A&A practice
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Transporting spontaneously ventilating adults with tracheostomies from the operating room (OR) or other anesthetizing locations to the intensive care unit (ICU) or other recovery locations presents significant challenges, as traditional T-pieces may not be readily available. This article describes a novel modification to the Ayre's T-piece, designed to address this gap by using readily available equipment. The modification integrates a 3-mL syringe, a size 7.0 endotracheal tube (ETT) connector, and oxygen tubing from an adult under-the-chin style facemask while adapting the expiratory and inspiratory limbs of the anesthesia circuit.
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Case Reports
Stellate Ganglion Block for Electrical Storm Associated With Takotsubo Cardiomyopathy: A Case Report.
Takotsubo cardiomyopathy (TCM) is a reversible condition characterized by apical ballooning of the left ventricle, primarily triggered by catecholamine discharge due to stress. Patients may present with symptoms similar to acute coronary syndrome or with refractory ventricular arrhythmias such as QT prolongation, ventricular tachycardia, and ventricular fibrillation. We report a case of TCM with prolonged QT intervals and refractory ventricular arrhythmias, triggered by noncardiac systemic insult, that responded successfully to stellate ganglion block (SGB). This case highlights the potential of SGB as an effective intervention for managing refractory arrhythmias in TCM patients.
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PHARC syndrome (polyneuropathy, hearing loss, ataxia, retinitis pigmentosa, and cataracts) is a rare autosomal recessive disease, caused by genetic mutation of the ABHD12 gene. This syndrome is still not well known and can be misdiagnosed, especially in the early stages, as it can be easily confused with other neurodegenerative diseases. We present the first description of the anesthetic management of 2 siblings with PHARC syndrome who underwent unilateral cochlear implantation.