A&A practice
-
Ultrasound (US)-guided transversalis fascia plane block (TFPB) was first described by Hebbard as a technique for blockade of T12-L1 nerves. Although this technique appears similar to the quadratus lumborum 1 block, the point of injection is more caudal and anterior, specifically targeting ilioinguinal and iliohypogastric nerves. ⋯ We report the use of US-guided TFPB in a patient undergoing inguinal herniorrhaphy. Our experience suggests that this technique could represent a viable alternative to general anesthesia and standard regional techniques for inguinal hernia repair.
-
Airway management and ventilation during a tracheobronchial stenting procedure are challenging given that mandatory positive pressure ventilation cannot be fully achieved while using a rigid bronchoscope due to leakage from the scope tip. Biphasic cuirass ventilation is a negative pressure ventilation method using an external cuirass fitted to the anterior chest, which could assist in spontaneous breathing and ventilation support. We report 3 successful anesthesia cases in which we could maintain adequate ventilation and oxygenation, supported by biphasic cuirass ventilation, in patients undergoing tracheobronchial stent placement or removal procedures using rigid bronchoscopy.
-
Tranexamic acid (TXA), an antifibrinolytic, is routinely used to decrease transfusion rates in total joint replacement surgery. While recent publications have indicated a low risk of TXA-associated thromboembolic events in this orthopedic population, few studies specifically address the safety of TXA administration in high-risk patients. We present a case of acute coronary thrombus requiring emergent intervention in a patient with indwelling coronary stents who underwent shoulder arthroplasty with TXA administration.
-
We present a case of a 2-year-old boy who underwent thoracoscopic resection of a left paraspinal mediastinal mass and developed Harlequin syndrome postoperatively. Harlequin syndrome is a rare neurological condition characterized by unilateral hyperhidrosis and erythema of the head and neck. Our discussion highlights this condition and other differential diagnoses that may present similarly in the postoperative period.
-
Jehovah's Witness patients have unique perioperative challenges involving blood products. We describe the use of a novel method to maintain a closed circuit between a Jehovah's Witness patient's arterial blood and the epidural space while performing a blood patch for postdural puncture headache. Previously described methods have utilized venous catheters to maintain a closed circuit between the body and the epidural space. This is the first report we are aware of that utilizes a closed-circuit arterial blood supply to create an epidural blood patch in a Jehovah's Witness patient.