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Case Report 

Anesthesia Considerations for the Repair of a Left Ventricular to Right Atrial Shunt (Gerbode Defect) Post Double-Valve Repair

Koh Li Ying, Loh Kenny and Shah SS

Abstract

The Gerbode defect is a rare type of ventricular septal defect (VSD) causing a left ventricle (LV) to right atrium (RA) shunt. These are usually congenital but acquired defects are increasingly being reported. Direct surgical repair remains one of the treatment options and presents considerable anesthetic challenges. We present a case report on anesthesia considerations for acquired Gerbode defect post mitral and tricuspid valve repair.

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Research Article 

Real-Time Locating Systems and the Effects on Efficiency of Anesthesiologists

Cindy Yeoh, Jennifer Mascarenhas, Kay See Tan and Luis Tollinche

Abstract

A retrospective chart review was performed for all outpatient and short-stay patients who received General Anesthesia care at our institution between January 2016 and October 2017. Patients included were over 18 years and had ASA classification scores of 1, 2, and 3. Only first cases of the day for individual anesthesiologists were included. Duration between two perioperative time points was collected and used as a measure of efficiency. Two groups of anesthesiologists were compared.

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CASE REPORT 

Spontaneous Cerebrospinal Hypotension: A Case Report

SR Gopal, PRAM Depauw, J Peluso and F Van Eijs

Abstract

Spontaneous cerebrospinal hypotension may be caused by leakage of cerebrospinal fluid. The characteristic symptom is orthostatic headache. MRI scan may yield a number of characteristic abnormalities. Treatment initially is conservative.

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CASE REPORT 

Neuroanesthesia in an Awake Patient in a University Hospital in Latin America: Case Report

Ocampo Pérez Ana-María, Arenas Villamizar Angel-Ricardo, Gonzalez Solarte Karen-Dayana and Husband Luque Johnnie-Smith

Abstract

The anesthetic technique for tumors resection that affect extensive motor areas with an awakened patient, poses a challenge for surgical teams. The advancement in neuroimaging and the incursion of neuronavigation as a surgical tool, allow reducing motor sequelae and extending the safety margins in the resection of these types of tumors.

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REVIEW ARTICLE 

Ketamine: New Use for an Old Hat

Hassan I Khidr and Rif S El-Mallakh

Abstract

This article aims at examining the available knowledge about ketamine as a novel treatment option for management of treatment-resistant major depression.

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CASE REPORT 

Prolonged Cardiac Arrest and Localized Thoracic Spinal Cord Ischemia

Sridhar Musuku

Abstract

A 29-year-old man presented to the emergency with a sudden onset of shortness of breath and syncope. Electrocardiogram showed a right bundle branch block, ST elevation in leads V1-V4. A transthoracic echocardiography showed an embolus in transit at the inferior vena cava and right atrial junction.

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Review Article 

Reasons to Avoid Pain Scales in Newborns, and Reasons to Use Them

Carlo V Bellieni

Abstract

Aim of this paper is a critical examination of the use of neonatal pain assessment tools. It emerged that neonatal pain scales for acute pain are complex to use, give a score when the maneuver is over, and they are not validated for levels of pain higher than those due to a heel-prick.

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Case Report 

Difficult Direct Laryngoscopy Followed by Easy Video Laryngoscopic Intubation in a Patient with Bilateral Mandibular Tori: Should the Patient be Labeled as Having a "Difficult Airway?"

Tan J, Joseph R Ruiz, Steven Y Huang, Samara Blair and Carin A Hagberg

Abstract

Mandibular tori are intraoral bony prominences which can make direct laryngoscopic intubation difficult. We present a case where we were unable to intubate a patient with bilateral mandibular tori using direct laryngoscopy, but then succeeded using video laryngoscopy.

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RESEARCH ARTICLE 

The Preliminary Impact of Pain Management Integration into an HIV Specialty Clinic

Sheran Mahatme, Timothy J Atkinson, Amy Spallone and Jeffrey Fudin

Abstract

A significant number of HIV (human immunodeficiency virus) infected patients suffer from chronic pain where providers often lack access to specialty pain management services. Emerging evidence about risks of chronic opioid use has resulted in closer scrutiny of long-term opioid therapy.

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ORIGINAL RESEARCH 

Acupuncture in Conjunction with Drug Therapy in the Treatment of Glossopharyngeal Neuralgia

Dominic P Lu, Gabriel P Lu and Ping-Shi Wu

Abstract

In this study, 35 patients who suffered from glossopharyngeal neuralgia and received acupuncture with drug therapy were divided into 4 groups according to the medication they were prescribed to take. Those who took phenytoin were placed in Group I, those took gabapentin were in Group II, those who took carbamazepine were categorized as Group III, and those took amitriptyline and gabapentin belonged to Group IV.

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