A & A case reports
-
Uterine dehiscence is a known but uncommon complication during pregnancy. The symptoms of uterine dehiscence can be subclinical and usually occur during prolonged augmented labor in women who had previous cesarean delivery and/or are carrying a macrosomic baby. ⋯ However, to our knowledge, spontaneous uterine dehiscence during performance of spinal anesthesia for an elective cesarean delivery has not been reported in obstetric anesthesia practice. Here, we report a case of uterine dehiscence while subarachnoid block was being performed.
-
We present the case of a 25-year-old woman with acute fatty liver of pregnancy, a rare mitochondrial disorder that manifests during pregnancy and has a significant mortality rate. Postoperative pain management is challenging for myriad reasons. With the increasing application of transversus abdominis plane blocks for postcesarean delivery analgesia, we describe the real and potential complications of this method of regional analgesia in patients with this disease.
-
We describe the perioperative management of a patient requiring removal of a 56.7-kg ovarian cystadenoma, highlighting our techniques in managing the changes in the patient's respiratory, vascular, renal, and gastrointestinal systems due to the large mass. An appreciation of the unique physiologic and anatomical changes in patients with large abdominal masses allows for appropriate precautions in the perioperative period.
-
We report the case of a 25-year-old female scheduled for laparoscopic gynecologic surgery under general anesthesia. At the end of laparoscopy, an intraperitoneal infiltration (ropivacaine 0.75%, 20 mL) was administered by the surgeon without informing the anesthesiologist. ⋯ An infusion of 20% lipid emulsion was successful in converting the ventricular arrhythmia to a sinus rhythm. This overdose could have been avoided with better communication between anesthesiologist and surgeon.