Auto-Brewery Syndrome and General Anesthesia: A Case Report.

Auto-brewery syndrome (ABS) is a rare condition in which ethanol is endogenously fermented by fungi in the gut following a carbohydrate-rich meal, resulting in intoxication. We present a case of a patient with ABS successfully undergoing general anesthesia for symptomatic wisdom tooth extraction. During previous anesthetics, the patient had experienced postoperative nausea and vomiting (PONV) and awareness under anesthesia.

Succinylcholine Use and Dantrolene Availability for Malignant Hyperthermia Treatment: Database Analyses and Systematic Review.

Background: Although dantrolene effectively treats malignant hyperthermia (MH), discrepant recommendations exist concerning dantrolene availability. Whereas Malignant Hyperthermia Association of the United States guidelines state dantrolene must be available within 10 min of the decision to treat MH wherever volatile anesthetics or succinylcholine are administered, a Society for Ambulatory Anesthesia protocol permits Class B ambulatory facilities to stock succinylcholine for airway rescue without dantrolene. The authors investigated (1) succinylcholine use rates, including for airway rescue, in anesthetizing/sedating locations; (2) whether succinylcholine without volatile anesthetics triggers MH warranting dantrolene; and (3) the relationship between dantrolene administration and MH morbidity/mortality.

The Development of Dental Anesthesiology As a Discipline and Its Role As a Model of Interdisciplinary Collaboration.

The majority of dental procedures can be performed with an awake patient and the use of a local anesthetic, but when deep sedation and general anesthesia are needed, they typically are provided by those dentists with advanced training in anesthesiology, i.e., oral and maxillofacial surgeons and dentist anesthesiologists.

Perioperative temperature elevation: not all hyperthermia is malignant hyperthermia.

Objectives: The objective of this review is to assist the readers, anesthesiologists, intensivists, and emergency physicians in making a more accurate diagnosis of perioperative fever or hyperthermia and subsequently choose the proper course of treatment.

Aim: To identify the many sources of perioperative fever and after a more accurate differential diagnosis, select appropriate treatment options. Most anesthesiologists, intensivists, and emergency physicians are not familiar with an expansive differential of perioperative fever.

Anesthetic emergencies in oral surgery: malignant hyperthermia, endocrinopathy, and neurologic events.

Despite the impressive safety of office-based anesthesia, serious emergencies still occur. Early and appropriate treatment is likely to improve outcomes. This article discusses selected emergencies with backgrounds and rationale for emergent treatment.

Perioperative dental evaluation.

Typically, a patient's intraoral condition is not a chief perioperative concern. The need for proper dental care is often unmet prior to a surgical procedure. Consequently, patients presenting for surgery may possess untreated decayed teeth and/or periodontal disease.

Focused local anesthesia and analgesia for head and neck surgery.

Facility in the use of head and neck regional blocks will provide excellent perioperative analgesia and patient satisfaction. The scope of ambulatory surgical care for head and neck surgery will undoubtedly increase as expertize in these blocks expand in the face of strict criteria for patient selection. Supplemental sedation will be more precise with the intended result of less hangover and nausea and vomiting.

Strategies to reduce blood loss during posterior spinal fusion for neuromuscular scoliosis: a review of current techniques and experience with a unique bipolar electrocautery device.

In this chapter, we review current techniques employed to decrease blood loss and describe the effective use of a unique bipolar electrocautery device in a patient with neuromuscular scoliosis undergoing posterior spinal fusion (PSF). The reduction of blood loss and subsequent elimination of allogeneic blood transfusion is a desired outcome in all surgeries and is a major concern during PSF. In the child or adolescent with neuromuscular scoliosis, this becomes a greater concern due to a variety of factors such as the inability of the musculature to compress blood vessels, extensive surgical exposure, and the duration of the operation.

Anesthesia in a patient with chromosome 11;22 translocation: a case report and literature review.

Chromosome 11;22 translocation is a rare genetic condition, which results in characteristic features some of which may present problems when these children require surgery and anesthesia. We describe a child with this chromosomal variant who presented for surgery and anesthesia. The case report and review of the literature is presented here.