A&A practice
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Review Case Reports
Bilateral Sciatic Neuropathies as a Complication of Positioning During Neuraxial Anesthesia for Cesarean Delivery: A Case Report.
Neurologic complications following neuraxial anesthesia for cesarean delivery are rare. We present a 33-year-old parturient who developed prolonged lower extremity weakness following a single-shot subarachnoid block for cesarean delivery. ⋯ We review the incidence of nerve injury associated with neuraxial anesthesia and risk factors for developing peripheral nerve injury in this context. We offer a solution to prevent this complication from occurring.
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Percutaneous cryoablation of pulmonary tumors at the posterior lung base is challenging due to diaphragmatic motion and the requirement for prone positioning. High-frequency jet ventilation allows oxygenation and ventilation with minimal diaphragmatic movement. In this case report, we describe the use of high-frequency jet ventilation in the prone position to facilitate the cryoablation of a peridiaphragmatic pulmonary neoplasm.
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Shoulder surgery in the beach chair position is routinely performed, and central neurological events are rare but potentially devastating. We present a patient with transient neurological deficits after a sudden blood pressure drop with a simultaneous decrease of regional cerebral saturation values registered by cerebral oximetry. We reviewed published cases and proposed possible strategies to prevent the occurrence of similar complications in this context.
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We report the case of a 55-year-old woman who required extracorporeal membrane oxygenation for extreme respiratory distress after a liver transplant and eventually died. As is so often the case, this patient's values and wishes were not documented before she had a risky surgical procedure. Anesthesiologists, in partnership with surgeons, can participate in preoperative discussions exploring wishes and values and document them in advance directives which will help clinicians respect patients' preferences.
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Case Reports
Peripartum Hyperkalemia Caused by Magnesium Infusion in a Woman With End-Stage Renal Disease: A Case Report.
Pregnancy in the setting of renal failure has higher rates of adverse events necessitating increased monitoring and treatment. Pregnant women with end-stage renal disease have higher rates of hypertension, and 50% of pregnancies are complicated by preeclampsia. ⋯ The magnesium infusion was stopped, and the patient underwent emergent hemodialysis with subsequent improvement. Hyperkalemia caused by magnesium infusion is a rare and not very well-understood phenomenon.