A&A practice
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Perioperative pain management in patients undergoing major surgery with restrictive lung disease can be a challenge. Facioscapulohumeral muscular dystrophy, a rare genetic disorder, causes progressive proximal weakness resulting in chronic pain. ⋯ We used interscalene brachial plexus and erector spinae plane block with catheter insertion using continuous local anesthetic infusion. The aim was to reduce potential respiratory complications in a patient with severe restrictive lung disease and reduce hospital stay.
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Case Reports
The Anesthetic Challenges of Caring for a Pediatric Patient With Incontinentia Pigmenti: A Case Report.
Incontinentia pigmenti (IP) is a rare X-linked dominant disorder. We present a case of an infant with IP who was brought to the operating room for panretinal diode photocoagulation under general anesthesia. ⋯ Anesthesia for IP patients also poses challenges such as prevention of the oculocardiac reflex, obesity and airway management, and preemptive measures for intravenous access due to skin manifestations. Patients with IP may present with many challenges for the anesthesiologist during all phases of anesthetic management.
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Case Reports
Stellate Ganglion Block as a Diagnostic and Therapeutic Option in Chronic Pericardial Pain: A Case Report.
The underlying pathophysiology and treatment of chronic pericardial chest pain remains unclear. We describe a clinical case of a 38-year-old patient with chronic chest pain in the context of Marfan syndrome, status post-valve-sparing aortic root repair, and recurrent pericarditis. ⋯ A left-sided stellate ganglion block (SGB) was performed for both diagnostic and therapeutic purposes. Postprocedure follow-up demonstrated significant analgesic benefit at 8 months after the procedure.
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Foreign body (FB) injuries of the airway and of the digestive tract are common in pediatric patients. Available literature cites small blunt objects as a common FB leading to FB aspiration or ingestion. ⋯ Airway management can be particularly challenging when access to the oral cavity is severely restricted. We present the anesthetic management of a child with complete oral cavity obstruction by a large fishing lure.