Dexmedetomidine, A Perfect Drug for Aortogram Run-off

Hi everyone, I hope you are all doing well. I can’t believe it is almost Christmas. Time flew by. I have been absent for a little while as I mentioned that I started my new job at an academic center. Starting this August, I took on research projects. I have submitted two prospective clinical research…

Pheochromocytoma and the Role of Remifentanyl during Adrenalectomy

In the past few years, I have had a few encounters with pheochromocytoma cases. It gave me an opportunity to compare different anesthetic techniques in managing the laparoscopic adrenal mass resection case. The traditional anesthetic management includes vasodilators and vasopressors to control hemodynamic changes in response to adrenaline resection. The first 2 cases of pheochromocytoma…

ALS and Anesthetic Management

Two weeks ago, I had a patient who came in for exploratory laparotomy s/p peg tubal insertion. She has unrelieved pain after the peg tube placement. Patient is in her mid 30’s. Needed the ped tube due to losing weight. She has been bedridden for a year and exhibited muscle atrophy in her extremities. She…

Post Dural Puncture Headache, True or False?

Haven’t we all experienced the common blame game in OB? Patient may not even have an epidural but the nurse would still call you to evaluate thinking automatically the post-dural puncture headache. If patients have epidural placed, the assumption of PDPH is even higher. However, we the OB anesthesia providers know the headache of an OB…

Part II: What’s Your Differential?

I called my attending to be in the room as SpO2 dropped to 90%. We did our differential and treated according to what we thought it was the case. But SpO2 was still hovering low 90’s. BP was borderline low. Patient was young and healthy and no medical history. Good thing is that it was a…

What Is Your Differential?

This is the topic I thought I knew so well, yet I failed my test. Let’s see if you can get it right. I had a lumpectomy and lymph node dissection case scheduled under MAC yesterday. We were not able to get an IV in a timely manner. My attending decided that it might be the best to do…