Anesthetics Consideration and Literature Review in Traumatic Biliothoracic Fistula
Priscila Alvarenga,
Lucas Ferreira Gomes Pereira,
Carlos Darcy Alves Bersot,
Augusto José Cavalcanti Neto,
José Eduardo Guimarães Pereira
Issue:
Volume 7, Issue 2, December 2019
Pages:
29-34
Received:
31 October 2019
Accepted:
2 December 2019
Published:
10 December 2019
Abstract: The literature is sparse about anesthetic management for thoracobiliary fistula (TBF) correction surgeries. A gunshot wound victim to the right thoracoabdominal region presented a green colored secretion draining from the right hemithorax during the postoperative period. Laboratory analysis of the secretion along with ultrasound and CT scan confirmed the clinical suspicion of pleurobiliary fistula (PBF). Laparotomy with diaphragm and liver repair plus thoracic drainage was performed. The patient was discharged home after an uneventful postoperative recovery and returned 15 days later for follow-up visit without complaints. PBF is a clinical condition prone to complications and its recognition along with the differential diagnosis from BBF is important to determine which anesthetic and surgical measures should be taken. Anesthesia for PBF correction should preconize appropriate analgesia and remain vigilant to the risk of cardiovascular instability during fistula correction.
Abstract: The literature is sparse about anesthetic management for thoracobiliary fistula (TBF) correction surgeries. A gunshot wound victim to the right thoracoabdominal region presented a green colored secretion draining from the right hemithorax during the postoperative period. Laboratory analysis of the secretion along with ultrasound and CT scan confirm...
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Continuous ESP Block Technique for an Open Thoracotomy in Neurofibromatosis Patient
Matheus de Castro Abi-Ramia Chimelli,
Amanda Caroline Figueiredo Gomes Andrade,
Marcelo Grisólia Gonçalo,
Clarissa Mayara de Sales Guimarães,
Carlos Frederico Panisset Lanhas La Cava,
Carlos Darcy Alves Bersot
Issue:
Volume 7, Issue 2, December 2019
Pages:
35-37
Received:
9 November 2019
Accepted:
17 December 2019
Published:
30 December 2019
Abstract: Neurofibromatosis remains a challenge for the anesthesiologist as it brings issues especially regarding safety of anesthetic management such as airway management and neuraxial anesthesia. We report a case of a 60 year-old woman with controlled clinical comorbidities and neurofibromatosis, admitted for an open thoracotomy for excision of a growing pulmonary lesion, highly suspicious for malignancy. She had cutaneous tumors covering the majority of her skin. No neuroimage was available to exclude neuraxial or intracranial tumors, ensuring the safety for neuraxial anesthesia, therefore a combined technique was proposed with general anesthesia and a continuous erector spinae plane (ESP) block for anesthesia and analgesia. Surgery occurred successfully and there was no need to supplement or alter the initially planned anesthetic technique. Patient referred pain score ranging from 0-1 in rest and motion postoperative and required no complementary opioid for pain control. Infusion in the ESP catheter was maintained for 48h, after which it was removed and patient discharged without further complications or pain.
Abstract: Neurofibromatosis remains a challenge for the anesthesiologist as it brings issues especially regarding safety of anesthetic management such as airway management and neuraxial anesthesia. We report a case of a 60 year-old woman with controlled clinical comorbidities and neurofibromatosis, admitted for an open thoracotomy for excision of a growing p...
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