A&A practice
-
Epidural steroid injections (ESI) are an effective nonsurgical option for the management of chronic lower back pain. Despite the increased frequency of ESI for low back pain management, there is a paucity in the literature surrounding systemic long-term effects. ⋯ This case report describes the development of anorgasmia in a 49-year-old man with chronic low back pain and bilateral leg radiculopathy, after a fluoroscopically guided L5/S1 interlaminar ESI with dexamethasone. This adverse effect highlights, to the best of our knowledge, the first documented case of anorgasmia after an ESI.
-
Hip disarticulation is a morbid procedure for those whose bony or soft tissues are unable to be salvaged. It involves extensive resection, and the patient featured in this report expressed mechanical pain from their sacroiliac joint (SIJ) as well as phantom limb pain (PLP). Spinal cord stimulation is known to assist with neuropathic pain syndromes, and SIJ fusion is effective in these cases of multifactorial pain. This report presents a successful off-label use of thoracic spinal cord stimulation in a complex pain condition consisting of coexisting PLP and mechanical SIJ pain in a hip disarticulation patient.
-
Review Case Reports
Hereditary Angioedema in Pregnancy: A Case Report and Review of Obstetric Anesthesia Management.
Hereditary angioedema (HAE) is a rare disorder due to C1 esterase inhibitor deficiency, causing recurrent swelling. Pregnancy can exacerbate HAE due to estrogen fluctuations alongside peripartum stress and trauma. ⋯ Angioedema prevention involves timely anesthesia consultation, accessible emergency airway equipment, early neuraxial anesthesia, planned vaginal delivery, and 48 to 72 hours of close postpartum monitoring. Readily available C1-inhibitor and a multidisciplinary approach with these recommendations are crucial for peripartum management.