A&A practice
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Case Reports
Use of a Rigid Bronchoscope as the Sole Prebypass Airway During Pediatric Tracheal Tumor Resection: A Case Report.
We describe the anesthetic and operative techniques utilized for a tracheal tumor resection in a pediatric patient with 95% tracheal occlusion. In prior tracheal tumor cases that dictated complete resection, our team had been able to comfortably bypass a tumor with an endotracheal tube. In this case, we could not intubate past the tumor. A rigid bronchoscope was able to be placed past the tumor, so we continued with sternotomy and dissection before cardiopulmonary bypass while ventilating through that bronchoscope as our definitive airway.
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Perioperative pain management in patients undergoing major surgery with restrictive lung disease can be a challenge. Facioscapulohumeral muscular dystrophy, a rare genetic disorder, causes progressive proximal weakness resulting in chronic pain. ⋯ We used interscalene brachial plexus and erector spinae plane block with catheter insertion using continuous local anesthetic infusion. The aim was to reduce potential respiratory complications in a patient with severe restrictive lung disease and reduce hospital stay.
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Foreign body (FB) injuries of the airway and of the digestive tract are common in pediatric patients. Available literature cites small blunt objects as a common FB leading to FB aspiration or ingestion. ⋯ Airway management can be particularly challenging when access to the oral cavity is severely restricted. We present the anesthetic management of a child with complete oral cavity obstruction by a large fishing lure.
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Case Reports
Stellate Ganglion Block as a Diagnostic and Therapeutic Option in Chronic Pericardial Pain: A Case Report.
The underlying pathophysiology and treatment of chronic pericardial chest pain remains unclear. We describe a clinical case of a 38-year-old patient with chronic chest pain in the context of Marfan syndrome, status post-valve-sparing aortic root repair, and recurrent pericarditis. ⋯ A left-sided stellate ganglion block (SGB) was performed for both diagnostic and therapeutic purposes. Postprocedure follow-up demonstrated significant analgesic benefit at 8 months after the procedure.