- |||||||||| hydromorphone hydrochloride / Generic mfg., midazolam hydrochloride / Generic mfg.
[VIRTUAL] Hydromorphone-based Analgosedation in the PICU: A Pilot Study () - Sep 25, 2021 - Abstract #AAPNCE2021AAP_NCE_1102;
This pilot study demonstrated overall improvement in short-term patient outcomes when compared to F-ASP, but due to limited power, results did not reach statistical significance. Further large-scale studies are necessary to demonstrate efficacy and long-term sustainability.
- |||||||||| fentanyl citrate / Generic mfg., ropivacaine / Generic mfg.
Comparison Of Neuraxial Techniques For Labor Analgesia: A Retrospective Analysis (Sails Pavilion) - Sep 25, 2021 - Abstract #ASA2021ASA_5239;
DPE was used more in those with higher BMI and CSE was more commonly used in multiparous patients with shorter duration of labor analgesia. Catheters placed by EPL technique needed more replacements than those placed by CSE and DPE techniques consistent with previous data indicating confirmation with successful dural puncture with CSE and DPE techniques may reduce catheter failure.
- |||||||||| ketamine / Generic mfg.
The Novel 6-2-2 Sedation Method: Safe In The Elderly And Morbidly Obese Patients For Ocular Blocks And Ophthalmic Surgery (Sails Pavilion) - Sep 25, 2021 - Abstract #ASA2021ASA_5177;
Catheters placed by EPL technique needed more replacements than those placed by CSE and DPE techniques consistent with previous data indicating confirmation with successful dural puncture with CSE and DPE techniques may reduce catheter failure. This retrospective study demonstrates that although the anesthetic management of the high-risk groups, specifically the elderly and the obese can be a challenge, through our methods of utilizing a mixture of propofol with narcotics (alfentanil, fentanyl, hydromorphone) and lidocaine/or ketamine an anesthesia provider can provide adequate sedation and analgesia for ophthalmic blocks and surgery while maintaining hemodynamic stability and airway patency comparable to the younger or normal weight patients.
- |||||||||| ketamine / Generic mfg.
Novel Non-opioid Anesthetic Mixture More Effective Than Opioid-based 6-2-2 For Ocular Block And Ophthalmic Surgery (Sails Pavilion) - Sep 25, 2021 - Abstract #ASA2021ASA_5175;
The novel non-opioid multimodal single syringe 6:2:2 mixture with propofol, ketamine and etomidate is superior to the opioid-based 6:2:2 mixtures with average 36 seconds for patient readiness for ocular block and 98% painless response without head movement, while maintaining airway patency and hemodynamic stability for ophthalmic surgery. It can potentially be used in other surgical and diagnostic procedures under MAC.
- |||||||||| fentanyl citrate / Generic mfg., morphine sulphate / Generic mfg., epinephrine / Generic mfg.
Spinal Anesthesia In Suspected Brugada Syndrome (Exhibit Hall) - Sep 25, 2021 - Abstract #ASA2021ASA_5144;
After an unsuccessful trial of labor, she elected for a cesarean section and received spinal anesthesia with 12mg of hyperbaric bupivacaine, 10mcg fentanyl, 150mcg morphine, and 100mcg epinephrine. She was discharged a few days later without complications.
- |||||||||| fentanyl citrate / Generic mfg., isoflurane / Generic mfg., nitroglycerin / Generic mfg.
Not All Hypertension Cases Are Essential (Exhibit Hall) - Sep 25, 2021 - Abstract #ASA2021ASA_5131;
On postoperative day 3, patient had sonography performed for abdominal distention, which revealed polycystic kidney disease. Patient was discharged on adjusted antihypertensive regimen with nephrology follow up.
- |||||||||| midazolam hydrochloride / Generic mfg.
A Case Of Difficult Left Subclavian Central Venous Access (Exhibit Hall) - Sep 25, 2021 - Abstract #ASA2021ASA_5095;
The guidewire was removed. The right subclavian vein was cannulated, and the chest x-ray showed the correct placement of the right subclavian chemo port with the absence of pneumothorax.
- |||||||||| fentanyl citrate / Generic mfg.
Difficult By Design: Challenges Of Pain Management In Patients Using Novel Synthetic Opioids (Exhibit Hall) - Sep 25, 2021 - Abstract #ASA2021ASA_5013;
NSOs include fentanyl analogs and non-fentanyl drugs with high potency...We describe a case of a patient who experienced atypical withdrawal patterns secondary to NSO-related opioid use disorder. The epidemiology of NSO usage and the perioperative implications of NSO usage are summarized in order to enable anesthesiologists to recognize and treat this disorder and its associated complications.
- |||||||||| fentanyl citrate / Generic mfg., rocuronium / Generic mfg., dexmedetomidine / Generic mfg.
Inadvertent Intra-arterial Anesthetic Induction (Exhibit Hall) - Sep 25, 2021 - Abstract #ASA2021ASA_5008;
Although few case reports discuss inadvertent intra-arterial injections, this case is unique in that four anesthetic drugs (propofol, fentanyl, dexmedetomidine, and rocuronium) were given simultaneously. We discuss the management and sequelae of the case, the risks of intra-arterial injection of medications, as well as recommendations for treatment in such events.
- |||||||||| fentanyl citrate / Generic mfg., morphine sulphate / Generic mfg.
Cesarean Delivery In A Parturient With Marfan Syndrome Complicated By A Dilating Aortic Root (Exhibit Hall) - Sep 25, 2021 - Abstract #ASA2021ASA_4975;
An elective cesarean delivery was done at 28 weeks: intrathecal fentanyl 15mcg and morphine 0.2mg were given and general anesthesia was performed with pre-induction arterial and central lines and FloTrac monitoring. Surgery and extubation were uneventful, and the patient was discharged after 6 days.
- |||||||||| fentanyl citrate / Generic mfg.
Epidural Labor Analgesia In Patient With Lumboperitoneal Shunt (Exhibit Hall) - Sep 25, 2021 - Abstract #ASA2021ASA_4897;
Loss of resistance obtained at 8cm. Labor course was uncomplicated: analgesia obtained with programmed intermittent boluses of 0.125% bupivacaine with fentanyl.
- |||||||||| fentanyl citrate / Generic mfg., morphine sulphate / Generic mfg., dexmedetomidine / Generic mfg.
Extremely High Opioid Requirements In Postoperative Care (Exhibit Hall) - Sep 25, 2021 - Abstract #ASA2021ASA_4862;
However his postoperative care was complicated by right upper quadrant pain consistent with preoperative exam. In order to manage his pain, he required in total 37.25 mg of intravenous hydromorphone, 3.1 grams of intravenous fentanyl, and 30 mg of morphine through his jejunostomy tube over the course of his 11-hour stay.
- |||||||||| midazolam hydrochloride / Generic mfg., duloxetine / Generic mfg.
Serotonin Syndrome Following Pancreatectomy, Splenectomy, And Hepatic Artery Bypass (Exhibit Hall) - Sep 25, 2021 - Abstract #ASA2021ASA_4814;
Intra-op he received methylene blue and epidural fentanyl infusion...He was treated with cyproheptadine, midazolam infusion, acetaminophen, and active cooling. 24 hours later sedation was weaned and the patient was neurologically intact.
- |||||||||| fentanyl citrate / Generic mfg., hydromorphone hydrochloride / Generic mfg.
Airway Management In Patient With Severe Facial Edema After Mandibular Orif (Exhibit Hall) - Sep 25, 2021 - Abstract #ASA2021ASA_4780;
A tracheostomy was performed due to continued concern of airway compromise in setting of suspected angioedema. Her symptoms resolved with discontinuation of hydromorphone and initiation of steroids.
- |||||||||| baclofen / Generic mfg.
A Case Of Postoperative Pyrexia: Baclofen Withdrawal Or Malignant Hyperpyrexia (Exhibit Hall) - Sep 25, 2021 - Abstract #ASA2021ASA_4778;
In the postoperative period, his temperature increased to 1030 C with tachycardia, hypertension, and increased muscle spasticity. He was treated with dantrolene, surface cooling, and intravenous hydration to the point of resolution of hypermetabolic signs.
- |||||||||| cefazolin / Generic mfg., dexamethasone / Generic mfg., midazolam hydrochloride / Generic mfg.
Anaphylaxis After Multiple Uneventful Cefazolin Exposures: A Case Report (Exhibit Hall) - Sep 25, 2021 - Abstract #ASA2021ASA_4760;
Just prior to hemodialysis catheter repositioning, she was sedated with midazolam, fentanyl, and dexmedetomidine...The patient was intubated and given epinephrine, diphenhydramine, dexamethasone, with clinical stabilization...The patient had received cefazolin 8 times and the sedation medications multiple times prior. We report this rare anaphylaxis in a patient who received cefazolin repeatedly without prior allergic reaction.
- |||||||||| midazolam hydrochloride / Generic mfg.
Recurrent Anaphylactic Shock Under General Anesthesia; Searching For A Culprit (Exhibit Hall) - Sep 25, 2021 - Abstract #ASA2021ASA_4700;
After placement of a latex Foley and central line the patient became severely hypotensive requiring epinephrine...Again, the patient exhibited signs of anaphylactic shock after central line placement and again tryptase returned positive. We highlight the importance of rare and unanticipated causes of anaphylaxis; in this case, suspected central line medication impregnation.
- |||||||||| fentanyl citrate / Generic mfg., sevoflurane / Generic mfg., methamphetamine / Generic mfg.
Analgesic Considerations In A Polysubstance Drug Abuser (Exhibit Hall) - Sep 25, 2021 - Abstract #ASA2021ASA_4664;
As a result, the patient required increased doses of both induction and maintenance agents, including above average dosing of sevoflurane and multiple doses of analgesic agents, including fentanyl and IV hydromorphone, for pain control during the procedure. We would like to review contributing factors that affect the MAC requirements for patients with polysubstance use disorder, as well as the efficacy of multimodal anesthetic agents in this patient population.
- |||||||||| Eladur (bupivacaine) / Amneal
Hypothermia Induced Bradycardia, Without Hypotension, Secondary To Spinal Anesthesia (Exhibit Hall) - Sep 25, 2021 - Abstract #ASA2021ASA_4649;
This patient's case was complicated by symptomatic bradycardia (40s) without hypotension, likely secondary to hypothermia (94.7 F orally) from spinal anesthesia (intrathecal bupivacaine, fentanyl, and morphine). Given the patient's previous history of post-operative nausea/vomiting, and classes of medications administered during perioperative stay, the patient required a prolonged stay in the PACU prior to being transferred to Labor and Delivery and ultimately discharged home.
- |||||||||| ketamine / Generic mfg.
Awake Fiberoptic Intubation In A Patient With A Large Obstructing Tongue Mass (Exhibit Hall) - Sep 25, 2021 - Abstract #ASA2021ASA_4645;
Ketamine was administered followed by fiberoptic bronchoscope insertion through an ovassapian airway...Propofol and succinylcholine were bolused, and upon resolution of laryngospasm, the bronchoscope was advanced. A 7.0mm endotracheal tube was placed and confirmed with capnography.
- |||||||||| lorazepam / Generic mfg., labetalol / Generic mfg.
Perioperative Management Of A Parturient With Eclampsia/preeclampsia (Exhibit Hall) - Sep 25, 2021 - Abstract #ASA2021ASA_4630;
She received lorazepam, magnesium, labetalol and hydralazine...An A line was placed and fentanyl, rocuronium, propofol infusion and sevoflurane were administered...EEG was unremarkable. POD1 she was extubated and discharged on POD 8.
- |||||||||| midazolam hydrochloride / Generic mfg.
Pulmonary Edema And Pea Arrest Necessitating Va Ecmo During Resuscitation Efforts In A Patient Undergoing Elective Termination Of Pregnancy. (Exhibit Hall) - Sep 25, 2021 - Abstract #ASA2021ASA_4565;
22-year-old female on heart transplant list, stage D congestive heart failure, LVEF 15%, non-ischemic cardiomyopathy from myopericarditis on milrinone infusion was admitted for bacteremia and PICC line revision...She received 2mg of midazolam and 100mcg fentanyl incrementally for sedation...Upon intubation, copious pink frothy sputum was suctioned from endotracheal tube suggestive of pulmonary edema. Patient was placed on veno-arterial ECMO and decannulated ten days later.
- |||||||||| ketamine / Generic mfg.
Chloroprocaine Labor Epidural For A Parturient With Local Anesthetic Resistance (Exhibit Hall) - Sep 25, 2021 - Abstract #ASA2021ASA_4554;
A successful chloroprocaine skin patch test led to a continuous epidural infusion of 0.3% 3-chloroprocaine for labor, with intermittent boluses of 3% chloroprocaine and fentanyl for breakthrough pain. The patient reported adequate pain relief for her uneventful vaginal delivery.
- |||||||||| fentanyl citrate / Generic mfg., morphine sulphate / Generic mfg.
Case Of A High Spinal In An Obese Parturient Despite Dose Reduction (Exhibit Hall) - Sep 25, 2021 - Abstract #ASA2021ASA_4537;
This case describes a high spinal in an obese parturient despite dose reduction, highlighting the variability of response to intrathecal dosing and elevated risk for high spinal in obese parturients. Therefore, additional intrathecal dose reductions with a catheter-based technique may be warranted in obese parturients.
- |||||||||| fentanyl citrate / Generic mfg.
Repeat Sinus Arrest Following Propofol Induction (Exhibit Hall) - Sep 25, 2021 - Abstract #ASA2021ASA_4460;
Here we present a 67 year-old male with past medical history of atrial fibrillation status-post ablation, colon cancer status-post resection, and carotid stenosis who experienced asystolic arrest following induction of anesthesia with fentanyl, lidocaine, and propofol for scheduled carotid endarterectomy...Shortly following induction for the rescheduled surgery, the patient again experienced asystolic arrest despite pre-treatment with glycopyrrolate. ROSC was achieved in 1.5 minutes, and the procedure was completed successfully.
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