A & A case reports
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Ethanol sclerotherapy is a first-line treatment for low-flow vascular malformations. Although many complications of ethanol sclerotherapy have been described in the literature, bronchospasm is uncommon. We present a case of a patient in whom bronchospasm was precipitated by injection of ethanol during percutaneous sclerotherapy for craniofacial venous malformations that occurred during general anesthesia. The evidence for ethanol-induced bronchospasm is discussed.
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Extracorporeal life support may be used in patients with refractory cardiogenic shock. The femoral venoarterial route can be used for implanting cannulae in patients who are hemodynamically unstable. ⋯ The procedure was performed using 40 mL of a 50:50 mixture of 0.5% levobupivacaine and 2% lidocaine (30 mL for transversus abdominis plane and 10 mL for genitofemoral block) associated with low-dose remifentanil infusion during spontaneous breathing. A left ventricular assist device was successfully implanted 4 days later.
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The mucopolysaccharidoses are a group of lysosomal storage diseases with many skeletal and airway features that pose a challenge to anesthetists. We present the anesthetic management of a woman with mucopolysaccharidosis type VI undergoing cervical spine surgery and review the perioperative issues that may arise with this disease.
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Understanding the functioning of modern anesthesia workstations is very important because workstation failures in the intraoperative period may place the patient at risk of perioperative hypoxia and lead to unnecessary anxiety and confusion among anesthesia care providers. We present and simulate a critical event leading to Dräger Fabius GS ventilator failure.
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Current literature reports a 3.1% incidence of durotomy with spine surgery, and this number increases to 15.9% with revision spine surgery. With the use of a blood patch to treat a dural tear, the anesthesia team was able to prevent a second reoperation. This treatment option offers anesthesiologists the opportunity to minimize further patient harm and increased cost associated with dural tears.