A&A practice
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Ex utero intrapartum treatment procedures are mainly indicated to secure the airways of fetuses featuring a risk of obstruction at birth while ensuring uteroplacental circulation. This report documents a successful intubation case with a C-MAC video laryngoscope during an ex utero intrapartum treatment procedure in a newborn featuring an infiltrative neck mass. Despite technical challenges faced in this procedure, the C-MAC video laryngoscope allowed an optimal view of airway structures. This novel approach, where laryngoscopy relies on the usage of C-MAC to optimize intubation conditions, may lead to increased chances of success in this particular scenario.
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Complex abdominal wall hernia repairs can have high failure rates. Many surgical techniques have been proposed with variable success. ⋯ Toxin was administered into the 3 abdominal wall muscle layers under ultrasound guidance at multiple sites 2 weeks before surgery. The resulting flaccid paralysis of the abdominal musculature facilitated a successful primary surgical closure with no postoperative complications.
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We report the case of a 55-year-old woman who required extracorporeal membrane oxygenation for extreme respiratory distress after a liver transplant and eventually died. As is so often the case, this patient's values and wishes were not documented before she had a risky surgical procedure. Anesthesiologists, in partnership with surgeons, can participate in preoperative discussions exploring wishes and values and document them in advance directives which will help clinicians respect patients' preferences.
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Shoulder surgery in the beach chair position is routinely performed, and central neurological events are rare but potentially devastating. We present a patient with transient neurological deficits after a sudden blood pressure drop with a simultaneous decrease of regional cerebral saturation values registered by cerebral oximetry. We reviewed published cases and proposed possible strategies to prevent the occurrence of similar complications in this context.
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Case Reports
Transnasal Sphenopalatine Ganglion Block for Postdural Puncture Headache in an Adolescent: A Case Report.
We present a pediatric patient with postdural puncture headache after a lumbar puncture, who was successfully treated with a sphenopalatine ganglion block. An uneventful autologous epidural blood patch had been placed 2 days before, but the patient reported a recurrence of symptoms after about 5 hours. Sphenopalatine ganglion block is well described in the treatment of postdural puncture headache for the obstetric population, but examples of its use in the pediatric population are not described. To our knowledge, this is the first pediatric case of sphenopalatine ganglion block for postdural puncture headache reported in the literature.