A&A practice
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Case Reports
Hypermetabolic Syndrome and Dyskinesia After Neurologic Surgery for Labrune Syndrome: A Case Report.
A 20-year-old man with a rare neurodegenerative disease developed hypermetabolic symptoms with dyskinesia after a third ventriculostomy for hydrocephalus. The initial presentation was concerning for an acute dystonic reaction after metoclopramide was administered for nausea. ⋯ The diagnosis was broadened to include neuroleptic malignant syndrome, serotonin syndrome, and malignant hyperthermia. Although perhaps less intellectually satisfying but more true to clinical reality, we did not isolate a single diagnosis but treated effectively all 3 with dantrolene sodium and benzodiazepine.
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Case Reports
Use of Augmented Reality During Inhaled Induction of General Anesthesia in 3 Pediatric Patients: A Case Report.
Preoperative anxiety is common in children undergoing surgery and general anesthesia (GA). Augmented reality (AR), an interactive technology that superimposes computer-generated information on the real-world environment, can be a valuable tool to address preoperative anxiety. ⋯ Patients and parents were satisfied with the experience and described less patient anxiety as compared to previous inductions. AR can be beneficial as an adjunct or alternative to existing pharmacologic and behavioral distraction techniques for preoperative anxiety.
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We report weaning from mechanical ventilation with no coughing in a patient with coronavirus disease 2019 (COVID-19). Substituting the endotracheal tube for a supraglottic airway (SGA), which is less stimulating to the trachea, can reduce coughing with weaning from mechanical ventilation and extubation. Personal protective equipment is in short supply worldwide. Reducing spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is beneficial in terms of occupational health of health care workers.
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Case Reports
Neuraxial Morphine-Induced Hypothermia After Cesarean Delivery Managed With Nalbuphine: A Case Report.
Neuraxial morphine-induced hypothermia has been reported as a relatively rare complication, with the successful use of naloxone and lorazepam to reverse symptoms. We report a case of intrathecal morphine-induced hypothermia with profuse sweating, intractable nausea, and vomiting in a primigravid woman undergoing cesarean delivery in the setting of preeclampsia. All symptoms rapidly resolved after a single dose of intravenous nalbuphine. Because nalbuphine has a long track record of safe use on labor and delivery units, it is an attractive and novel choice for treatment of neuraxial morphine-induced hypothermia.