A&A practice
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Retroauricular or facelift approach for robotic thyroidectomy involves a long incision with extensive subcutaneous dissection causing severe pain and discomfort. Multimodal analgesic regimen with inclusion of intermediate cervical plexus block by anterior route provided excellent perioperative analgesia without affecting recurrent laryngeal nerve monitoring in 10 cases. ⋯ Median numeric pain rating scale score in 24 hours postoperatively was 3. None of the cases had any significant complications on follow-up.
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Case Reports
Peripartum Diagnosis of Currarino Syndrome With Anterior Sacral Meningocele: A Case Report.
Neurologic conditions without prenatal optimization can pose anesthetic and obstetrical challenges. We present a case of Currarino syndrome; an autosomal dominant triad of agenesis of the sacrum, anterior sacral meningocele (ASM) with sacral teratomas, and anorectal stenosis; diagnosed during pregnancy; and the subsequent anesthetic considerations. ⋯ Eligibility for neuraxial anesthesia should be made on a case-by-case basis with risk-benefit analysis, and deficits should be documented allowing prompt identification and intervention should complications arise. Multidisciplinary team coordination is vital to help facilitate maternal safety.
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Multichannel patient monitors apparently display the electrocardiogram, intra-arterial blood pressure, and pulse oximetry waveforms in synchrony during sinus cardiac rhythm. We recorded 20 events of a premature cardiac contraction on multichannel monitors from 10 patients. Interestingly, during premature cardiac contraction, the low-amplitude arterial trace was aligned with the premature electrocardiogram, but the low-amplitude pulse oximetry plethysmograph was aligned with the next normal electrocardiogram and arterial tracing. In conclusion, the pulse oximetry plethysmograph tracing is offset by 1 ventricular depolarization on the electrocardiogram (QRS) and the arterial tracing on multichannel monitors.