A&A practice
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Case Reports
Radiofrequency Ablation of the Stellate Ganglion for Management of Acute Digital Ischemia: A Case Report.
The authors present a report of a pulsed radiofrequency ablation of the stellate ganglion performed on a patient with microemboli to the hand from a thrombosed abandoned arteriovenous fistula. The patient was initially managed using vasodilators and anticoagulation. ⋯ Ablation of the stellate ganglia increased perfusion to his hand and likely prevented amputation that has lasted for approximately 1 year. While radiofrequency ablation is more commonly used for pain syndromes, this is an example of its use in the treatment and potential treatment of acute ischemia.
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Neonates with laryngeal webs pose unique challenges to the anesthesiologist. We present a 2-day-old neonate with aphonia and stridor who underwent microdirect laryngoscopy. Intraoperatively, a Cohen type 4 laryngeal web was diagnosed not immediately amenable to resection. ⋯ After endotracheal intubation, there was acute respiratory compromise and oxygen desaturation that improved moderately after urgent tracheostomy. A chest radiograph revealed a large pneumothorax. Our experience suggests that in the presence of high-grade laryngeal webs, the possibility of intraoperative development of pneumothorax should be considered if respiratory difficulties are encountered.
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Case Reports
Continuous Pectoral Fascia Blocks for Postoperative Analgesia After Median Sternotomy: A Case Report.
We report a novel case of a patient who presented for aortic valve replacement via median sternotomy. Bilateral continuous pectoral fascia blocks were placed to provide postoperative analgesia. Both numerical rating scale pain scores and opioid consumption after surgery were suggestive of analgesic benefit.