-year-old female was presented with the diagnosis of familial Mediterranean fever related chronic renal insufficiency. An attempt was made to place a central venous catheter via the right internal jugular vein without image guidance and the patient experienced dyspnea and pain at the catheter insertion site...
September 2014: Journal of Vascular Access
Raghunath Prabhu, Rajgopal Shenoy, Nitin Thinda, Anisha Patel, Sakshi Sadhu
Obtaining an intravenous (IV) access is a simple procedure which can be done in almost any hospital setting. One of the most dreaded complications of this procedure is an inadvertent intra-arterial cannulation. This can result in an accidental injection of medications intra-arterially, which can potentially lead to life altering consequences. In the hope that these types of events can be prevented, we are presenting a case of a 57-year-old male who underwent bougie dilatation for an oesophageal stricture and was accidentally given medication for pain management intra-arterially through an improperly placed IV line, which resulted in ischaemia, gangrene and subsequent loss of the hand...
March 2014: Journal of Clinical and Diagnostic Research: JCDR
Tomasz Gołębiowski, Mariusz Kusztal, Ewa Wątorek, Jerzy Garcarek, Krzysztof Letachowicz, Wacław Weyde, Marian Klinger
We describe a 65-year-old woman with diabetes on hemodialysis maintenance, with a number of complications associated with high-flow arteriovenous fistula (AVF, anastomosis between brachial artery and medial vein of the forearm) requiring an extended diagnostic and individual approach. The patient was admitted to our hospital because of pain, edema of the limb, hand ischemia, and infection caused by steal syndrome. To reduce fistula flow, banding of the proximal cephalic vein was performed. Simultaneously because of necrosis, amputation of the fifth finger was necessary...
July 2014: Annals of Vascular Surgery
O Akdas, G Basaranoglu, H Ozdemir, M Comlekci, K Erkalp, L Saidoglu
BACKGROUND: Venipuncture is one of the most painful events for children in hospitals. Valsalva maneuver (VM) decreases the incidence and severity of pain on venipuncture pain in adults. This study was designed to evaluate VM as compared with Eutectic Mixture of Local Anesthetic (EMLA(®)) cream for venipuncture pain in children. METHOD: In this study, we evaluated the effect of VM on venipuncture pain in children. 60 patients scheduled for elective surgery were randomly divided into three groups...
December 2014: Irish Journal of Medical Science
G Redaelli, A Annoni, R Caruso, F Formica, V Meroni, L Avalli
A 60-year-old man with history of hypertension and unspecified left ventricular dysfunction had chest pain at home at 9 am. At 1 pm he was transported to a peripheal hospital and treated for acute myocardial infarction. At 4.30 pm, despite pharmacological and intra aortic balloon pump support , the extreme hemodynamic instability and the echocardiographic signs forced the doctors in charge to contact the "extracorporeal membrane oxygenation team" of our Intensive Care Unit. The team, that in our hospital is composed of an intensivist, a cardiac surgeon, a perfusionist and a nurse, reached the hospital at 5...
2010: HSR Proceedings in Intensive Care & Cardiovascular Anesthesia
D Michael McMullan
A healthy 14-year-old presented to an emergency department in Alaska, complaining of shortness of breath, chest pain, and 72 hours of malaise and headache. On admission, her blood pressure was 80/50 mm Hg, and she had cool extremities. Electrocardiography revealed wide-complex ventricular tachycardia. She underwent synchronized electrical cardioversion. Although she initially converted to sinus rhythm, she subsequently became pulseless, with electrocardiographic evidence of ventricular tachycardia. Despite cardiopulmonary resuscitation, she failed to achieve a perfusing rhythm...
March 2013: Pediatrics
Sanjith Saseedharan, Sunil Bhargava
UNLABELLED: A 56-year-old female, recently (3 months) diagnosed with chronic kidney disease (CKD), on maintenance dialysis through jugular hemodialysis lines with a preexisting nonfunctional mature AV fistula made at diagnosis of CKD, presented to the hospital for a peritoneal dialysis line. The recently inserted indwelling dialysis catheter in left internal jugular vein had no flow on hemodialysis as was the right-sided catheter which was removed a day before insertion of the left-sided line...
January 2012: International Journal of Critical Illness and Injury Science
Nuntarat Sukthinthai, Aporn Sittipraneet, Banluesak Tummanittayangkoon, Somkiat Vasuvattakul, Thawee Chanchairujira
BACKGROUND: The buttonhole (constant site) arteriovenous fistulae cannulation technique, in which the inserted needle utilizes exactly the same site and the same angle every dialysis session, offers the advantage of an easier cannulation procedure, less pain associated with cannulation, and fewer complications when compared with the traditional method. OBJECTIVE: To compare buttonhole arteriovenous fistula (AVF) cannulation technique with area puncture method on the effect of hemostasis after needle withdrawal and pain during needle puncture...
February 2012: Journal of the Medical Association of Thailand, Chotmaihet Thangphaet
J Lindholm, K Palmér, B Frenckner
A previously healthy 60-year-old male presented with fever, general pain and a C-reactive protein (CRP) of 160 mg/L. He was prescribed doxycycline. In the emergency room three days later, he was intubated and had a saturation of 70% on 100% oxygen. The chest X-ray showed bilateral lobar pneumonia. Streptococcus pneumonia was later verified. As a Jehovah's Witness, he had refused blood transfusions, but accepted albumin. Two days after admission, veno-venous extracorporeal membrane oxygenation (V-V ECMO) was started and the patient was then transported on ECMO to Stockholm...
July 2012: Perfusion
Murtaza Y Dawood, Eric J Lehr, Andreas de Biasi, Reyaz Haque, Alina Grigore, Bartley P Griffith, Johannes O Bonatti
Robotic assistance has enabled coronary artery bypass surgery to be performed safely in a completely endoscopic fashion, but diffusely diseased target vessels may pose a technical challenge. We present a case in which coronary endarterectomy was performed on the left anterior descending coronary artery during a two-vessel totally endoscopic coronary artery bypass procedure. A 52-year-old woman presented with intermittent substernal pain. Preoperative studies showed diffuse disease in the left coronary artery system...
November 2011: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
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