Orthotopic Liver Transplantation in a Patient with Acutely Decompensated Liver Disease and Personal History of Malignant HyperthermiaRead the full article
Case Reports in Anesthesiology publishes case reports and case series related to anesthetic administration and efficacy, preoperative and postoperative considerations, perioperative care, critical care etc.
Case Reports in Anesthesiology maintains an Editorial Board of practicing researchers from around the world, to ensure manuscripts are handled by editors who are experts in the field of study.
Abstracting and Indexing
Latest ArticlesMore articles
Airway Management of Esophageal Atresia and Tracheoesophageal Fistula Combined with Anal Atresia
Esophageal atresia (EA) associated with tracheoesophageal fistula (TEF) is a common congenital airway anomaly and may be associated with other gastrointestinal abnormalities. Neonates with EA/TEF are at high risk of gastrointestinal distension due to the shunting of air via the fistula, leading to progressive diaphragmatic elevation and regurgitation of the gastrointestinal contents. EA/TEF associated with anal atresia in a neonate makes airway management even more challenging particularly when managed for the repair of TEF through thoracotomy. Here, we report a case where we succeeded in conducting the flexible bronchoscopy insertion through a laryngeal mask to block the fistula by bronchial blocker under spontaneous breathing.
Diagnosis and Management of a Unique Iatrogenic Biatrial Gerbode Defect
The Gerbode defect was first described in the late 1950s as a congenital peri-membranous ventricular septal defect (VSD), resulting in a left to right ventriculoatrial shunt. We present a case of a patient with restenosis of a prior bioprosthetic aortic valve (AV) who underwent reoperative AV replacement (AVR), which was complicated by a unique iatrogenic Gerbode defect with concurrent LV-LA communication. Our case highlights the unique complications resulting from ventriculoatrial shunts, with consideration paid to the management of ventriculoatrial defects described.
Labor Analgesia in Brugada Syndrome and the Importance of Contingency Planning
Brugada syndrome is an autosomal dominant disorder that affects cardiac sodium channels and predisposes patients to an increased risk of sudden cardiac death. Obstetric anesthesia management in patients with Brugada syndrome poses a challenge due to the prevalence of local anesthetic use for labor analgesia or cesarean section. However, central neuraxial techniques and local anesthetics have been used safely in parturients with this syndrome and may be offered to patients during preadmission counseling. We present the case of a primigravida who opted for further labor analgesia via a combined spinal-epidural technique. To our knowledge, this is the first case report of a lidocaine infusion administered via an epidural catheter to a laboring parturient with Brugada syndrome. We further discuss the use of local anesthetics, other medications, and central neuraxial techniques in those with Brugada syndrome to assist anesthesiologists caring for expectant mothers.
The Successful Anesthetic Management of a Cesarean Delivery in a Patient with Fanconi–Bickel Syndrome
Introduction. Fanconi–Bickel syndrome (FBS) is a rare genetic condition characterized by extremely short stature, renal tubular dysfunction, osteoporosis, and rickets. The literature is scant regarding the successful reproduction of women with FBS. Cesarean delivery is indicated due to the risk of pelvic fracture from vaginal delivery in a patient with FBS and rickets, yet no case describing the anesthetic has been reported. Clinical Findings. We present a 39-inch-tall, 46.47 kg/m2 BMI woman with FBS who was scheduled for cesarean delivery and requesting neuraxial anesthesia. A low-dose, combined spinal-epidural technique (CSE) was employed to account for her extreme short stature yet allow for additional dosing if needed. The cesarean delivery, hospital course, and follow-up were all uneventful. Conclusion. A single case of an FBS patient’s successful pregnancy was previously reported in the literature without describing the anesthetic technique. Our case is unique in that it is the first case in the literature that we are aware of describing the anesthetic technique. This case may provide a template for clinicians treating FBS patients and patients with extremely short stature.
When Left Is Right and Right Is Wrong: A Case Report of Two Near-Miss Wrong-Sided Peripheral Nerve Blocks
Wrong-sided peripheral nerve blocks occur with a surprisingly high frequency despite being described as a “never event.” Timeout procedures are performed and documented, yet timeout omission is rarely cited as a contributing factor for wrong-sided blocks. We present two cases of near-miss wrong-sided peripheral nerve blocks and provide recommendations based on the current literature and the most common contributing factors.
Cardiac Transplantation following Cobalt Cardiomyopathy from Bilateral Metal-on-Metal Hip Replacements
A fifty-two-year-old man underwent heart transplantation at our centre after four years of developing progressive heart failure symptoms due to cobalt toxicity-related cardiomyopathy. Between the ages of forty and forty-two, he underwent bilateral metal-on-metal hip arthroplasties for early onset osteoarthritis. Six years later, he developed increasing fatigue and pericardial effusions. Following a prolonged period of deterioration without a clear cause, the diagnosis of cobalt toxicity-related cardiomyopathy due to cobalt-chromium alloy hip prostheses was eventually made. He underwent bilateral revision hip arthroplasties and was listed for heart transplantation. Metal-on-metal joint replacement is a rare cause of iatrogenic cobalt toxicity. Anaesthetists may encounter patients with unexplained symptoms of heart failure, having a high index of suspicion presenting an opportunity for early diagnosis and intervention before end-stage disease develops.