Case Discussion
TAP Blocks and C-Sections: Case Discussion for the Week of November 16, 2009
A 25 year-old female presents for elective c-section at 39 weeks gestation. She had a c-section with her last pregnancy due to failure to progress. She did not have an epidural with her last labor, and received an intrathecal anesthetic with “that morphine stuff they put in your back” for her c-section. . She remembers [...]
Regional Anesthesia for Breast Surgery: Case Discussion for the Week of November 2, 2009
A 45 year-old female presents for unilateral, radical mastectomy. The patient has a history of malignant hyperthermia, is allergic to egg yolks, refuses etomidate due to nausea with prior uses, fears bad dreams from ketamine, worries about drug interactions with thiopental, dislikes the forgetfulness of benzodiazepines, and fears addiction from opioids. The patient is also [...]
Legal Case of the Month: October 2009
A 42 year-old high earning medical professional that mostly works with his hand (he was a surgeon), and is also a very keen fly fisherman, developed a small rotator cuff tear that bothered him with fly-fishing. He sought the help of a famous orthopaedic surgeon in another state who could fix this tear arthroscopically.The anesthesia selected for this procedure was a continuous interscalene nerve block combined with light general anesthesia, although the patient expressed the doubt if he needed the continuous nerve block. In spite of that…
Delayed onset quadriparesis and bilateral ptosis following an interscalene block- Case discussion week of 0ct 5th 2009
Interesting case report published recently in Anesthesia and Analgesia.
A nerve stimulator guided interscalene nerve block was placed for rotator cuff repair. Patient underwent an uneventful general anesthetic in the sitting position for the surgical procedure. MAP was between 60-79 during the case.
Two hours after surgery the patient was found to have weakness in [...]
Whither the multimers? vWD and Regional Anesthesia: Case Discussion for the Week of September 14, 2009
A 47 year-old female presents for revision of total hip arthroplasty. Prior medical history is notable for von Willebrand’s Disease (vWD). When asked about her disease, she is unsure which type of von Willebrand’s Disease she has been diagnosed with. She does note that extremely heavy menses led to a hysterectomy at the age of [...]
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