A&A practice
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We present a case of a child with Aicardi-Goutières Syndrome (AGS) undergoing general anesthesia for placement of a laparoscopic gastrostomy tube. AGS is a rare genetic leukodystrophy that can affect most organ systems with extensive neurologic effects. ⋯ We describe our anesthetic management and discuss these implications. The patient had a prolonged duration of action of rocuronium and an otherwise uneventful anesthetic course.
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Effective rescue after failed intubation is important to limit the number of attempts and patient risk. Nothing is known about the Total Control Introducer's (TCI) effectiveness as an intubation rescue device. A single system's airway management database was studied. ⋯ First-pass success was 32 of 33 (97%). First-pass rescue was successful in 12 of 12 (100%) after video and direct laryngoscopy had failed. In this case series, the TCI was found to be a highly effective rescue technique after failed direct and video laryngoscopy.
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Sugammadex, given its high affinity for amino-steroid neuromuscular blockers, offers rapid and reliable neuromuscular blockade reversal, making it a popular reversal agent. This characteristic can be very useful in pregnant women, where incomplete reversal can have poor maternal and fetal outcomes. However, its use antenatally in pregnancy is controversial given concerns for progesterone binding, a hormone that is crucial for maintenance of pregnancy. This case series presents obstetric and fetal outcomes in 25 pregnant women who received sugammadex during the antenatal period, thus highlighting the need for further research into the safety of sugammadex during pregnancy.