A&A practice
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Case Reports
Anesthetic Implications of Previously Undiagnosed Temporomandibular Joint Ankylosis: A Case Report.
Temporomandibular joint (TMJ) ankylosis is characterized by bony fusion that limits TMJ mobility. We present the case of an elderly woman who was brought to the operating room for dental rehabilitation under general anesthesia. ⋯ The surgical team canceled the case due to limited access to the surgical field. We discuss the factors that suggest TMJ ankylosis and propose the perioperative management when TMJ ankylosis is suspected but unconfirmed.
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Cangrelor is a P2Y12 inhibitor antiplatelet agent, with a rapid onset and offset. The available literature only reviews short-term administration over a few hours. ⋯ Despite multiple therapeutic interruptions for surgical procedures, no hemorrhagic events occurred, and there was only one transient ischemic event, which occurred during transition from cangrelor to ticagrelor. Cangrelor can be a therapeutic option for patients with a high likelihood of requiring revision neurosurgery after intracranial stenting.
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Case Reports
Management of Hemorrhage During Cesarean Delivery in a Patient With Vascular Ehlers-Danlos Syndrome: A Case Report.
Parturients with vascular Ehlers-Danlos syndrome are at particular risk of hemorrhage, and there is little evidence to guide prevention or management of hemorrhage in these patients. We present the case of a patient with vascular Ehlers-Danlos syndrome who had a cesarean delivery complicated by an intraoperative hemorrhage. Administration of desmopressin and tranexamic acid appeared to be of marked benefit in achieving hemostasis. To the best of our knowledge, this is the first report of the use of desmopressin during major obstetric hemorrhage in vascular Ehlers-Danlos syndrome.
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Landmark-guided zygomaticotemporal nerve blocks are a well-described modality to manage headaches in the temporal region. We report 3 cases in which ultrasound-guided zygomaticotemporal nerve blocks were performed for severe unilateral temporal headaches that failed to respond to standard treatment in the outpatient pain clinic. All the patients reported substantial and durable pain relief with no complications.
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Systemic anticoagulation is a relative contraindication for performing nasal intubation due to the risk of hazardous bleeding. However, nasal intubation may sometimes be the only way to facilitate surgical exposure. ⋯ None of them had any epistaxis. Telescoping the endotracheal tube using a red rubber catheter may be an effective and safe method for nasal intubation when there is a high risk of epistaxis.