RESUMO
Anesthetic management of patients with coagulation disorders presents safety and technical challenges. This case describes a 58-year-old woman with factor V Leiden mutation who required distal saphenous vein harvest and axillo-brachial bypass to treat axillary artery occlusion. The patient underwent surgery with satisfactory anesthesia using infraclavicular brachial plexus block, thoracic paravertebral block, and unilateral subarachnoid block. These three regional anesthetic interventions were performed in lieu of general anesthesia to minimize risks of thrombotic events, pain, and to decrease recovery time. Despite higher failure rates of regional anesthesia, longer time required for procedures, and added discomforts during surgery, the benefits may outweigh risks for selected high-risk patients, including those with factor V Leiden mutations.
Assuntos
Anlodipino/intoxicação , Bloqueadores dos Canais de Cálcio/intoxicação , Cardiotônicos/uso terapêutico , Hidrazonas/uso terapêutico , Piridazinas/uso terapêutico , Adolescente , Agonistas alfa-Adrenérgicos/administração & dosagem , Antídotos/administração & dosagem , Cloreto de Cálcio/administração & dosagem , Carvão Vegetal/administração & dosagem , Soluções Cristaloides , Dopamina/administração & dosagem , Overdose de Drogas , Feminino , Lavagem Gástrica , Humanos , Insulina/administração & dosagem , Soluções Isotônicas/administração & dosagem , Norepinefrina/administração & dosagem , Simendana , Resultado do TratamentoRESUMO
Foreign bodies in the external auditory canal may cause otalgia, and live insects have been reported among the causes. A number of methods have been used to immobilize the live insects. In our manuscript, we describe immobilization of an insect and provision of analgesia using EMLA cream.
