A&A practice
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Pain after limb amputation is frequently challenging to adequately treat with local anesthetic-based regional anesthesia techniques due to its relatively long duration. Furthermore, uncontrolled pain in the immediate postoperative period is associated with persistent postsurgical pain, and frequently phantom limb pain. ⋯ All reported profound analgesia in the postoperative period without persistent postsurgical residual limb or phantom pain in the following months. No adverse events associated with the cryoneurolysis procedure occurred.
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Case Reports
Right-to-Left Shunt During Transseptal Mitral Valve-in-Valve Replacement: A Case Report.
The following case report details an 88-year-old woman with severe mitral stenosis and moderate mitral regurgitation who presented with worsening dyspnea on exertion. The patient had undergone 4-vessel coronary artery bypass graft and mitral valve replacement 14 years before and was deemed high risk for redo sternotomy. ⋯ Successful atrial septal defect closure resolved the hypoxia and hypotension. The patient had a brief and uncomplicated postoperative course.
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Patients who are Jehovah's Witnesses are known to the medical community for frequently declining blood products, even at times of life-threatening anemia. Alternatives to red blood cell transfusion are being developed, including hemoglobin (Hb)-based oxygen carriers. We present the case of a 77-year-old male Jehovah's Witness who underwent a cystoprostatectomy and radical nephrectomy with a postoperative Hb nadir of 4.5 g/dL. He received an Hb-based oxygen carrier, PEGylated carboxyhemoglobin bovine (Sanguinate), with gradual improvement in anemia symptoms and eventual discharge to a short-term rehabilitation facility.