A & A case reports
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Case Reports
Chest Pain During Cesarean Delivery in Relation to Anomalous Right Coronary Artery: A Case Report.
Chest pain during labor can have many etiologies, one of which is myocardial ischemia. We report a 38-year-old woman with American Society of Anesthesiology physical status I scheduled for elective cesarean delivery who experienced chest pain and electrocardiographic signs of myocardial ischemia immediately after carbetocin administration. ⋯ This was considered the likely cause of the patient's chest pain. The patient gave written permission for the authors to publish this report.
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Case Reports
Elective Venovenous Extracorporeal Membrane Oxygenation for Resection of Endotracheal Tumor: A Case Report.
We present a case in which we electively used venovenous extracorporeal membrane oxygenation (VV-ECMO) to facilitate safe resection of a nearly obstructing airway tumor near the carina in a 37-year-old male. The patient was brought to the operating room and underwent bifemoral cannulation for VV-ECMO under light sedation while maintaining spontaneous ventilation. After VV-ECMO was initiated, general anesthesia was induced, and the tumor was resected via rigid bronchoscopy. After resection, the patient was intubated, weaned from ECMO, decannulated, awoken, extubated, and taken to the postanesthesia care unit for recovery.
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In a patient undergoing thoracoscopic esophagectomy and concomitant wedge resection, an iatrogenic lesion in the left main bronchus was observed following deflation of the right lung. Because the bronchial cuff of the double-lumen tube was visible through the lesion, repair was only possible after deflation of the bulging cuff. ⋯ This challenging situation was resolved using the Ventrain device to oxygenate the patient through a small-bore catheter placed through the lumen beyond the bronchial defect. With the use of this technique, oxygenation was maintained at an acceptable level during repair.
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Case Reports
Intraoperative Hyperkalemia and Ventricular Arrhythmia During Parathyroidectomy: A Case Report.
We present a case of acute hyperkalemia and ventricular arrhythmia during parathyroidectomy in a patient with end-stage renal disease. This case highlights the under-recognized alterations in potassium homeostasis associated with parathyroidectomy and underscores the importance of preoperative optimization.
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Case Reports
Temporary Decompression of Symptomatic Epidural Hematoma via an In Situ Epidural Catheter: A Case Report.
Spinal epidural hematoma (SEH) following neuraxial anesthesia needs prompt recognition and early decompressive measures to prevent long-term neurologic injury. We report a case of SEH presenting on the second postoperative day during an ongoing epidural infusion. ⋯ We describe the timeline of the presentation of SEH and the subsequent clinical course in our patient. Aspiration of blood through an in situ epidural catheter may not only point toward the possibility of SEH but may also temporarily decompress the spinal canal.