A&A practice
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Coccygodynia results from traumatic, nontraumatic, or idiopathic causes. Chronic cases resistant to conservative treatments may necessitate surgery. ⋯ S-MPB was chosen for its simplicity, efficacy, and safety, providing postoperative analgesia without complications. This approach suggests that S-MPB is a promising addition to the pain management arsenal for coccygectomy, warranting further investigation to optimize its application and outcomes.
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Case Reports
Erector Spinae Plane Block Together With Inter-Transverse Process Block for Open Gastrectomy: Case Report.
Fascial plane blocks of the posterior thoracic wall (erector spinae plane [ESP] and intertransverse plane [ITP]) may offer advantages for high-risk patients requiring open abdominal surgery in whom thoracic epidural analgesia (TEA) combined with general anesthesia (GA) may be relatively contraindicated. As a primary anesthesia method, ESP/ITP (paravertebral by proxy) blocks proved effective in a case of open gastrectomy by avoiding airway intervention, mechanical ventilation, and effectively managing visceral pain. This article highlights the use of ESP/ITP blocks in a high-risk patient for whom GA and TEA posed substantial risks, with the patient who experienced favorable perioperative outcomes.
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Case Reports
All Implantable Cardioverter Defibrillators Are Not Programmed Equal: A Case Report of Pseudomalfunction.
As the population ages, the need for anesthesiologists to manage complicated implantable cardioverter defibrillators (ICDs) has increased. We present a case of hemodynamically unstable ventricular tachycardia occurring during a transcatheter aortic valve replacement where magnet removal from the ICD did not result in the expected tachytherapies. When managing patients with an ICD, we emphasize preoperative placement of external defibrillator pads and prompt use of external shocks rather than relying on the ICD to manage hemodynamically unstable tachyarrhythmias.
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Case Reports
Peripheral Nerve Stimulation and Improved Functional Outcomes in a Prosthetic User: A Case Report.
Peripheral nerve stimulation (PNS) is an emerging option for postamputation pain. However, its impact on prosthesis use and comfort remains underexplored. ⋯ After failing conservative therapies, successful treatment was achieved with sciatic PNS which improved pain, prosthesis comfort, and functional outcomes as measured by the Orthotic and Prosthetic Users Survey Lower Extremity Functional Status Measure and Prosthetic Limb Users Survey of Mobility. Although surgical techniques, such as targeted muscle reinnervation, also enhance prosthetic function, PNS offers unique advantages.