• 主题
高级搜索  >
历史搜索 清空历史

您现在的位置：首页>美国卫生研究院文献>Case Reports in Anesthesiology

期刊信息

  • 期刊名称：

    -

  • 刊频：
  • NLM标题：
  • iso缩写： -
  • ISSN： -

年度选择

更多>>

  • 排序：
  • 显示：
  • 每页：
全选（0）
<12/13>
共260条结果
  • 1.

    【2hr】In Vitro Contracture Test Results and Anaesthetic Management of a Patient with Emery-Dreifuss Muscular Dystrophy for Cardiac Transplantation

    包量

    机译 心脏移植的金刚砂-Dreifuss肌营养不良患者的体外挛缩测试结果和麻醉管理
    摘要：Emery-Dreifuss muscular dystrophy (EDMD) is a hereditary neuromuscular disorder characterized by slowly progressive muscle weakness, early contractures, and dilated cardiomyopathy. We reported an uneventful general anaesthesia using total intravenous anaesthesia (TIVA) for cardiac transplantation in a 19-year-old woman suffering from EDMD. In vitro contracture test results of two pectoralis major muscle bundles of the patient suggest that exposition to triggering agents does not induce a pathological sarcoplasmic calcium release in the lamin A/C phenotype. However, due to the lack of evidence in the literature, we would recommend TIVA for patients with EDMD if general anaesthesia is required.
  • 2.

    【2hr】Fetal Hydantoin Syndrome and Its Anaesthetic Implications: A Case Report

    包量

    机译 胎儿乙内酰脲综合征及其麻醉意义：一例报告
    摘要：Fetal hydantoin syndrome is a rare disorder that is believed to be caused by exposure of a fetus to the anticonvulsant drug phenytoin. The classic features of fetal hydantoin syndrome include craniofacial anomalies, prenatal and postnatal growth deficiencies, underdeveloped nails of the fingers and toes, and mental retardation. Less frequently observed anomalies include cleft lip and palate, microcephaly, ocular defects, cardiovascular anomalies, hypospadias, umbilical and inguinal hernias, and significant developmental delays. Anaesthesia for incidental surgery in such a patient poses unique challenges for the anesthesiologist. We report the successful management of a 4-year-old male child with fetal hydantoin syndrome, cleft palate, spina bifida, atrial septal defect, and dextrocardia for tibialis anterior lengthening under subarachnoid block.
  • 3.

    【2hr】Idiopathic Peripheral Neuropathy Responsive to Sympathetic Nerve Blockade and Oral Clonidine

    包量

    机译 特发性周围神经病变反应交感神经阻滞和口服可乐定
    摘要：A 52-year-old female presented with idiopathic stocking-glove neuropathy. She underwent a series of right and left stellate ganglion blocks with ropivacaine and clonidine, followed by lumbar sympathetic blocks. This resulted in complete symptom relief for two weeks. These procedures were repeated after a two-month interval; at that time she was still experiencing partial relief from the first series. She again remained completely pain free for several weeks following the injections. As the pain partially returned, daily oral clonidine was initiated and resulted in almost complete cessation of her symptoms, which persisted at a three-month follow-up examination.
  • 4.

    【2hr】Spinal Anaesthesia for Emergency Caesarean Section in a Morbid Obese Woman with Severe Preeclampsia

    包量

    机译 患有严重先兆子痫的病态肥胖妇女的紧急剖腹产脊柱麻醉
    摘要：Background. Morbid obesity in a pregnancy is a great challenge to medical practice especially when the patient requires caesarean section. Case Summary. A 38-year-old unbooked gravida 3 Para 2+0 weight 195 kg, height 1.7 m with a blood pressure of 210/160 mmhg had spinal anaesthesia for emergency caesarean section which was technically difficult for severe preeclampsia at 32-week gestation. She had poor wound healing and spent 18 days postoperatively on hospital admission. Conclusion. Morbid obesity is a challenge to both obstetric and anaesthetic practice. Antenatal care is necessary in reducing both maternal morbidity and mortality.
  • 5.

    【2hr】Impossible Airway Requiring Venovenous Bypass for Tracheostomy

    包量

    机译 不可能的气道需要气管切开术进行静脉旁路
    摘要：The elective surgical airway is the definitive management for a tracheal stenotic lesion that is not a candidate for tracheal resection, or who has failed multiple-tracheal dilations. This case report details the management of a patient who has failed an elective awake tracheostomy secondary to the inability to be intubated as well as severe scar tissue at the surgical site. A combination of regional anesthesia and venovenous bypass is used to facilitate the surgical airway management of this patient. Cerebral oximetry and a multidisciplinary team approach aid in early detection of an oxygenation issue, as well as the emergent intervention that preserved this patient's life.
  • 6.

    【2hr】Ambulatory Anesthesia in an Adult Patient with Corrected Hypoplastic Left Heart Syndrome

    包量

    机译 成人成年左室发育不全综合征纠正患者的动态麻醉
    摘要：With recent advancements in clinical science, an increasing number of patients with congenital heart defects are surviving into adulthood and presenting for noncardiac surgeries. We describe one such example of a 26-year-old patient with corrected hypoplastic left heart syndrome presenting for knee arthroscopy and performed under general anesthesia with preoperative ultrasound guided saphenous nerve block. In this case, we review the anesthetic implications of corrected single ventricle physiology, anesthetic implications, as well as discuss the technique and role of saphenous nerve block in patients undergoing knee arthroscopy.
  • 7.

    【2hr】Accidental Intrathecal Injection of Tranexamic Acid

    包量

    机译 意外鞘内注射氨甲环酸
    摘要：Tranexamic acid (TXA) is a popular antifibrinolytic drug that is commonly used in patients with bleeding disorder. Major morbidities and mortalities have been reported following inadvertent intrathecal injection of TXA. In this paper, inadvertent intrathecal injection of TXA has resulted from similarities in appearance between TXA and heavy bupivacaine 0.5% ampoules. The patient experienced severe pain in the back and gluteal region upon injection in association with systemic hypertension and tachycardia followed by generalized myoclonic seizures and ventricular fibrillation.
  • 8.

    【2hr】Unexpected High Sensory Blockade during Continuous Spinal Anesthesiology (CSA) in an Elderly Patient

    包量

    机译 一名老年患者在持续脊柱麻醉期间发生意外的高感觉阻滞
    摘要：A 98-year-old woman presented for a hemiarthroplasty of the left hip. Because of her age and cardiac and pulmonary co-existing diseases we decided to provide adequate regional anesthesia by continuous spinal anesthesia. Fragmented doses of isobaric bupivacaine 0.5% were administered through a system consisting of a spinal catheter connected to an antimicrobial filter. After an uneventful surgical procedure, prior to removal of the catheter, this system was flushed with 10 mL of normal saline in order to try to prevent post-dural-puncture headache. After arrival at the postanesthesia care unit and fifteen minutes after removal of the catheter the patient suffered an unexpected high thoracic sensory blockade and hypotension requiring treatment. The continuous spinal anesthesia technique can be used in selected cases to be able to administer local anesthetic agents in a slow and controlled manner to reach the desired effect. The risk of post-dural-puncture headache using this technique in elderly patients is very low and therefore precludes the need to try to prevent it. We have described a potentially dangerous complication of flushing a bupivacaine-filled system into the spinal canal of an elderly patient resulting in an undesirable high sensory blockade.
  • 9.

    【2hr】Mounier-Kuhn Syndrome: Anesthetic Experience

    包量

    机译 Mounier-Kuhn综合征：麻醉经验
    摘要：Mounier Kuhn syndrome, or congenital tracheobronchomegaly, is an under diagnosed clinical entity with peculiar anatomical and physiological features making anesthetic care challenging. A 58-year-old chronic smoker with history of recurrent pneumonia and bronchiectasis presented for septoplasty. Thoracic imaging revealed a dilated trachea and main bronchi, tracheal and bronchial diverticuli, and chronic bronchiectasis with mediastinal lymphadenopathy. An 8.5 cuffed endotracheal tube (ETT) proved too big for his glottic aperture. An 8.0 cuffed ETT with wet gauze packing yielding an adequate seal. Postoperative continuous positive airway pressure to prevent airway collapse followed awake extubation. Anesthetic concerns include grossly enlarged and weakened airways, inefficient cough mechanisms, presence of tracheal diverticuli, and post operative tracheal collapse. Anesthetic planning includes management of endotracheal cuff size. Small size yields air leak and ineffective ventilation. Large size may lead to mucosal damage. Tube dislodgement, copious secretions, chance of expiratory collapse due to the abnormally dilated and thin airways, and post operative monitoring all must be considered.
  • 10.

    【2hr】BIS-Guided Total Intravenous Anesthesia for Orchiopexy and Circumcision in a Child with Severe Autism: A Case Report

    包量

    机译 BIS指导的严重自闭症儿童的睾丸切除术和包皮环切术全静脉麻醉：一例报告
    摘要：Autistic children are very difficult to manage in the hospital setting because they react badly to any change in routine. We describe a case of 10-year-old male patient with severe autism undergoing orchidopexy and circumcision. Following premedication, anesthesia was induced with remifentanil, propofol, atracurium, and maintained with total intravenous anesthesia (propofol and remifentanil). The Bispectral Index System was monitored for determination of the depth of anesthesia. After surgery, all infusions were discontinued. The patient was then transferred to the postanesthetic care unit. There were no adverse events observed during the anesthetic management. The patient was discharged from the hospital on the second postoperative day. Bispectral Index System-guided Total Intravenous Anesthesia can provide some advantages for patient with autism, such as hemodynamic stability, early and easy recovery, to facilitate faster discharge, to optimize the delivery of anesthetic agents, to minimize its adverse effects, and to maximize its safety.
  • 11.

    【2hr】Unilateral Hemiparesis with Thoracic Epidural in an Adolescent

    包量

    机译 青少年单侧偏瘫伴胸膜硬膜外
    摘要：Objective. Unilateral sensory and motor blockade is known to occur with epidural anesthesia but is rarely reported in children. The differential diagnosis should include the presence of a midline epidural septum. Case Report. We describe a case of a 16-year-old adolescent who developed repeated complete unilateral extensive epidural sensory and motor blockade with Horner's syndrome after thoracic epidural catheter placement. This unusual presentation of complete hemibody neural blockade has not been reported in the pediatric population. Maneuvers to improve contralateral uniform neural blockade were unsuccessful. An epidurogram was performed to ascertain the correct location of the catheter within the epidural space and presence of sagittal compartmentalization. Conclusion. This case report highlights a less frequently reported reason for unilateral sensory and motor blockade with epidural anesthesia in children. The presence of a midline epidural septum should be considered in the differential diagnosis of unilateral epidural blockade.
  • 12.

    【2hr】Anesthesia and Intensive Care Management in a Pregnant Woman with PRES: A Case Report

    包量

    机译 PRES孕妇的麻醉和重症监护管理：一例报告
    摘要：Posterior reversible encephalopathy syndrome (PRES) is a temporary condition that is diagnosed clinically, neurologically, and radiologically. Its symptoms vary, and nonspecific headaches, confusion, impairment of consciousness, nausea, vomiting, and visual impairment may occur. Acute hypertension often accompanies these symptoms. Patients can also suffer from convulsions, cortical visual impairment, and coma. Diagnosis can be difficult due to focal neurologic signs. Nevertheless, knowing the clinical risk factors can lead to the right diagnosis. It has been reported that this condition may also occur during organ transplantation, immunosuppressive treatment, and autoimmune diseases and chemotherapy, and also patients with eclampsia. In this paper, a 21-year-old, 31-week pregnant woman, who had been diagnosed with PRES and thanks to early diagnosis and treatment had fully recovered and discharged from the intensive care unit, is presented, and the relevant literature is discussed.
  • 13.

    【2hr】A Common Anesthesiology Procedure for a Patient with an Uncommon Combination of Diseases: A Case Report

    包量

    机译 罕见疾病合并患者的普通麻醉程序：一例报告
    摘要：Administering neuraxial anesthesia to a patient with an underlying neurological disease and a combination of four other pathological disorders can be challenging. We report in this paper the case of a 45-year-old woman with neurological deficit due to ischemic brain infarct, multiple sclerosis, antiphospholipid syndrome, and β-heterozygous thalassemia that was subjected to abdominal hysterectomy and bilateral salpingoophorectomy under epidural anesthesia for ovarian cancer.
  • 14.

    【2hr】Ultrasound-Guided Popliteal Nerve Block in a Patient with Malignant Degeneration of Neurofibromatosis 1

    包量

    机译 超声引导的Pop神经神经阻滞患者神经纤维瘤病1的恶性变性
    摘要：A 41-year-old female patient with neurofibromatosis 1 presented with new neurologic deficits secondary to malignant degeneration of a tibial lesion. Ultrasound mapping of the popliteal nerve revealed changes consistent with an intraneural neurofibroma. Successful popliteal nerve blockade was achieved under ultrasound guidance.
  • 15.

    【2hr】Fever following an Epidural Blood Patch in a Child

    包量

    机译 小儿硬膜外血液修补后的发烧
    摘要：There is increasing evidence that children suffer from the consequences of spontaneous or iatrogenic intracranial hypotension. Pediatric epidural blood patch is gaining popularity because of its ability to alter cerebrospinal fluid dynamics and to alleviate headaches attributed to low cerebrospinal fluid pressure. There is, however, still not enough data to document the safety profile of an epidural blood patch. Here we describe a case of a fever in a child temporally related to the administration of an epidural blood patch. This case depicts the dilemmas in making the diagnosis and instituting treatment for complications of this procedure in the pediatric population.
  • 16.

    【2hr】Inability to Ventilate after Tube Exchange Postoperative to Pneumonectomy

    包量

    机译 进行肺切除术的换管后无法通气
    摘要：We report a case of inability to ventilate a patient after completion of pneumonectomy, due to migrated tumor tissue to the contralateral side. This represents an unusual complication with a high mortality rate. We have managed to find the cause in time and were able to remove the obstructive tissue using bronchoscopy.
  • 17.

    【2hr】Intraoperative Pontine Infarction: A Hidden Challenge

    包量

    机译 术中桥性脑梗死：一项隐藏的挑战
    摘要：Apneusis, or apneustic respirations, is characterized by an abnormal breathing pattern involving gasping and the inability to fully expire. A loss of gag reflex and other cranial nerve deficits are also often accompanied with these respiratory changes. In neurological intensive care units (NICUs), these respiratory and airway changes are not uncommon and have been well documented (Lee et al. 1976). These clinical changes are often associated with pontine trauma as it is the core pneumotaxic center in the brain stem. We describe the airway management of a patient with an acute, occult pontine infarct status post craniectomy and cervical laminectomy for decompression of known Chiari malformation in the postanesthesia care unit (PACU).
  • 18.

    【2hr】Submental Intubation Including Extubation: Airway Complications of Maxillomandibular Fixation

    包量

    机译 包括拔管在内的皮下气管插管：上颌下颌固定的气道并发症
    摘要：Hernandez first described the submental route for endotracheal intubation in 1986 as an alternative airway maneuver for maxillofacial procedures. Since that time, several case studies have been performed demonstrating the efficacy of the submental approach. This method was recently implemented in the case of a patient with altered nasal anatomy who sustained a mandibular fracture necessitating maxillomandibular fixation. Unlike most of the cases described in the literature, this patient's operative course was confounded by the need to extubate through the submental tunnel. The patient tolerated the procedure well and was able to avoid other forms of surgical airway.
  • 19.

    【2hr】Asystole following Reintubation during Suspension Laryngoscopy

    包量

    机译 悬吊喉镜检查中再插管后的心搏停止
    摘要：Transient increase in heart rate and mean arterial pressure commonly occur during manipulation of the airway via direct laryngoscopy. This phenomenon is understood to be due to a sympathetic nervous system reflex causing an increase in plasma catecholamines. Rarely, severe bradycardia and possible asystole can occur following laryngoscopy. One previous report described asystole during suspension laryngoscopy after uneventful direct laryngoscopy. Here we report a case of asystole occurring at the time of reinsertion and cuff inflation of an endotracheal tube in a patient who had been hemodynamically stable during initial direct laryngoscopy and the ensuing suspension laryngoscopy. The asystole was immediately recognized and successful cardiopulmonary resuscitation was performed with the patient returning to baseline sinus rhythm. Cardiac arrest following laryngoscopy is rare. This case highlights the importance of continued vigilance even after the initial manipulations of the airway by both direct laryngoscopy and suspension laryngoscopy are to be performed. Identifying patients who may benefit from premedication with a vagolytic drug may prevent adversity. Preoperative heart rate analysis can identify patients with strong vagal tone.
  • 20.

    【2hr】Inverted Takotsubo-Like Left Ventricular Dysfunction with Pulmonary Oedema Developed after Caesarean Delivery Complicated by Massive Haemorrhage in a Severe Preeclamptic Parturient with a Prolonged Painful Labour

    包量

    机译 严重先兆子痫伴长期痛性分娩的剖腹产并发大量出血后，发生倒Takotsubo样左心功能不全伴肺水肿。
    摘要：Inverted takotsubo cardiomyopathy (TTC), a variant of stress-induced cardiomyopathy, features transient myocardial dysfunction characterized by a hyperdynamic left ventricular apex and akinesia of the base. Herein, we describe a 38-year-old primigravida with severe preeclampsia who had active labour for 4 h followed by an emergency caesarean delivery. She developed postpartum haemorrhage due to uterine atony complicated by pulmonary oedema, which was managed with large-volume infusion and hysterectomy. Her haemodynamic instability was associated with cardiac biomarkers indicative of diffuse myocardial injury and echocardiographic findings of an “inverted” TTC. The patient was almost fully recovered one month later. Our case shows that a reversible inverted TTC may result from a prolonged painful labour. TTC should be listed in the differential diagnosis of the patient presenting with pulmonary oedema of unknown origin, especially in patients with severe preeclampsia.
题名 作者 来源 发表时间

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号