Search

A frequent complication after limb amputation is the appearance of phantom limb syndrome, a phenomenon that has also been studied in the amputation of different body parts. Cases reported in relation to ophthalmologic surgery are few and evidence is limited in terms of specific management, which makes this a very important study. We report the case of a patient diagnosed with phantom eye syndrome in the post-operative period of an orbital exenteration surgery. A comprehensive approach was taken with multimodal symptom management, including intervention treatment. Significant improvement regarding the pain was achieved; however, non-painful phantom sensations persisted. Upon reviewing the available literature on the subject, its pathophysiology is not fully elucidated. Its incidence is highly variable, as well as the symptoms' appearance. The presence of headache and eye pain prior to surgery seem to be risk factors. Climate and psychological stress are exacerbating factors of the symptomatology. No high-quality evidence was found in terms of management guidelines, with the use of antidepressants, anticonvulsants and opioids being the most recommended. Interventional management is an option according to the characteristics of the pain and associated symptoms. [ABSTRACT FROM AUTHOR]

Sickle cell anemia or drepanocytosis is a hemoglobinopathy with autosomal recessive inheritance. A longer life expectancy of these patients and the fact that 50% have aseptic osteonecrosis of the hip make total hip arthroplasty a frequent procedure. We present the case of a 34-year-old male diagnosed with homozygous sickle cell disease scheduled for surgery in the operating room. Our aim is to offer perioperative strategies based on a multidisciplinary approach among anesthesiologists, surgeons, and hematologists to avoid complications of the disease itself, exacerbated by moderatehigh risk surgeries. [ABSTRACT FROM AUTHOR]

Introduction: Phantom limb pain (PLP) is a chronic debilitating condition, frequently observed in amputees. At present, there is no standard treatment, and its optimal management requires a multidisciplinary approach in which minimally invasive treatment should be considered in more complex cases. Objective: To report successful treatment of 2 cases of PLP treated with ziconotide as part of multimodal intrathecal management. Materials and methods: Descriptive, retrospective case report developed in a multimodal pain treatment unit. Results: A total of 2 cases of patients with diagnosis of PLP refractory tomedical therapy, treated with intrathecal multimodal therapy, are presented. Their favorable course, with 50% pain reduction, is described. Conclusion: Implantation of infusion systems for administration of intrathecal analgesia with ziconotide at the cervical and supraspinal level proved to be effective in the described cases; this technique should be evaluated in specific trials for the treatment of PLP refractory to other therapies. [ABSTRACT FROM AUTHOR]

Introduction: Not transfusing in certain medical settings can be a life-threatening decision; however, Jehovah's Witness patients who reject transfusions have led to learning and multiplemedical interventions to avoid it. Despite this, heart surgery follows a specialty that is clearly related to the risk of transfusion, making operating on a Jehovah's Witness patient a challenge. Case presentation: An ascending aorta surgery was performed on a Jehovah's Witness patient, where different strategies were applied, both for blood saving and for the prevention and management of coagulopathy. Results: Surgery of the ascending aorta with extracorporeal circulation was successfully performed without requiring administration of blood components. Conclusions: Adequate planning and implementation of bleeding prevention strategies and coagulopathy management maycontribute to avoid and/or reduce the administration of blood products, allowing for the absence of transfusions to not be utopia in major cardiac surgery. [ABSTRACT FROM AUTHOR]

Fetal surgery in utero is an alternative for treatable congenital malformations. Prognosis will improve with early correction. Once the surgical technique is planned, the anesthetist's knowledge of maternal and fetal physiology is crucial for the selection of the ideal anesthetic technique for each individual case, considering the type of surgical procedure and the expected degree of fetal stimulation. In this way, the optimal surgical field with maternal and fetal safety will be ensured. This article describes 1 case of twin-to-twin transfusion syndrome under spinal anesthesia and sedation, and a second case of hydrothorax drainage under sedation. [ABSTRACT FROM AUTHOR]

Introduction: In pregnancies with a diagnosis of fetal myelomeningocele (MMC), studies have shown that prenatal correction, as compared with postnatal correction, results in better outcomes in infancy, requiring less ventriculoperitoneal shunts, and resulting in improved motor function of the lower limbs. However, maternal morbidity, the risk of uterine repair dehiscence, uterine rupture secondary to hysterotomy, and the need for cesarean section are all increased. This case report is the first successful experience of intrauterine repair of a MMC in Peru. Case presentation: We describe the case of a primigravida at 25 weeks of gestation with a diagnosis of fetalmalformation (MMC and Arnold Chiari II syndrome) taken to intrauterine correction of the neural tube defect under general anesthesia plus epidural analgesia. Conclusion: The use of total intravenous anesthesia associated with nitroglycerine infusion for uterine relaxation, ethylephrine infusion to maintain maternal hemodynamic stability, and adequate postoperative pain management with epidural analgesia was successful in this case. [ABSTRACT FROM AUTHOR]

Head and neck arteriovenous fistulas are uncommon. Central venous catheterization is a very frequent medical procedure, and complications are not unusual. We report a case of a 56-year-old woman who developed an arteriovenous vertebro-vertebral fistula after internal jugular vein cannulation. The only clinical manifestation was tinnitus, and physical examination revealed systolic cervical murmur and cervical thrill. The diagnosis was made with computed tomography and angiography, and the treatment was performed by means of non-invasive fistula closure with platinum coil embolization. [ABSTRACT FROM AUTHOR]

Se trata de un paciente de sexo masculino de cinco años de edad y 13 kg de peso, con diagnóstico de caries dental y programado para tratamiento odontológico integral. Al retirar la cinta adhesiva de los ojos, se observó midriasis derecha fija, sin reflejo a la luz, y sin otros cambios en el examen físico. Al cuarto día fue evaluado por neurología, con mejoría del tamaño pupilar. En el quinto día, la pupila volvió a su tamaño natural, sin secuelas, según el seguimiento y la información de un familiar. [ABSTRACT FROM AUTHOR]