scholarly journals Extreme Tracheal Compression due to Substernal Goiter: Surgical and Anesthetic Management

2012 ◽  
Vol 4 (2) ◽  
pp. 71-73 ◽  
Author(s):  
Benzon Dy ◽  
Kevin Wise ◽  
David Farley ◽  
Brian McGlinch
Keyword(s):  
Operative Treatment ◽  
Multidisciplinary Approach ◽  
Anesthetic Management ◽  
Perioperative Period ◽  
Airway Compromise ◽  
Successful Management ◽  
Tracheal Compression ◽  
Substernal Goiter ◽  
Biochemical Abnormalities

ABSTRACT Substernal goiters can have a range of presentations and pathology from a complete lack of symptoms to minimal biochemical abnormalities to potentially lethal physical derangements due to tracheal compression. We review a case of a substernal goiter with severe tracheal compression and airway compromise and describe the presentation, diagnosis, operative treatment, perianesthetic management and outcome of this patient. Substernal goiters can have a myriad of symptoms and etiologies. Once the diagnosis is secured, a multidisciplinary approach is key to successful management in the perioperative period. How to cite this article Dy B, Wise K, Farley D, McGlinch B. Extreme Tracheal Compression due to Substernal Goiter: Surgical and Anesthetic Management. World J Endocr Surg 2012;4(2):71-73.

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 ORi™: a new indicator of oxygenation

2021 ◽  
Author(s):  
Yusuke Ishida ◽  
Toshio Okada ◽  
Takayuki Kobayashi ◽  
Hiroyuki Uchino
Keyword(s):  
Respiratory Function ◽  
Early Stage ◽  
Anesthetic Management ◽  
Perioperative Period ◽  
Arterial Oxygen ◽  
Reserve Capacity ◽  
Monitoring Method ◽  
Unit Scale ◽  
Noninvasive Monitor ◽  
Near Future

AbstractIn the perioperative period, hypoxemia and hyperoxia are crucial factors that require attention, because they greatly affect patient prognoses. The pulse oximeter has been the only noninvasive monitor that can be used as a reference of oxygenation in current anesthetic management; however, in recent years, a new monitoring method that uses the oxygen reserve index (ORi™) has been developed by Masimo Corp. ORi is an index that reflects the state of moderate hyperoxia (partial pressure of arterial oxygen [PaO2] between 100 and 200 mmHg) using a non-unit scale between 0.00 and 1.00. ORi monitoring performed together with percutaneous oxygen saturation (SpO2) measurements may become an important technique in the field of anesthetic management, for measuring oxygenation reserve capacity. By measuring ORi, it is possible to predict hypoxemia and to detect hyperoxia at an early stage. In this review, we summarize the method of ORi, cautions for its use, and suitable cases for its use. In the near future, the monitoring of oxygen concentrations using ORi may become increasingly common for the management of respiratory function before, after, and during surgery.

scholarly journals Remimazolam anesthesia for cardiac surgery with cardiopulmonary bypass: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Kota Saito ◽  
Sho Ohno ◽  
Makishi Maeda ◽  
Naoyuki Hirata ◽  
Michiaki Yamakage
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Oxygen Saturation ◽  
Anesthetic Management ◽  
Perioperative Period ◽  
Maze Procedure ◽  
Intraoperative Awareness ◽  
Case Presentation ◽  
Venous Oxygen Saturation ◽  
Index Value

Abstract Background Remimazolam has less cardiovascular depressant effects than propofol in non-cardiac surgical patients. However, the efficacy and safety of remimazolam in cardiac surgery with cardiopulmonary bypass (CPB) have not been reported. We present a case of successful anesthetic management using remimazolam in cardiac surgery with CPB. Case presentation A 76-year-old female was scheduled for mitral valve repair, tricuspid annuloplasty, maze procedure, and left atrial appendage closure. We used remimazolam in induction (6.0 mg/kg/h) and maintenance (0.6–1.0 mg/kg/h) of general anesthesia, and the bispectral index value was maintained in the range of 36 to 48 including the period of CPB. Hemodynamics, mixed venous oxygen saturation, and bilateral regional cerebral oxygen saturation were maintained within acceptable ranges. There was no intraoperative awareness/recall or serious complications associated with remimazolam throughout the perioperative period. Conclusions Remimazolam can be used the same as other existing anesthetics in cardiac surgery with CPB.

scholarly journals Multimodal anesthesia and analgesia at the stages of the perioperative period in children with abdominal surgical pathology

2021 ◽  
Vol 24 (1) ◽  
pp. 27-31
Author(s):  
Elmira A. Satvaldieva ◽  
Otabek Ya. Fayziev ◽  
Anvar S. Yusupov
Keyword(s):  
General Anesthesia ◽  
Postoperative Period ◽  
Surgical Intervention ◽  
Anesthetic Management ◽  
Perioperative Period ◽  
Postoperative Recovery ◽  
Surgical Pathology ◽  
Abdominal Organ ◽  
Epidural Blockade ◽  
Abdominal Operations

Aim of the study was assess both the effectiveness and safety of anesthetic management and optimizing postoperative anesthesia under conditions of multimodal anesthesia and analgesia during abdominal operations in children. Patients and methods. The authors examined 58 children aged 1 to 17 years with abdominal operations (malformations, diseases, and abdominal organ injuries). To ensure anesthetic protection, patients underwent combined general anesthesia with propofol and fentanil (induction) with inhalation of sevoflurane + propofol intra venous (maintenance) in combination with epidural blockade with bupivacaine. Results. According to surgical intervention, the arrangement of perioperative analgesic protection provided a favorable correction of the hemodynamic status of patients, a decrease in inhalation anesthetic, promoted a smooth course of the postoperative period, a long painless period, an excellent psychoemotional background, and rapid postoperative recovery.

scholarly journals A Case Report with Severe Thrombocytopenia Induced by Axitinib

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Ulkuhan I. Koksal ◽  
Janeiro Valle Goffin ◽  
Brian Lewis ◽  
Oliver A. Sartor ◽  
Elizaveta Belyaeva ◽  
...  
Keyword(s):  
Multidisciplinary Approach ◽  
Kinase Inhibitor ◽  
Checkpoint Inhibitors ◽  
Severe Thrombocytopenia ◽  
Vascular Endothelial ◽  
Successful Management ◽  
Antiangiogenic Therapies ◽  
Diagnostic Work ◽  
Endothelial Growth Factor ◽  
Work Up

Axitinib is an oral, second-generation tyrosine kinase inhibitor that is selective for vascular endothelial growth factor receptors (VEGFR). This agent is approved as monotherapy or in combination with immune checkpoint inhibitors for the treatment of metastatic renal cell carcinoma. Axitinib is associated with a safety profile very similar to other anti-VEGFR inhibitors but usually with fewer hematologic adverse events, due to the selectivity for VEGF. In this report, we presented a rare case of grade 4 axitinib-induced thrombocytopenia, not observed with other antiangiogenic therapies. We discuss the differential diagnostic work-up, the necessary multidisciplinary approach, and the successful management of the case.

scholarly journals Unanticipated Difficulty in an Anticipated Difficult Airway in the Neurointervention Suite: A Case Report

2018 ◽  
Vol 05 (03) ◽  
pp. 190-192
Author(s):  
Rajashree Uday Gandhe ◽  
Chinmaya Pradeep Bhave ◽  
Avinash Sahebarav Kakde ◽  
Kalyani Anand Sathe
Keyword(s):  
Case Report ◽  
Airway Management ◽  
Difficult Airway ◽  
Vascular Malformation ◽  
Vascular Malformations ◽  
Anesthetic Management ◽  
Endovascular Embolization ◽  
Airway Compromise

AbstractAirway management of patients with craniofacial vascular malformations poses many challenges. Establishment of a secure airway is a prerequisite for safe anesthetic management of these patients. We report a case of a 45-year-old man presenting with a facial vascular malformation involving the tongue, parapharynx, and extending into the neck, resulting in airway compromise scheduled for endovascular embolization.

Hemispherectomy: a hemidecortication approach and review of 52 cases

1996 ◽  
Vol 84 (6) ◽  
pp. 903-911 ◽  
Author(s):  
Benjamin S. Carson ◽  
Sam P. Javedan ◽  
John M. Freeman ◽  
Eileen P. G. Vining ◽  
Aaron L. Zuckerberg ◽  
...  
Keyword(s):  
Assisted Living ◽  
Multidisciplinary Approach ◽  
Seizure Control ◽  
Anesthetic Management ◽  
Clinical Experiences ◽  
Content Type ◽  
Medical Institutions ◽  
Age At Surgery ◽  
Age Appropriate

✓ Between 1975 and 1994, 52 hemispherectomies, of which two were anatomical and 50 hemidecortications, were performed at Johns Hopkins Medical Institutions. Eighteen patients were 2 years old or less. There were three perioperative mortalities and one patient died 9 months later from causes not related to surgery. One patient developed hydrocephalus 6 years postsurgery and has been treated effectively. Seizure control and the functional status of each patient were measured as outcome variables. Forty-six (96%) of the surviving patients were seizure free or had reduced seizures as of their last follow-up examination. Twenty-one individuals (44%) were participating in age-appropriate classes or working independently, 18 were classified as semiindependent, and nine children will likely depend on a lifetime of assisted living. The relationships between the outcome variables and the patient's age at surgery, the interval to surgery, and the etiology of the disease were compared. The authors' clinical experiences strongly suggest the importance of a multidisciplinary approach to patient selection and follow-up care. Moreover, anesthetic management of infant surgery is a major component of success.

scholarly journals Successful management of perimortem cesarian section with two types of pelvic packing; a case report

2021 ◽  
Vol 6 (1) ◽  
pp. 68-70
Author(s):  
Helvacioglu Caglar ◽  
Boukari Bako Bibata ◽  
Serdar Karakuzu ◽  
Ali Emre Cetinkol ◽  
Nursen Atasoy
Keyword(s):  
Cardiac Arrest ◽  
Case Report ◽  
Multidisciplinary Approach ◽  
Successful Management ◽  
Pelvic Packing ◽  
Peripartum Hysterectomy ◽  
Maternal Survival ◽  
Different Types ◽  
Cesarian Section

Perimortem cesarean is rare and one of the worst possible scenarios in obstetrics. Multidisciplinary approach and speed are extremely important. Pelvic packing in massive postpartum hemorrhages is a method which obstetricians do not commonly use. The patient who had cardiac arrest during travail was successfully managed with a peripartum hysterectomy and two different types of pelvic packing after perimortem cesarean. The mother and baby were healthily discharged. Fetal and maternal survival after perimortem cesarean is quite low. The most important factor determining survival is speed. Pelvic packing is effective in postpartum unstoppable bleeding.

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