A&A practice
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Effective pain management is crucial for modified radical mastectomy (MRM) surgeries. The Serratus Posterior Superior Intercostal Plane Block (SPSIPB), introduced in 2023, shows promise for postoperative analgesia. ⋯ NRS scores of patients were ≤4 and total tramadol consumption was 0 mg in 3 of 7 patients. In conclusion, SPSIPB appears to be an effective, safe, and easily applicable option for analgesia.
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Case Reports
Airway Management May Not Improve in Adult Patients With Pierre Robin Sequence: A Case Report.
Infants with Pierre Robin sequence present with difficult airways due to their triad of micrognathia, glossoptosis, and cleft palate. This creates a difficult airway to intubate and ventilate. ⋯ Surgeries, such as coronoidectomy, have been found to ease the difficulty of intubation in pediatric patients, but the results are not always permanent. We present an adult with Pierre Robin sequence who continued to have a difficult airway, suggesting that airway management does not necessarily improve with age.
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In Switzerland, approximately 32,000 patients are hospitalized annually due to adverse drug reactions (ADRs), representing 2.3% of all hospitalizations. During the perioperative period, the administration of a variety of drugs from different classes over a relatively short period of time increases the risk of ADR. ⋯ Six hours after the event, she was extubated without residual effects. We discuss potential ADR for droperidol.
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We report 2 cases of gastrointestinal bleeding and profound anemia in Jehovah's Witness patients (with nadir hemoglobin of 2.1 and 2.8 g/dL), both of whom survived until discharge to home. Management included supportive care, antifibrinolytics, and an aggressive erythropoietic regimen. Despite previous reports of high mortality with hemoglobin concentrations less than 5 to 6 g/dL, these patients illustrate that meticulous care in selected patients with severe anemia can lead to successful outcomes, without transfusion.
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Parkinsonism-hyperpyrexia syndrome (PHS) is a rare, fatal complication of Parkinson's disease (PD) that manifests in patients who abruptly discontinue or reduce their antiParkinsonian medication. To the best of our knowledge, this is the first report of a PHS case occurring in a patient undergoing general anesthesia. In the perioperative period of PD patients, it is important for anesthesiologists to prevent PHS as well as monitor patients to enable early detection and prompt response when it occurs.