scholarly journals Sentinel Node Biopsy and Lumpectomy in a Patient with Machado–Joseph Disease

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
N. N. Aldawoodi ◽  
A. R. Escher Jr. ◽  
A. Padalia ◽  
D. Padalia
Keyword(s):  
General Anesthesia ◽  
Perioperative Management ◽  
Trinucleotide Repeat ◽  
Neurodegenerative Disorder ◽  
Case Reports ◽  
Anesthetic Management ◽  
Node Biopsy ◽  
Machado Joseph Disease ◽  
Regional Anesthetic ◽  
Spinocerebellar Ataxia 3

Spinocerebellar ataxia 3 (SCA3), also known as Machado–Joseph disease (MJD) is an autosomal dominant, progressive neurodegenerative disorder. Patients present with cerebellar ataxia, dystonia, rigidity, and neuropathy that worsen with time. On a molecular level, it occurs due to a CAG trinucleotide repeat expansion in the ATXN3 gene. Due to the risk of pulmonary aspiration, hypoventilation, autonomic and thermoregulatory dysfunction, vocal cord paralysis, progressive paraplegia, parkinsonian symptoms, and chronic pain, it has significant anesthesia implications. Rarely, case reports occur in the literature describing regional anesthetic management of patients with SCA3, but none that describe general anesthesia specifically with MJD. We therefore describe a case of a patient with SCA3 who successfully underwent general anesthesia and considerations for perioperative management of this patient population.

scholarly journals Anesthetic Management and Perioperative Events of Peripartum Cardiomyopathy during Cesarean Delivery a Series of Five Cases

2018 ◽  
Vol 03 (02/03) ◽  
pp. 198-203
Author(s):  
Sree Rama Mellacheruvu ◽  
Kousalya Chakravarthy ◽  
Khaliq Ahmed
Keyword(s):  
Cesarean Section ◽  
General Anesthesia ◽  
Case Reports ◽  
Anesthetic Management ◽  
Rare Condition ◽  
Late Pregnancy ◽  
Postoperative Management ◽  
Peripartum Cardiomyopathy ◽  
Morbidity And Mortality ◽  
High Morbidity

AbstractPeripartum cardiomyopathy (PPCM) is a rare idiopathic cardiomyopathy having an incidence of less than 0.1%. PPCM is associated with high morbidity and mortality rates ranging from 5 to 32%. In this review, the authors report a series of five PPCM cases. The case reports included pregnant women with PPCM, admitted in the hospital from October 1, 2017 to June 1, 2018 over a period of 9 months who required cesarean section. The authors aim to discuss the presentation, optimization, anesthetic management, and postoperative care of this rare condition. One of the cases was a booked case. The remaining four pregnant patients were referred in late pregnancy with features of congestive cardiac failure. One patient was in acute pulmonary edema, required intubation, and subsequently had cesarean section under general anesthesia. Four patients were managed with incremental epidural anesthesia. The need for proper preoperative optimization and intra- and postoperative management was discussed. The authors had one maternal mortality in our series. There was no neonatal mortality. Early diagnosis of PPCM, prompt treatment of heart failure, planning the delivery, and postpartum care can decrease maternal morbidity and mortality. Incremental epidural dosing can be used for cesarean section and has the advantage of stable hemodynamic status without the risks associated with general anesthesia.

scholarly journals Sugammadex in systemic mastocytosis

2021 ◽  
Author(s):  
A. Becerra-Bolaños ◽  
V. Muiño-Palomar ◽  
S. Cabrera-Doreste ◽  
A. Rodríguez-Pérez
Keyword(s):  
Systematic Review ◽  
Case Report ◽  
Search Strategy ◽  
Perioperative Management ◽  
Systemic Mastocytosis ◽  
Case Reports ◽  
Anesthetic Management ◽  
Google Scholar ◽  
Current Evidence

AbstractPerioperative management in patients suffering from systemic mastocytosis is challenging. Most recommendations regarding anesthetic management in these patients are based on clinical reports, and there are controversies about the use of rocuronium and sugammadex. We present a case report of a patient with systemic mastocytosis who was given sugammadex for rocuronium reversal. Tryptase levels were monitored during the first postoperative 24 h, without evidence of elevation. We also performed a systematic review to provide an overview of current evidence regarding the safety of using sugammadex in patients suffering from systemic mastocytosis. The search strategy included PubMed and Google Scholar. All studies published up to and including January 2021 concerning anesthetic management in systemic mastocytosis were included. Of the 122 articles located, 9 articles were included: 2 reviews and 7 case reports. Data from reviewed studies confirm that sugammadex can safely be administered in patients suffering from systemic mastocytosis.

scholarly journals Anesthetic management in parturients with kyphoscoliosis

2019 ◽  
Vol 14 (2) ◽  
pp. 71-75
Author(s):  
Jay Prakash Thakur ◽  
Tara Gurung ◽  
Sangeeta Shrestha ◽  
Ujjwal Basnet ◽  
AP Pradhan
Keyword(s):  
General Anesthesia ◽  
Spinal Anesthesia ◽  
Case Reports ◽  
Anesthetic Management ◽  
Ultrasound Guided ◽  
Successful Management

Pregnancy in kyphoscoliotic woman is uncommon, with a reported incidence of 0.072%. It produces significant challenges for both anesthesiologist and obstetrician. Dealing with dual life, there is risk for both mother and fetus due to alterations in maternal physiology and change in spine anatomy. There are many case reports available with successful management both using spinal or general anesthesia. Here we present four case reports of successful management of such cases using general anesthesia or spinal anesthesia with palpatory and ultrasound guided method during a period of 6 months in Paropakar Maternity and Women’s Hospital.

scholarly journals Ultrasound-guided perioperative management of 28-month-old patient with congenital diaphragmatic eventration

2019 ◽  
Vol 7 ◽  
pp. 2050313X1982773
Author(s):  
Hyemin Kang ◽  
Sangmin Lee ◽  
Hyunwoo Park ◽  
Yeojung Kim ◽  
YoungKwon Ko ◽  
...  
Keyword(s):  
Case Report ◽  
General Anesthesia ◽  
Perioperative Management ◽  
Anesthetic Management ◽  
Male Infant ◽  
Lung Ultrasonography ◽  
Ultrasound Guided ◽  
Distal Ulna ◽  
Diaphragmatic Eventration ◽  
The Right

Diaphragmatic eventration is a rare anomaly. When patients with this condition undergo general anesthesia, anesthetic management should be performed with particular care owing to the risk of diaphragmatic rupture. Such a rupture can be perioperatively diagnosed using multiple tools including lung ultrasonography. This case report describes the anesthetic management of a male infant with osteochondroma in the distal ulna, presenting with diaphragmatic eventration on the right side.

scholarly journals Perioperative management of a patient undergoing resection of interleukin-6 producing pheochromocytoma

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Masahiro Kuroki ◽  
Hiroto Suzuki ◽  
Misato Kurota ◽  
Masaki Nakane ◽  
Kaneyuki Kawamae
Keyword(s):  
General Anesthesia ◽  
Interleukin 6 ◽  
Perioperative Management ◽  
Anesthetic Management ◽  
Elevated Serum ◽  
Surgical Removal ◽  
Tumor Removal ◽  
Case Presentation ◽  
Postoperative Course ◽  
Inflammatory State

Abstract Background Pheochromocytomas produce hormones, cytokines, and catecholamines. We report perioperative anesthetic management of a rare interleukin-6 (IL-6)-producing pheochromocytoma. Case presentation A 32-year-old female was scheduled for laparoscopic adrenalectomy for pheochromocytoma. She had a sustained high fever with elevated serum noradrenaline and IL-6 levels. The persistent high inflammatory state, followed by anemia, malnutrition, and coagulopathy, led us to prepone her date of surgery. During general anesthesia, alpha-blockers allowed hemodynamic fluctuations to be controlled. During surgery, simultaneous increases in noradrenaline and IL-6 levels were observed, which rapidly declined after tumor removal. Her postoperative course was uneventful, without pulmonary edema caused by cytokine storms. Conclusions The conventional pheochromocytoma strategy allowed surgical removal of an IL-6-producing pheochromocytoma under general anesthesia. However, management of high inflammatory states that induce anemia and coagulopathy is necessary.

scholarly journals General anesthesia with remimazolam in a patient with mitochondrial encephalomyopathy: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Yuji Suzuki ◽  
Matsuyuki Doi ◽  
Yoshiki Nakajima
Keyword(s):  
Lactic Acidosis ◽  
General Anesthesia ◽  
Mitochondrial Disease ◽  
Muscle Relaxation ◽  
Anesthetic Management ◽  
Perioperative Period ◽  
Mitochondrial Encephalomyopathy ◽  
Anesthesia Induction ◽  
General Anesthetic ◽  
Anesthetic Agents

Abstract Background Systemic anesthetic management of patients with mitochondrial disease requires careful preoperative preparation to administer adequate anesthesia and address potential disease-related complications. The appropriate general anesthetic agents to use in these patients remain controversial. Case presentation A 54-year-old woman (height, 145 cm; weight, 43 kg) diagnosed with mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes underwent elective cochlear implantation. Infusions of intravenous remimazolam and remifentanil guided by patient state index monitoring were used for anesthesia induction and maintenance. Neither lactic acidosis nor prolonged muscle relaxation occurred in the perioperative period. At the end of surgery, flumazenil was administered to antagonize sedation, which rapidly resulted in consciousness. Conclusions Remimazolam administration and reversal with flumazenil were successfully used for general anesthesia in a patient with mitochondrial disease.

scholarly journals RNA Sequencing of Human Peripheral Blood Cells Indicates Upregulation of Immune-Related Genes in Huntington's Disease

2020 ◽  
Vol 11 ◽  
Author(s):  
Miguel A. Andrade-Navarro ◽  
Katja Mühlenberg ◽  
Eike J. Spruth ◽  
Nancy Mah ◽  
Adrián González-López ◽  
...  
Keyword(s):  
Gene Expression ◽  
Huntington's Disease ◽  
Huntington’S Disease ◽  
Peripheral Blood ◽  
Blood Cells ◽  
Trinucleotide Repeat ◽  
Neurodegenerative Disorder ◽  
Gene Expression Signature ◽  
Interferon Response ◽  
Peripheral Blood Cells

Huntington's disease (HD) is an autosomal dominantly inherited neurodegenerative disorder caused by a trinucleotide repeat expansion in the Huntingtin gene. As disease-modifying therapies for HD are being developed, peripheral blood cells may be used to indicate disease progression and to monitor treatment response. In order to investigate whether gene expression changes can be found in the blood of individuals with HD that distinguish them from healthy controls, we performed transcriptome analysis by next-generation sequencing (RNA-seq). We detected a gene expression signature consistent with dysregulation of immune-related functions and inflammatory response in peripheral blood from HD cases vs. controls, including induction of the interferon response genes, IFITM3, IFI6 and IRF7. Our results suggest that it is possible to detect gene expression changes in blood samples from individuals with HD, which may reflect the immune pathology associated with the disease.

scholarly journals Junctional Rhythm Preoperatively and During General Anesthesia for Oral and Maxillofacial Surgery

2017 ◽  
Vol 64 (3) ◽  
pp. 165-167 ◽  
Author(s):  
Naotaka Kishimoto ◽  
Ikue Kinoshita ◽  
Yoshihiro Momota
Keyword(s):  
General Anesthesia ◽  
Local Anesthesia ◽  
Anesthetic Management ◽  
Maxillofacial Surgery ◽  
Oral And Maxillofacial Surgery ◽  
Anesthesia Induction ◽  
Sagittal Split Ramus Osteotomy ◽  
Junctional Rhythm ◽  
Appropriate Treatment ◽  
Slow Heart Rate

We report a case of junctional rhythm that occurred both preoperatively and later during a portion of general anesthesia. A 19-year-old woman was scheduled to undergo bilateral sagittal split ramus osteotomy after being diagnosed with a jaw deformity. Preoperative electrocardiography (ECG) revealed a junctional rhythm with a slow heart rate (HR). At 90 minutes after anesthesia induction, local anesthesia with 10 mL of 1% lidocaine and 1:100,000 adrenaline was administered. A junctional rhythm appeared 15 minutes after the local anesthesia. We believe that the atrioventricular nodal pacemaker cells accelerated because of the increased sympathetic activity due to the adrenaline. On the preoperative ECG, the junctional rhythm with slow HR appeared as an escaped beat caused by slowing of the primary pacemaker. Therefore, we think that the preoperative junctional rhythm and the junctional rhythm that appeared during general anesthesia were due to different causes. Understanding the cause of a junctional rhythm could lead to more appropriate treatment. We therefore believe that identifying the cause of the junctional rhythm is important in anesthetic management.

scholarly journals Perioperative Management of Buprenorphine: Solving the Conundrum

Pain Medicine ◽  
2018 ◽  
Vol 20 (7) ◽  
pp. 1395-1408 ◽  
Author(s):  
Aurora Naa-Afoley Quaye ◽  
Yi Zhang
Keyword(s):  
Perioperative Management ◽  
Case Reports ◽  
Management Strategies ◽  
Case Series ◽  
Analgesic Efficacy ◽  
Published Data ◽  
Opioid Use ◽  
Mu Opioid ◽  
Periprocedural Management ◽  
Opioid Agonists

Abstract Objective There is no consensus on the optimal perioperative management of patients on buprenorphine (BUP) for opioid use disorder (OUD). This article will review the available literature on BUP and the analgesic efficacy of BUP combined with full mu-opioid agonists and discuss the conflicting management strategies in the context of acute pain and our institution’s protocol for the periprocedural management of BUP. Methods We searched published data on BUP periprocedural management from inception through March 2018 without language restrictions. Study selection included publications reporting outcomes on perioperative pain management in OUD patients maintained on BUP. Results Our search resulted in four case reports supporting periprocedural discontinuation of BUP and two case series, one secondary observational study, one prospective matched cohort study, and four retrospective cohort studies supporting periprocedural continuation of BUP. No clinical trials were identified. Conclusions Maintaining BUP perioperatively does not lead to worsened clinical outcomes. Patients can receive adequate pain control from mu-opioid agonists while maintained on BUP. Based upon available evidence, we recommend continuing BUP at a reduced dose when indicated to avoid withdrawal symptoms and to facilitate the analgesic efficacy of mu-opioid agonists administered in combination for acute postoperative pain.

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