A & A case reports
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A 19-year-old girl suffered an unexpected gasoline-associated chemical burn injury that may have been intensified by a warming device and tissue pressure in the operating room. Anesthesiologists should be aware that serious skin injury may result from combination of cutaneous exposure to hydrocarbons, especially when warming devices are simultaneously used.
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An 8-year-old girl with McCune-Albright syndrome presented for resection of a very large fibrous dysplasia mass of the face with significant distortion of the airway anatomy. She had significant obstructive sleep apnea with daytime somnolence and hemoglobin oxygen desaturations while breathing room air preoperatively. We were able to successfully manage her airway by providing IV sedation, topical anesthesia of the airway, and oral fiberoptic intubation in close collaboration with our otorhinolaryngology colleagues.
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Hyphema, an ophthalmic pathology characterized by blood accumulation in the anterior chamber of the eye, has never been linked to administration of general anesthesia. We present the case of a spontaneous hyphema occurring on emergence from general anesthesia in a postlaparoscopic appendectomy patient. A valsalva-like maneuver with breath-holding during stage II of emergence or during CO2 insufflation may have led to the development of hyphema.
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Hair loss after surgery has many causes. If the onset is acute and it lasts for several months, it is often attributed to telogen effluvium. A case is presented where hair loss occurred after a surgical procedure, but it did not recur after a subsequent procedure with a similar anesthetic.
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Patients with glutaric aciduria type I are at risk for acute striatal injury precipitated by catabolic stress. Here, we report the successful interdisciplinary anesthetic and perioperative management of a child with glutaric aciduria type I undergoing cardiac surgery with extracorporeal circulation. Given the central focus on prevention of acute striatal injury, our anesthetic strategy emphasized avoiding a high protein load, high-dose inotropics, especially epinephrine (associated with impaired glucose utilization), deliberate hyperventilation, and other interventions associated with systemic inflammatory response.