A&A practice
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Case Reports
Not Your Typical Dyspnea of Pregnancy: A Case Report of Transcatheter Valve-in-Valve Replacement During Pregnancy.
Because technology for valvular replacement continues to evolve, we expect it to be further reaching in the applications for intermediate- to high-risk surgical candidates. Although the patient population for transcatheter aortic valve replacement has widened, it is still extremely rare in the pregnant patient. ⋯ The patient experienced an excellent outcome after comprehensive coordination across multiple services. We discuss anesthetic considerations in the care of the pregnant patient for transcatheter aortic valve implantation.
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Upper airway obstruction during anesthesia is the leading cause of complications during sedation, intubation, and emergence. Devices to support oxygenation and ventilation are costly, require capital equipment, and cannot be used during transport. ⋯ The SuperNO2VA nasal mask provided high-flow nasal oxygen and positive pressure during awake fiberoptic intubation and on extubation, maintaining airway patency in the operating room, during transport, and in recovery. The SuperNO2VA is inexpensive and portable and should be considered for high-risk patients with difficult airways.
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Case Reports
Laparoscopic Surgery in Infants Under Spinal Anesthesia Block: A Case Report of 3 Cases.
Spinal anesthesia (SA) is a valuable alternative to general anesthesia in infants, but laparoscopic surgery is considered a contraindication in this age group. We report 3 cases of SA for inguinal hernia repairs. The contralateral inguinal region was explored by laparoscopic port placement and pneumoperitoneum through the surgical site. ⋯ Opioids were spared in 2 patients. Pain scores were low throughout. SA as a primary anesthetic may be used in pediatric laparoscopic procedures.