A&A practice
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Point-of-care ultrasound (POCUS) has established its role as a "third eye of a clinician" by virtue of its ability to provide real-time visual information. The present case highlights the role of POCUS in an 11-year-old girl with a misplaced hemodialysis catheter scheduled for surgical exploration with the removal of the catheter and direct arterial repair.
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Case Reports
Unusual Resistance to Intravenous Anesthetic Drugs in a Rachipagus Infant: A Case Report.
In conjoined twins when one of the twins is incompletely formed and is dependent on the healthy counterpart for survival, they are described as heteropagus (parasitic) twins. Rachipagus is a type of parasitic twin joined at the spine above the sacrum. ⋯ The infant was resistant to multiple anesthetic drugs like fentanyl, propofol, and ketamine. Later general anesthesia was induced with thiopentone sodium, and the procedure went on uneventfully.
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Case Reports
Stellate Ganglion Block for Electrical Storm Associated With Takotsubo Cardiomyopathy: A Case Report.
Takotsubo cardiomyopathy (TCM) is a reversible condition characterized by apical ballooning of the left ventricle, primarily triggered by catecholamine discharge due to stress. Patients may present with symptoms similar to acute coronary syndrome or with refractory ventricular arrhythmias such as QT prolongation, ventricular tachycardia, and ventricular fibrillation. We report a case of TCM with prolonged QT intervals and refractory ventricular arrhythmias, triggered by noncardiac systemic insult, that responded successfully to stellate ganglion block (SGB). This case highlights the potential of SGB as an effective intervention for managing refractory arrhythmias in TCM patients.
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Spread of drugs in the epidural space may be unpredictable. The differential diagnosis of unilateral hemiparesis could be due to the unilateral spread of the drug, spinal epidural hematoma, intraspinal hematoma, and spinal cord injury. ⋯ We present a case of atypical spread of epidural local anesthetic causing hemiparesis. It emphasizes the need for careful monitoring of sensory levels on both sides and provides insight into the causes of unilateral drug spread in the epidural space.
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PHARC syndrome (polyneuropathy, hearing loss, ataxia, retinitis pigmentosa, and cataracts) is a rare autosomal recessive disease, caused by genetic mutation of the ABHD12 gene. This syndrome is still not well known and can be misdiagnosed, especially in the early stages, as it can be easily confused with other neurodegenerative diseases. We present the first description of the anesthetic management of 2 siblings with PHARC syndrome who underwent unilateral cochlear implantation.