Misconceived Retropharyngeal Calcific Tendinitis during Management of Myofascial Neck Pain Syndrome

Differential diagnosis of posterior neck pain is very challenging based on symptoms and physical examination only. Retropharyngeal calcific tendinitis is a rare and frequently misdiagnosed entity in various causes of neck pain. It results from calcium hydroxyapatite deposition in the longus colli muscle which is characterized by severe neck pain, painful restriction of neck movement, dysphagia, and odynophagia. We herein report a case of a patient with acute retropharyngeal calcific tendinitis, who complained of posterior neck pain, initially diagnosed and treated as a myofascial neck pain syndrome.

Nerve injury in an undiagnosed adult tethered cord syndrome patients following spinal anesthesia: A case report

Spinal anesthesia is a safe and widely used procedure. Spinal cord injury is a rare but serious complication from spinal anesthesia occurs, unexpectedly. Risks of direct neural injury from spinal anesthesia increase in tethered cord syndrome that the spinal cord is tethered by the inelastic structure and is, also, extended to the lower lumbar vertebra. A 52-years-old female patient undergoing anti-incontinence surgery developed neurologic symptoms following spinal anesthesia. The low-lying conus (L5 body level) and tethered cord were found during the assessment of neurological symptoms.

Comparison of palonosetron with ondansetron in preventing postoperative nausea and vomiting after thyroidectomy during a 48-hour period

BACKGROUND: Postoperative nausea and vomiting (PONV) are common complications after general anesthesia. This study compared the effects of palonosetron and ondansetron in preventing PONV in patients undergoing thyroidectomy. METHODS: 100 non-smoking female subjects were randomly assigned to a palonosetron group (n = 50) or an ondansetron group (n = 50). The patients of each group received 0.075 mg of palonosetron or 8 mg of ondansetron through intravenous bolus injection before induction of general anesthesia. The incidence of nausea and vomiting were monitored at 2 h, 24 h and 48 h after operation. RESULTS: The incidence of PONV during 48 h after operation had no significant differences between the groups. However, the incidence of nausea was lower in the palonosetron group than in the ondansetron group (34% vs. 56%, P = 0.027). No differences were observed in incidences of vomiting, use of antiemetics and adverse events between the groups. CONCLUSIONS: Palonosetron was more effective than ondansetron in preventing nausea for patients undergoing thyroidectomy. However, the effect of palonosetron or ondansetron in preventing PONV was similar.