AN EVENT OF UNDIAGNOSED INTRAOPERATIVE HYPERTENSION - STILL A NIGHTMARE - SUSPENSE CONTINUES …A CASE REPORT

2021 ◽  
pp. 74-75
Author(s):  
Kartik Sonawane ◽  
Noopur Prakash Chaudhar ◽  
Hrudini Dixit ◽  
Chelliah Sekar
Keyword(s):  
Case Report ◽  
Operating Room ◽  
Hypertensive Crisis ◽  
Stress Conditions ◽  
Essential Aspect ◽  
Before And After ◽  
Intraoperative Hypertension

Intraoperative events are not uncommon to any anesthesiologist. For every case inside the operating room, some major or minor events always occur related to patient, surgery, or anesthesia. Managing such events depends on the skill and experience of the anesthesiologist. When it becomes unmanageable due to undiagnosed and unanticipated conditions, it creates a “tug of war” situation inside the operating room. So, screening of such unidentied undiagnosed conditions is an essential aspect of the pre-anesthesia checkup. Unfortunately, sometimes due to asymptomatic presentations in non-stress conditions, it becomes difcult to screen them before surgery.We describe such an event of an intraoperative hypertensive crisis that remained undiagnosed before and after surgery leading to continuing suspense.

scholarly journals Resolution of Dialyzer Membrane-Associated Thrombocytopenia with Use of Cellulose Triacetate Membrane: A Case Report

2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Feyisayo Olafiranye ◽  
Win Kyaw ◽  
Oladipupo Olafiranye
Keyword(s):  
Platelet Count ◽  
Case Report ◽  
Cellulose Triacetate ◽  
Cellulose Membrane ◽  
Membrane Interaction ◽  
Synthetic Membranes ◽  
Synthetic Membrane ◽  
Before And After ◽  
The Difference ◽  
Modified Cellulose

Blood and dialyzer membrane interaction can cause significant thrombocytopenia through the activation of complement system. The extent of this interaction determines the biocompatibility of the membrane. Although the newer synthetic membranes have been shown to have better biocompatibility profile than the cellulose-based membranes, little is known about the difference in biocompatibility between synthetic membrane and modified cellulose membrane. Herein, we report a case of a patient on hemodialysis who developed dialyzer-membrane-related thrombocytopenia with use of synthetic membrane (F200NR polysulfone). The diagnosis of dialyzer membrane-associated thrombocytopenia was suspected by the trend of platelet count before and after dialysis, and the absence of other possible causes of thrombocytopenia. We observed significant improvement in platelet count when the membrane was changed to modified cellulose membrane (cellulose triacetate). In patients at high risk for thrombocytopenia, the modified cellulose membrane could be a better alternative to the standard synthetic membranes during hemodialysis.

Perioperative considerations in the management of cold agglutinin disease in laparoscopic surgery

2021 ◽  
Vol 14 (5) ◽  
pp. e241294
Author(s):  
Yisi D Ji ◽  
Paul M Cavallaro ◽  
Britlyn D Orgill
Keyword(s):  
Case Report ◽  
Laparoscopic Surgery ◽  
Acute Cholecystitis ◽  
Operating Room ◽  
Patient Outcomes ◽  
Cold Agglutinin ◽  
Surgical Team ◽  
Cold Agglutinin Disease ◽  
Disease Exacerbation ◽  
Multidisciplinary Collaboration

An 80-year-old man with idiopathic cold agglutinin disease presented with acute cholecystitis. We describe operating room and anaesthetic considerations for patients with cold agglutinin disease and measures that can be taken to prevent disease exacerbation in this case report. Multidisciplinary collaboration and planning between the operative room staff, anaesthesia team and surgical team are needed to ensure safe surgery and optimal patient outcomes.

scholarly journals Endoscopic Fascia Release for Forearm Chronic Exertional Compartment Syndrome: Case Report and Surgical Technique

Hand ◽  
2016 ◽  
Vol 12 (5) ◽  
pp. NP58-NP61 ◽  
Author(s):  
Elizabeth A. Miller ◽  
Anna L. Cobb ◽  
Tyson K. Cobb
Keyword(s):  
Case Report ◽  
Compartment Syndrome ◽  
Single Incision ◽  
Invasive Technique ◽  
Compartment Pressure ◽  
Chronic Exertional Compartment Syndrome ◽  
Exertional Compartment Syndrome ◽  
Before And After ◽  
History Of ◽  
Forearm Pain

Background: Chronic exertional compartment syndrome (CECS) of the forearm is traditionally treated with open compartment release requiring large incisions that can result in less than optimal esthetic results. The purpose of this study is to describe a case report of 2 professional motocross patients with forearm CECS treated endoscopically using a minimally invasive technique. Methods: Two professional motocross racers presented with a history of chronic proximal volar forearm pain when motocross riding. Other symptoms included paresthesia and weakness, which, at times, led to an inability to continue riding. Both failed conservative management. Compartment pressure measurements were performed before and after provocative exercises to confirm diagnosis of CECS. Release of both the volar and dorsal compartments was performed endoscopically through a single incision. Results: Symptoms resolved after surgery. The first patient resumed riding at 1 week, competing at 3 weeks, and continues to ride competitively without symptoms at 3 years postoperative. The second patient began riding at 1 week and won second place in the National Supercross finals 5 weeks after simultaneous bilateral release. Conclusions: This technique is simple and effective. The cannula used protects the superficial nerves while allowing release through a small, cosmetically pleasing incision.

scholarly journals Assessment of Immediate Skeletal Changes after Alternate Rapid Maxillary Expansion and Constriction – A Case Report

2021 ◽  
Vol 10 (34) ◽  
pp. 2954-2959
Author(s):  
Shilpa Venkatesh Pharande
Keyword(s):  
Case Report ◽  
Rapid Maxillary Expansion ◽  
Class Iii ◽  
Class Iii Malocclusion ◽  
Maxillary Expansion ◽  
Skeletal Class ◽  
Posterior Crossbite ◽  
Skeletal Changes ◽  
Before And After ◽  
Opening And Closing

The Alt-RAMEC protocol was introduced by Liou in the year 2005. It allows for sutural mobilisation by opening and closing the RME screw for 7-9 weeks. Maxillary protraction after the use of Alt-Ramec (alternate rapid maxillary expansion and contraction) protocol is an efficient method for early treatment of skeletal Class III malocclusion. This case report shows the results of using a hyrax bonded maxillary expander with the Alt-RAMEC protocol to treat a maxillary hypoplasia Class III malocclusion. A 12-year-old patient with skeletal class III malocclusion with anterior as well as the unilateral posterior crossbite was treated using this protocol. CBCT scans were taken before and after expansion. These CBCT scans were used for assessing and analysing the skeletal changes that have occurred after using the AltRamec protocol. The objective of this case report is to assess skeletal changes after using the Alt-RAMEC protocol.

scholarly journals Cytotoxicity of three-dimensional paper-based models from a three-dimensional paper-based printer

NEMESIS ◽  
2018 ◽  
Vol 3 (1) ◽  
pp. 15 ◽  
Author(s):  
Marcin Kozakiewicz ◽  
Piotr Szymor ◽  
Raphael Olszewski
Keyword(s):  
Operating Room ◽  
Dermal Fibroblast ◽  
Statistical Significance ◽  
Three Dimensional ◽  
Dermal Fibroblasts ◽  
Tissue Adhesive ◽  
Biological Behaviour ◽  
Sterilization Method ◽  
Significant Difference ◽  
Before And After

Objective: Our study aimed to determine the possibility of using models created with a low-cost, paper based 3D printer in an operating room. Therefore influence of different methods of sterilization on models was tested and cytotoxicity of generated models was determined. Material and methods: 30 cuboids divided into three groups were used for verification of shape stability after sterilization. Each group was sterilized either with: Ethylene oxide in temperature 55˚C, Hydrogen peroxide gas plasma in temperature 60˚C or Gamma irradiation at 21˚C, 25kGy. Each cuboid was measured using calliper three times before and three times after sterilization. Results were analysed statistically in Statgraphics Plus. Statistical significance was determined as p< 0.05. Sixty cylinders divided into six groups were used for cytotoxicity tests. Three of those groups were covered before sterilization with 2-octyl-cyanoacrylate. Each group was sterilized with one of the previously described methods. Cytotoxicity was tested by Nanostructural and Molecular Biophysics Laboratory in Technopark Lodz using normal adult human dermal fibroblasts. Survival of cells was tested using spectrophotometry with XTT and was defined as ratio of absorbency of tested probe to absorbency of control probe. Calcein/Ethidium dyeing test was performed according to LIVE/DEAD Viability/Cytotoxicity Kit protocol. Observation was done under Olympus GX71 fluorescence microscope. Results: There was no statistically significant difference for established statistical significance p=0.05 in cuboids dimensions before and after sterilization regardless of sterilization method. In XTT analysis all samples showed higher cytotoxicity against normal, human, adult dermal fibroblast culture when compared to positive control. ANOVA statistical analysis confirmed that 2-octyl cyanoacrylate coating of paper model improved biological behaviour of the material. It decreased cytotoxicity of the model independently of sterilization method. In calcein/ethidium dyeing test due to the high fluorescence of the background caused by cylinders of analysed substance it was impossible to perform the exact analysis of the number of marked cells. Conclusions: Acquired results allow to conclude that Mcor Technology Matrix 300 3D paper-based models can be used in operating room only if covered with cyanoacrylate tissue adhesive. Nemesis relevance: We found no statistically significant difference in cuboids dimensions before and after sterilization regardless of sterilization method. Three-dimensional paper-based models present with high cytotoxicity without coating.

scholarly journals Impact of Instituting General Anesthesia on Oral Sedation Care in a Tertiary Care Pediatric Dental Clinic

2019 ◽  
Vol 66 (4) ◽  
pp. 183-191 ◽  
Author(s):  
David L Moore ◽  
Lili Ding ◽  
Gang Yang ◽  
Stephen Wilson
Keyword(s):  
General Anesthesia ◽  
Operating Room ◽  
Low Income ◽  
Tertiary Care ◽  
Adverse Event Rate ◽  
Dental Clinic ◽  
Dental Services ◽  
Serious Adverse Events ◽  
Before And After ◽  
Oral Sedation

Tertiary pediatric medical centers disproportionately care for low-income, underserved children with significant dental needs. Long wait times for hospital operating room treatment increase tooth loss rather than restoration. Oral sedation has commonly been provided to avoid the long waits for operating room treatment. However, this can be challenging with young, anxious patients. High failure rates and repeat visits for oral sedation have resulted in continued waiting for definitive dental services in the operating room. The Division of Dentistry requested the Department of Anesthesiology to create a general anesthesia program in the dental clinic to increase the use of anesthesia services but align the cost of the anesthetic with the revenue stream. Our aim was to objectively measure the performance of a dental clinic anesthesia service by comparing the percentage of case completions, percentage of complete radiographs, and number of serious adverse events to clinic-based oral sedations. We were also interested in total number of cases completed. We retrospectively studied data regarding an in-office general anesthesia (IOGA) program for dentistry and compared it to oral sedations before and after instituting the IOGA program. Patients received either a general endotracheal anesthetic or nonintubated total intravenous general anesthesia. Successful case completion increased from 88.6% (oral sedation) to 99.5% (IOGA). One hundred percent of IOGA cases had complete radiographs, as opposed to 63.4% for oral sedation. This was an increase from 53.5% from the previous 2 years with oral sedation. Serious adverse event rate was 0% (0/508) for oral sedation and 0.2% (1/418) for IOGA. Comparing 2 years before and after IOGA revealed a decrease in oral sedations from 930 to 508, whereas IOGA increased from 0 to 418 cases. Anesthesia services in dental clinic increased complete dental care and complete radiographs, reduced failed sedations, and were performed safely.

Dislocation of the Fifth Metatarsal Base Following Partial Fourth and Fifth Ray Amputation

2012 ◽  
Vol 102 (1) ◽  
pp. 71-74 ◽  
Author(s):  
Russell M. Carlson ◽  
Nicholas C. Smith ◽  
Rodney M. Stuck ◽  
Ronald A. Sage
Keyword(s):  
Diabetes Mellitus ◽  
Case Report ◽  
Operating Room ◽  
Biomechanical Stability ◽  
Normal Gait ◽  
Peroneus Brevis ◽  
Postoperative Dislocation ◽  
Ray Amputation ◽  
Male Veteran ◽  
Chronic Ulceration

This case report presents a rare postoperative dislocation of the fifth metatarsal base following a healed open partial fourth and fifth ray amputation of a 62-year-old male veteran with poorly controlled diabetes mellitus. The dislocated fifth metatarsal base subsequently created a chronic ulceration and an inhibition of normal gait. The patient was taken to the operating room where the fifth metatarsal base was resected with transfer of the peroneus brevis tendon to the cuboid to maintain biomechanical stability. (J Am Podiatr Med Assoc 102(1): 71–74, 2012)

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