A&A practice
-
Case Reports
An Unusual Incident of "Cannot Ventilate" Situation Due to a Broken Soda Lime Canister: A Case Report.
The circle breathing system enables rebreathing using a carbon dioxide absorbent. This case report presents a rare incident of ventilation failure in a 30-year-old male patient due to a broken unidirectional valve in a soda lime canister. Despite the anesthesia machine passing automated checks, a mechanical blockage from caked soda lime in the inner inspiratory chamber led to insufficient tidal volume delivery. The incident underscores the importance of performing manual breathing circuit checks after replacing the soda lime canister, as well as the need for heightened vigilance in detecting equipment malfunctions to maintain patient safety during anesthesia.
-
Patients with aortic stenosis (AS) and other significant cardiopulmonary comorbidities are vulnerable to hemodynamic instability during anesthesia. This case report compares the use of remimazolam and midazolam in a 71-year-old man with symptomatic AS, chronic kidney disease, and ischemic cardiomyopathy. ⋯ While moderate sedation with midazolam resulted in significant hypotension, use of remimazolam in subsequent procedures demonstrated a stable hemodynamic profile despite increased disease burden. This report highlights the potential advantages of remimazolam compared to midazolam in high-risk patients undergoing interventional radiology procedures.
-
Case Reports
Anesthesia for Cesarean Delivery in a Patient With Spondylocostal Dysostosis: A Case Report.
Spondylocostal dysostosis (SCD) is an inherited skeleton growth disorder characterized by abnormalities of the vertebrae and ribs. Individuals are susceptible to kyphoscoliosis and pulmonary complications, which may be exacerbated by respiratory physiologic changes in pregnancy. We present a case of a parturient with severe kyphoscoliosis and restrictive lung disease who received a modified rapid sequence induction and transabdominal plane blocks for cesarean delivery. Our case describes the safe administration of general anesthesia for cesarean delivery and reviews the anesthetic considerations for managing patients with SCD.