A&A practice
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An esophageal bronchus is a subtype of congenital bronchopulmonary foregut malformations in which a lobar bronchus arises directly from the esophagus, creating a communication between the esophagus and lung tissue. Early diagnosis is crucial to prevent worsening pulmonary sequelae but is challenging due to the rarity of the anomaly and nonspecific respiratory symptoms. We present a child whose esophageal bronchus was identified incidentally during preanesthetic assessment for craniosynostosis repair and discuss the role an anesthesiologist can play in identifying and managing this diagnosis.
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Observational Study
A Case Series of Deep Subgluteal Block: A New Block Targeting the Missed Portion of the Hip for Analgesia After Total Hip Replacement.
The study aimed to evaluate the effectiveness of deep subgluteal block (DSGB) for pain relief after posterolateral-approached total hip replacement. The cadaver study and observational case series assessed the spread and outcomes of ultrasound-guided DSGB. ⋯ Anatomical dissection revealed effective spread of the injected substance. These findings suggest that DSGB could be a promising regional analgesic technique for postoperative pain management after posterolateral-approached total hip replacement.
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Peripheral nerve blocks provide a safe and reliable alternative in the anesthetic management of femur fractures in elderly subpopulations associated with significant comorbidities. Single-Insertion Multiple Nerve Block Anesthesia (SIMBA) is a technique where a single needle insertion is used to block all four nerves that supply the femur shaft: the femoral nerve, obturator nerve, lateral femoral cutaneous nerve, and sciatic nerve. The authors performed this technique in 11 cardiac compromised geriatric patients with midshaft/distal femur fractures, and the surgery was conducted successfully without any significant hemodynamic change and good postoperative analgesia.
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Case Reports
Airway Management May Not Improve in Adult Patients With Pierre Robin Sequence: A Case Report.
Infants with Pierre Robin sequence present with difficult airways due to their triad of micrognathia, glossoptosis, and cleft palate. This creates a difficult airway to intubate and ventilate. ⋯ Surgeries, such as coronoidectomy, have been found to ease the difficulty of intubation in pediatric patients, but the results are not always permanent. We present an adult with Pierre Robin sequence who continued to have a difficult airway, suggesting that airway management does not necessarily improve with age.