A&A practice
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Methemoglobinemia is a rare disorder of the blood in which there is an increase in methemoglobin, which occurs when hemoglobin is present in the oxidized form. Methemoglobin impairs hemoglobin's ability to transport oxygen, produces functional anemia, and leads to tissue hypoxia. ⋯ The cause of methemoglobinemia in this patient remains unknown. Hypoxia and methemoglobinemia did not respond to methylene blue and required administration of packed red blood cell transfusions.
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Case Reports
Management of Tracheoesophageal Fistula Repair With Cardiac Dextroposition and Right Lung Agenesis: A Case Report.
Tracheoesophageal fistulae (TEF) commonly occur as part of the vertebral defects, anal atresia, cardiac defects, tracheoesophageal fistula, renal, and limb abnormalities (VACTERL) association. However, pulmonary agenesis is not typically seen with TEF. We report the anesthetic management of a TEF repair in a 33-week-old, 1.6-kg, monochorionic diamniotic twin with right lung agenesis, intrauterine growth restriction, and cardiac dextroposition. Due to the unique position of the heart, the patient periodically lost complete cardiac output during the exposure and repair of the esophagus.
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We report a case of massive engorgement of an asymptomatic tongue hemangioma with the use of a supraglottic airway device (SGA) during general anesthesia for transurethral resection of a tumor on the lateral wall of the urinary bladder. This was probably a result of obstruction of the venous drainage of the hemangioma due to the pressure exerted by the inflated cuff of the SGA. The SGA was removed and the trachea was intubated and the engorgement resolved completely in a few hours.
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Opioid-tolerant individuals have greater risk of perioperative complications and worse clinical outcomes. A preoperative screening process and structured approach to opioid-tolerant patients was developed to identify and optimize these patients before elective surgery.
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Case Reports
Transforaminal Sacral Nerve Neurostimulation for the Treatment of Intractable Chronic Pelvic Pain: Case Report.
This article aims to report the successful treatment of 2 patients with intractable chronic pelvic pain treated with transforaminal sacral nerve neurostimulation. At 18-month follow-up, both patients reported significant pain relief and improved performance. ⋯ In both reported cases, it proved to be useful for pain management. This technique should be evaluated in clinical trials.