A&A practice
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Among the 2 million amputees in the United States, 60% to 90% will experience phantom limb pain (PLP). Managing PLP presents challenges with current evidence-based pharmacological and interventional therapies yielding varied results. ⋯ This case highlights further evidence supporting ST for PLP over 5 years. Furthermore, we provide clinical images of the amputation with ST electrodes as well as a 5-year record of pain and Edmonton Symptom Assessment System scores.
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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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Case Reports
Anesthetic Management of Cardiopulmonary Bypass in Hutchinson-Gilford Progeria Syndrome: A Case Report.
Hutchinson-Gilford Progeria Syndrome (HGPS) is an ultrarare disorder of segmental premature aging that is associated with the development of advanced atherosclerosis and significant cardiovascular and cerebrovascular disease. Treatment with lonafarnib has improved survival in patients with HGPS; however, in extended longitudinal follow-up, there has been an increase in the prevalence of rapidly progressive calcific aortic stenosis. The evolving course of HGPS has prompted reconsideration of conservative management and led to the development of strategies for anatomic treatment. In this case report, we describe the anesthetic management of patients with HGPS undergoing surgical management of aortic stenosis with cardiopulmonary bypass.
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We evaluated whether a hospital-based anesthesia department can validly use automated intensive care unit (ICU) admission data after elective ambulatory procedures to assess the quality of anesthetic care. Among 13,656 patients, 25 (0.2%) had an unplanned hospital length of stay >1 night and ICU admission. ⋯ The false-positive incidence of anesthetic complications was ≥96% for scheduled ambulatory cases with ICU admission. Therefore, fully automated computerized identification of all unexpected ICU admissions after ambulatory procedures without manual review is an unsuitable (invalid) metric of individual anesthesiologists' clinical performance.