A&A practice
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An infraclavicular catheter is a very efficient technique to provide excellent perioperative anesthesia/analgesia for upper limb surgery. However, complications can occur and are dependent on the technique used. We report the inadvertent placement of an infraclavicular catheter in the interscalene region when an ultrasound-guided infraclavicular catheter was threaded cranially. We proposed some strategies to avoid the occurrence of complications when performing this block.
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Left atrial (LA) dissections are rare phenomena, often iatrogenic, caused by blood flow into a false lumen, potentially obstructing the pulmonary veins or flow into the left ventricle. Severity can range from an incidental observation or complete circulatory collapse. ⋯ Here, we present a large LA dissection that was directly visualized and tracked to a coronary sinus injury from the retrograde cardioplegia cannula. The clinical presentation and echocardiography findings informed our subsequent management.
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We report a pediatric patient who underwent a central venous catheter (CVC) insertion and presented with a sudden protrusion of a guidewire from the neck 26 months later. The guidewire was extracted via femoral venotomy. ⋯ We recommend always using a CVC checklist, inspecting the guidewire before and after insertion, and carefully examining the postinsertion radiographs. This checklist should be mandatory with every CVC insertion, including the perioperative period.
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Case Reports
Motor-Sparing Nerve Blocks Can Improve the Results of Digit Tendon Surgery: A Case Report.
A 56-year-old woman presented with flexion dysfunction of the fifth digit 6 weeks after surgical repair of a flexor digitorum profundus laceration. She was scheduled for surgical adhesiolysis and restoration of the functionality of the finger. ⋯ Distal median and ulnar nerve blocks were used for anesthesia with the patient's ability to flex the finger. This case suggests that motor-sparing peripheral nerve blocks can improve functional outcome in certain hand surgeries.