Journal of clinical anesthesia
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The dorsal scapular nerve, a proximal branch of the brachial plexus, may be imaged using ultrasound. This nerve supplies the rhomboid and levator scapulae muscles while providing significant sensory innervation to the scapula. An ultrasound-guided nerve block of the dorsal scapular nerve provided analgesia after surgery of the scapula. Selective blockade of this nerve, without blocking the remainder of the brachial plexus, results in specific analgesia of the scapula, sparing sensory and motor function of the ipsilateral arm.
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The management of an infant who underwent corrective surgery for a supracardiac total anomalous pulmonary venous drainage, which was complicated by the development of pulmonary hemorrhage while separating from cardiopulmonary bypass, is presented. Initiation of high-frequency oscillatory ventilation was effective in weaning the patient off cardiopulmonary bypass.
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To determine the relationship between preoperative catecholamine levels and intraoperative peak plasma lactate levels in patients who underwent adrenalectomy for pheochromocytoma. ⋯ Catecholamine release caused by surgical manipulation may be a possible cause of intraoperative transient lactic acidosis, and it should be considered as a differential diagnosis of intraoperative lactic acidosis. Intraoperative peak plasma lactate level was correlated with preoperative epinephrine-releasing activity.
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A 65 year old man presented with fever, pancytopenia, hypoxemia, and cardiovascular collapse requiring intensive care unit admission. Computed tomographic pulmonary angiogram showed a right-sided mediastinal mass adjacent to the right atrium. ⋯ This shunt could be reversed with a norepinephrine infusion, resulting in improved oxygenation. Histopathology showed potentially curative diffuse large B cell lymphoma (DLBCL).
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Observational Study
Observational study of Mallampati changes after prone spinal surgery.
To evaluate airway changes in patients undergoing surgery in the prone position. ⋯ Modified Mallampati scores increased in the majority of patients after spinal surgery in the prone position.