A&A practice
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Case Reports
Electroencephalogram Suppression Despite Extremely Low-Dose Anesthetic During Cardiac Surgery: A Case Report.
A prominent feature of electroencephalogram (EEG) under general anesthesia is anteriorization of α waves. We report the case of a 63-year-old man anesthetized for coronary artery bypass grafting in whom the NeuroSENSE-processed EEG monitor recorded only δ waves in the absence of α frequencies, along with high EEG suppression despite extremely low doses of anesthetics during the whole procedure. The patient fully recovered from anesthesia 2 hours after the procedure and showed neither awareness nor neurological complications. This atypical EEG pattern under low concentration of anesthetics may be an intraoperative marker of a specific brain phenotype.
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Case Reports
Peripheral Nerve Block Efficacy on Refractory Neuralgia Complicating Ramsay Hunt Syndrome: A Case Report.
Several case studies have suggested the usefulness of peripheral nerve blocks in the management of various types of chronic pain that are unresponsive to standard medical treatment. We report here the case of a patient with severe neuralgia, secondary to Ramsay Hunt syndrome that was refractory to standard drug therapy. ⋯ Despite transient facial paralysis, pain was markedly reduced for 3 months with self-reported improved quality of life. To our knowledge, this block has never been described previously.
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We present a case of left ventricular outflow tract (LVOT) obstruction detected by limited bedside transthoracic echocardiography (TTE). This involved a young and otherwise healthy patient presenting for elective hand surgery with a previously undetected cardiac murmur. It highlights the utility of bedside TTE as an assessment tool and shows the importance of anesthesiologists as perioperative physicians.
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Comparative Study
Comparison of Twitter Use of the American Society of Anesthesiologists and the American Association of Nurse Anesthetists.
Twitter has become a powerful tool for dissemination of information. The objective of this study was to evaluate Twitter usage of the American Society of Anesthesiologists (ASA) and the American Association of Nurse Anesthetists (AANA). All tweets from ASA ("@ASALifeline") and AANA ("@aanawebupdates") were collected over a 1-year time period. ⋯ Twitter use was highest in October for ASA and September for AANA. Both societies are actively using Twitter. Future work should evaluate the impact of societal Twitter use.
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We present a case of a 69-year-old man who underwent tracheobronchoplasty for tracheobronchomalacia using a single-lumen endotracheal tube and a Y-shaped bronchial blocker for airway management. Tracheobronchoplasty is performed by sewing mesh to plicate the posterior, membranous wall of the distal trachea and main bronchi through a right posterolateral thoracotomy. ⋯ Ideally, only conventional airway management tools are used. This case demonstrates that a single-lumen endotracheal tube with a bronchial blocker can be a straightforward strategy for airway management during tracheobronchoplasty.