A&A practice最新文献

This case highlights a rare complication of endotracheal intubation: intestine perforation caused by an intubation-stylet fragment. A patient undergoing an appendectomy had an esophageal intubation on the first attempt and a successful endotracheal intubation on the second, using the same stylet. The missing fragment went unnoticed after intubation. Postoperative symptoms led to reimaging, revealing a foreign body in the intestine, later identified as a stylet fragment. The stylet fragment was removed, and the patient recovered by postoperative day 7. This case emphasizes the importance of vigilance in airway management, prompt evaluation of symptoms, and proper handling of damaged equipment.

Recorded operating rooms (ORs) in electronic health records can differ from the actual anesthetizing locations. A retrospective cohort of cases revealed a 40% (846/2123) room location error rate in the obstetrical (OB) suite compared to 0.03% (18/56,044) in 3 large surgical suites. Using meta-data providing physical locations of monitors transmitting pulse oximetry measurements and technicians' manual logs of replacement monitors, all actual ORs of the cases were determined. Simply identifying listed overlaps of cases in the same OR to identify potential location errors was insufficient for OB because surgical cases were infrequently ongoing simultaneously. We recommend overlap checking by suite.

Burning mouth syndrome (BMS) is a debilitating intraoral burning or dysesthesia sensation without any evident causative lesions on clinical examination and investigations. The etiopathogenesis of BMS remains uncertain, with proposed mechanisms including psychological, peripheral neuropathic, and central neuropathological factors. Management of BMS is generally symptomatic and often met with poor response. Published data on the successful pain management interventions are inadequate. This report describes the successful management of a 43-year-old patient with severe glossodynia, diagnosed as BMS, using ultrasound-guided suprazygomatic sphenopalatine ganglion block after poor response to the conventional therapies as well as stellate ganglion block.

Peripheral nerve stimulation (PNS) is an emerging option for postamputation pain. However, its impact on prosthesis use and comfort remains underexplored. This case report describes a patient whose chronic postamputation pain limited mobility, function, and prosthesis use. After failing conservative therapies, successful treatment was achieved with sciatic PNS which improved pain, prosthesis comfort, and functional outcomes as measured by the Orthotic and Prosthetic Users Survey Lower Extremity Functional Status Measure and Prosthetic Limb Users Survey of Mobility. Although surgical techniques, such as targeted muscle reinnervation, also enhance prosthetic function, PNS offers unique advantages.

Coccygodynia results from traumatic, nontraumatic, or idiopathic causes. Chronic cases resistant to conservative treatments may necessitate surgery. This case report highlights the innovative use of sacral multifidus plane block (S-MPB) for multimodal pain management after a coccygectomy performed under spinal anesthesia. The patient, suffering from chronic coccygodynia due to exostosis, underwent surgical removal of the coccyx and associated fistula. S-MPB was chosen for its simplicity, efficacy, and safety, providing postoperative analgesia without complications. This approach suggests that S-MPB is a promising addition to the pain management arsenal for coccygectomy, warranting further investigation to optimize its application and outcomes.