A&A practice
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Case Reports
A Unique Treatment for Compartment Syndrome After Intravenous Catheter Extravasation: A Case Report.
Intravenous cannulation is performed on nearly every patient presenting for an anesthetic. Complications of the procedure include infiltration and extravasation, which can have a varied impact on the patient. Here, we present a case of severe intravenous (IV) extravasation, resulting in compartment syndrome of the hand. Rather than treating the compartment syndrome with fasciotomies as is standard, we utilized compression therapy via an Esmarch surgical dressing wrapped distal to proximal on the effected limb, which resulted in marked decrease in swelling and return of perfusion to the hand.
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Case Reports
Postoperative Thyroid Storm After Evacuation of a Complete Hydatidiform Mole: A Case Report.
Gestational trophoblastic disease can lead to excess thyroid hormone release and rarely, thyroid storm. We present a case of complete molar pregnancy with hyperthyroidism that was not identified or treated before surgical evacuation of uterine contents. ⋯ Anesthesia providers should strongly consider preoperative consultation and treatment. Being prepared to treat intraoperative symptoms and thyroid storm is paramount.
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Case Reports
Rocuronium-Induced Dilated Nonreactive Pupils in a Patient With Coronavirus Disease 2019: A Case Report.
We report the clinical case of a patient with coronavirus disease 2019 (COVID-19) who had recently undergone neurosurgery and presented with dilated nonreactive pupils during continuous rocuronium infusion, which was reversible with the suspension of the drug. Both the neurosurgical procedure and possible disruption of the blood-brain barrier due to COVID-19 infection may have led to the action of rocuronium in the central nervous system (CNS). Thus, clinicians must remember that neuromuscular blocking agents (NMBAs) can cause dilated nonreactive pupils in patients with COVID-19.
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Angiomyomatous hamartomas are mixed-tissue benign lymphatic tumors that typically occur in the inguinal or axillary lymph nodes. These lesions may cause local lymphedema and painful compression neuralgias. ⋯ Previously, our group published a case report of a patient with an inguinal angiomyomatous hamartoma causing a compression neuralgia, whose pain was temporarily alleviated after blockade of the femoral branch of the genitofemoral nerve. We present a follow-up case report describing this patient's sustained pain relief after cryoablation therapy.
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Perioperative hypoxemia is common in patients with aortic dissection. Platypnea-orthodeoxia syndrome (POS), in which hypoxemia in the upright position improves with relocating to a recumbent position, can be a rare cause of hypoxemia. ⋯ Therefore, establishing the diagnosis was difficult. POS should be suspected when patients with high tortuosity and curvature of DTA show hypoxemia.