A&A practice
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Case Reports
Severe Dystrophic Calcification of a Spinal Cord Stimulator Pulse Generator Pocket: A Case Report.
A spinal cord stimulator is an important long-term treatment modality for refractory chronic pain of multiple etiologies. Hardware-related complications remain known adverse events associated with this intervention. Understanding the risk factors for development of such complications is important for optimizing the efficacy and longevity of spinal cord stimulators. This case report highlights an uncommon case of implantable pulse generator site calcification that was discovered incidentally on spinal cord stimulator explant.
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The effects of critical illness on electroencephalographic (EEG) signatures of sedatives have not been described, limiting the use of EEG-guided sedation in the intensive care unit (ICU). We report the case of a 36-year-old man recovering from acute respiratory distress syndrome (ARDS). ⋯ The alpha power emerged as ARDS resolved. This case raises the question of whether inflammatory states can alter EEG signatures during sedation.
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Case Reports
Anesthetic Considerations for an Adult With Bannayan-Riley-Ruvalcaba Syndrome: A Case Report.
Anesthetic considerations for adults with Bannayan-Riley-Ruvalcaba syndrome, part of the PTEN (phosphatase and tensin homolog) hamartoma tumor syndrome, are not well described. As patients may require surgical intervention for associated musculoskeletal, intestinal, oncologic, or soft tissue masses, knowledge of implications of anesthesia is necessary. ⋯ This report describes a patient with typical features, nonreassuring external airway anatomy, and developmental delay, which precluded an awake airway management technique. The airway was secured with the use of high-flow nasal oxygen and videolaryngoscopy.
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Traditional intravenous anesthetics and opioid analgesics are susceptible to inducing hemodynamic instability. Herein, we describe a case of open reduction and internal fixation of a femoral neck fracture in a patient with severe aortic stenosis. ⋯ During the surgical procedure, the need for circulatory agonist was reduced to a single dose, and satisfactory pain management was achieved. This approach represents an alternative method for patients with circulatory risk undergoing femoral surgery.
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Anesthetic induction in children can have significant psychological and behavioral impacts. Strategies like premedication or parental presence for induction may reduce distress. ⋯ The use of parental presence by video may aid in this transition. It might also be a reasonable approach for those children who have adverse reactions to medications commonly used for anxiolysis before procedures.