Anesthesia and analgesia
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Anesthesia and analgesia · Jan 2011
Case ReportsCase report: computed tomography scan-guided Gasserian ganglion injection of dexamethasone and lidocaine for the treatment of recalcitrant pain associated with herpes simplex type 1 infection of the ophthalmic division of the trigeminal nerve.
We describe the case of a 17-year-old boy with dermatologic herpes simplex virus-1 outbreaks with incapacitating facial pain requiring multiple hospitalizations. He failed to respond to aggressive treatments including antiviral drugs, opioid analgesics, stellate ganglion, and supraorbital and supratrochlear nerve blocks. ⋯ The patient remained pain free during 6-month follow-up visits. This is the first reported use of Gasserian ganglion block for treatment of herpes simplex virus-1 infection of the trigeminal nerve.
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Anesthesia and analgesia · Jan 2011
Case ReportsCase report: intracranial placement of a nasotracheal tube in a patient with Goldenhar syndrome associated with cribriform plate agenesis.
We describe a case of inadvertent intracranial placement of a nasotracheal tube in a patient with an undiagnosed major congenital cranial anomaly (a variant of Goldenhar syndrome, which included absence of the cribriform plate). We believe that this is the first reported case in which this complication arose as a result of a congenital abnormality rather than traumatic or iatrogenic disruption of the skull base. We conclude that patients with known craniofacial abnormalities or associated syndromes scheduled for procedures involving planned nasotracheal intubation or nasogastric tube placement should undergo preoperative cranial imaging studies to verify an intact skull base.