A&A practice
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Case Reports
Airway Management Through a Facial Defect Resulting From Noma (Orofacial Gangrene): A Case Report.
At a rural district hospital in Burundi, a 3-year-old severely malnourished girl with Noma presented to the operating room for placement of a gastrostomy tube. The child had a large left-sided facial defect as well as trismus. ⋯ Given that the hospital has no fiberoptic bronchoscope, direct laryngoscopy and intubation were performed directly through her facial defect. After securing the airway, the surgery proceeded without difficulty.
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Case Reports
Pecs Blocks for Chronic Pain: A Case Report of Successful Postmastectomy Pain Syndrome Management.
Mastectomies can be complicated by difficult-to-treat postmastectomy pain syndrome (PMPS) and axillary web syndrome (AWS). We present a case of PMPS and AWS successfully treated with Pecs I and II blocks and trigger point injections. ⋯ This case presents the utility of a multimodal approach for a patient with pain after mastectomy. This case report is the first-time demonstration of Pecs blocks to treat chronic PMPS.
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During surgery, cardiac implantable electronic device (CIED) function may be disrupted by electromagnetic interference (EMI) from monopolar electrosurgery and cause adverse sequelae. Monopolar electrosurgery requires a dispersive electrode. ⋯ We present a case in which an underbody electrode was used, and EMI occurred even though the surgical site was inferior to the umbilicus. Since little is known about EMI risk with underbody electrodes, practitioners should be wary of their use in CIED patients undergoing surgery until more information is available.
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Electroconvulsive therapy (ECT) in a patient with an implantable cardioverter-defibrillator (ICD) presents challenges to anesthesiologists. We encountered a patient who received an inappropriate shock during ECT despite magnet application. The phenomenon provides insight into how ICDs work-how they can inappropriately detect ECT stimulation and how they deliver antitachycardia therapy. We illuminate issues related to using magnets, discuss risks associated with inappropriate ICD therapy, and provide guidance for ICD management during ECT.