A&A practice
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Twitter is a social media platform that has been encouraged for use among anesthesiologists as a way to stimulate conversation, distribute research, enhance conference experiences, and expand journal club sessions. We aimed to establish the typical baseline use of hashtags that are not related to events such as conferences. ⋯ The most popular and relevant hashtags within anesthesia subspecialties or interest groups include #pedsanes, #anesJC, #OBanes, #intubation, #regionalanesthesia, #neuroanesthesia, and #cardiacanesthesia. We have identified the most popular anesthesia-related hashtags on Twitter to help anesthesiologists increase the reach and degree of discussions in anesthesia-related social media or twitter verse.
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Case Reports
Spinal Cord Stimulation as Treatment for Truncal Chronic Regional Pain Syndrome After Cardiac Surgery: A Case Report.
A 59-year-old man presented 7 months after coronary artery bypass with continued bilateral axillary pain. His symptoms progressed over a period of months to allodynia, edema, erythema, decreased range of motion, and skin changes consistent with complex regional pain syndrome type I. ⋯ Leads positioned in the posterior epidural space from the seventh cervical to the third thoracic vertebral levels resulted in complete paresthesia coverage of his truncal chronic regional pain syndrome (CRPS) and the stimulation was associated with almost complete resolution of CRPS. This case report suggests that spinal cord stimulation may provide effective treatment for truncal CRPS after coronary artery bypass graft surgery.
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Case Reports
Novel Preoxygenation Technique to Deliver High-Flow Oxygen in a Patient With Facial Trauma: A Case Report.
This case demonstrates a novel preoxygenation technique in a patient with difficult access to the airway after a traumatic facial injury. To find a solution, a fusion of oxygenation equipment was trialed by altering and combining a tracheostomy mask and the tubing of an Optiflow circuit from which the nasal cannula component had been removed. ⋯ Effective preoxygenation was confirmed by arterial gas measurements. This study supports the use of this novel Optiflow-tracheostomy mask fusion device in appropriately selected cases.
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Surgery requires many electrically driven devices. Three events occurred recently in an operating room (OR) suite circa the 1980s wherein circuit breakers tripped due to overloaded circuits. This led to us to (1) increase OR electric capacity; (2) record each instrument's power requirements, map their OR location, and determine when during surgery they were used; (3) provide users with instruction and diagrams into which outlet to plug each instrument. When introducing surgeries requiring devices, especially with high electrical power (current or amperage) demands, or renovating older or planning new ORs, it is important to provide ORs with sufficient electric current, circuits, and outlets.
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We present a rarely described complication of unilateral rhinorrhea and sneezing in a patient who received intravenous sedation with propofol and supplemental oxygen via a nasal cannula during upper gastrointestinal endoscopy. The literature is reviewed and a mechanism is proposed. Mechanical irritation of the nasal mucosa is felt to be the trigger. Suggestions to avoid and to treat are offered.