Intracavernosal ephedrine for management of intraoperative penile erection during urological procedure under general anesthesia

Intraoperative penile tumescence during urological procedure can occur after regional or general anesthesia. It is a rare event but can cause delay or defer of the surgery. Pathophysiology of intraoperative erection is mainly due to autonomic imbalance during anesthesia. Various physical and pharmacological management of tumescence have been tried with variable success and complication. We injected ephedrine 15 mg intracavernous resulting immediate de-tumescence and minimum complication.

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Intraoperative Awareness

Anesthesiology: A Problem-Based Learning Approach ◽

10.1093/med/9780190850692.003.0050 ◽

2018 ◽

pp. 443-446

Author(s):

Jennifer Knuth ◽

Lindsay Gennari ◽

John Cagino

Keyword(s):

Risk Factors ◽

General Anesthesia ◽

Trauma Surgery ◽

Rare Event ◽

General Anesthetic ◽

Intraoperative Awareness ◽

Patient Reports ◽

Increased Risk ◽

Patient’S Outcome

Awareness following general anesthesia is a rare event; however, it may have significant impact on patient satisfaction and long-term morbidity. Detecting intraoperative awareness during a general anesthetic is difficult due to the fact that the signs and symptoms are often absent in documented cases of awareness. Often, intraoperative awareness goes unnoticed until a patient reports the experience. Anesthesiologists should be cognizant of the risk factors associated with an increased risk of intraoperative awareness. Cesarean section performed under general anesthesia, cardiac surgery, and trauma surgery all carry an increased risk. Anesthesiologists should consider patient specific risk factors involving a higher than expected anesthetic requirement in developing their anesthetic plan. In the event of intraoperative awareness, the anesthesiologist’s actions and interactions with the patient are critical in improving the patient’s’ outcome and minimizing long-term psychological stress. Anesthesiologists should acknowledge the event and create a supportive relationship with the patient.

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Benzodiazepine Treatment of Penile Erection under General Anesthesia

Anesthesia & Analgesia ◽

10.1213/00000539-198806000-00021 ◽

1988 ◽

Vol 67 (6) ◽

pp. 596???597 ◽

Cited By ~ 2

Author(s):

Anis Baraka ◽

Abdel Nour Sibai

Keyword(s):

General Anesthesia ◽

Penile Erection

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Cardiac Arrest Due to Severe Dynamic Left Ventricular Outﬂow Obstruction and Hypertrophy Following Anesthesia Induction

10.22514/sv.2020.16.0071 ◽

2020 ◽

Keyword(s):

Cardiac Arrest ◽

General Anesthesia ◽

Rare Event ◽

Chronic Neck Pain ◽

Spontaneous Circulation ◽

Left Ventricular ◽

Anesthesia Induction ◽

Outflow Obstruction ◽

Ventricular Outflow Obstruction ◽

Left Ventricular Outflow

Cardiac arrest following induction of general anesthesia is a rare event. A 47-year-old woman with a history of chronic neck pain secondary to spinal stenosis presented for elective cervical laminectomy. Induction of general anesthesia induced cardiac arrest and emergency insertion of the transesophageal echocardiogram probe identified severe, undiagnosed left ventricular hypertrophy with dynamic outflow obstruction. Resuscitative treatment was immediately implemented to include aggressive intravenous fluid resuscitation, intravenous esmolol and phenylephrine to augment preload, afterload, and reflex bradycardia effect. Return of spontaneous circulation was achieved and the patient was admitted to the ICU, where she was extubated with preserved neurocognitive function on the same day. Our case describes the risk presented by undiagnosed cardiac abnormalities in what was accepted as a low-to-intermediate risk patient undergoing an elective procedure. The increasing popularity and use of pocket-sized handheld ultrasound devices may help reduce the risk of occurrences such as this in the future.

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Response and Reinforcement in Operant Audiometry

Journal of Speech and Hearing Disorders ◽

10.1044/jshd.5203.294 ◽

1987 ◽

Vol 52 (3) ◽

pp. 294-299 ◽

Cited By ~ 8

Author(s):

Michael A. Primus

Keyword(s):

Operant Conditioning ◽

Space Versus ◽

Visual Space ◽

Central Processing ◽

Operant Discrimination ◽

Conditioning Rate ◽

Significant Difference ◽

Simple Detection ◽

Variable Success ◽

Response Task

Variable success in audiometric assessment of young children with operant conditioning indicates the need for systematic examination of commonly employed techniques. The current study investigated response and reinforcement features of two operant discrimination paradigms with normal I7-month-old children. Findings indicated more responses prior to the onset of habituation when the response task was based on complex central processing skills (localization and coordination of auditory/visual space) versus simple detection. Use of animation in toy reinforcers resulted in more than a twofold increase in the number of subject responses. Results showed no significant difference in response conditioning rate or consistency for the response tasks and forms of reinforcement examined.

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