Journal of clinical anesthesia
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To describe the success and complication rate of intraosseous (IO) access for delivery of anesthesia with the use of an 18-gauge (G) intravenous (IV) needle. ⋯ The IO route provided for rapid delivery of anesthesia, induction, and maintenance in this series of critically ill infants undergoing emergency surgery when other vascular access routes failed. Few complications were noted. Intraosseous access was achieved through a simple technique using an 18-gauge IV needle.
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Observational Study
Anesthetic implications for robot-assisted transaxillary thyroid and parathyroid surgery: a report of twenty cases.
Gasless transaxillary robot-assisted endoscopic thyroid surgery has recently been proposed and developed in South Korea and the United States. Perianesthetic implications and their evolution for 20 patients scheduled to undergo this innovative surgical technique are presented. The anesthetic considerations focus on the length of surgery due to the learning curve, the risk of the ipsilateral arm posture, and postoperative pain evaluation and management.
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Case Reports
Paraneoplastic limbic encephalitis in a patient with adenocarcinoma of the colon: a case report.
Paraneoplastic limbic encephalitis is a rare clinical entity characterized by the development of neuropsychiatric symptoms associated with malignancies. A case of a woman who presented to the Emergency Department with abdominal pain, hyperglycemia, and altered mental status is presented. After initial stabilization and correction of hyperglycemia the patient underwent emergency surgery. ⋯ Magnetic resonance imaging (MRI) showed hyperintensities in both hippocampal areas, and electroencephalography (EEG) showed sharp-wave activity in the temporal lobes. Cerebrospinal fluid (CSF) examination showed slightly elevated protein levels, and laboratory assessments showed an elevated titer of anti-Yo antibodies. Although we do not have pathological confirmation of limbic encephalitis, the diagnosis of paraneoplastic limbic encephalitis was presumed on the basis of MRI findings, EEG abnormality, elevated CSF protein, positive anti YO antibodies, and neurological findings.
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Case Reports
Transient hemidiaphragmatic paresis after ultrasound-guided lateral sagittal infraclavicular block.
As compared with medial approaches for the infraclavicular brachial plexus block, lateral approaches generally have no impact on the phrenic nerve or pulmonary function. A patient experienced transient hemidiaphragmatic paresis after ultrasound-guided lateral sagittal infraclavicular block for lower arm surgery. An accessory phrenic nerve, ie, an anatomical variation, may have been the mechanism of transient hemidiaphragmatic paresis in this patient.