Carpal tunnel syndrome caused by thrombosed persistent median artery - A case report -

A rare case of carpal tunnel syndrome caused by a thrombosed persistent median artery is presented here. The diagnosis was delayed due to the overlapping cervical radiculopathy. Acute severe pain and nocturnal paresthesia were chief complaints. Ultrasonography, magnetic resonance imaging, and computed tomography angiography revealed that the median nerve was compressed by the occluded median artery. Instead of surgery, conservative therapy was tried. It worked well for six months. The importance of using modalities for decision making of diagnosis and treatment is emphasized in this report.

Intrauterine fetal bradycardia after accidental administration of the anesthetic agent in the subdural space during epidural labor analgesia: A case report / 대한마취과학회지

Subdural injection of epidural anesthesia is rare and is usually undiagnosed during epidural anesthesia causing severely delayed maternal hypotension, hypoxia, and fetal distress. A 38-year-old primiparous woman was administered epidural labor analgesia at 40(+6) weeks' gestation, and developed progressive maternal respiratory depression, bradycardia, and hypotension after accidental subdural administration of the anesthetic agent. Furthermore, fetal distress occurred soon after administration. The patient was managed with oxygen, position changes, fluid resuscitation, and ephedrine. Intrauterine fetal resuscitation was successfully performed with atropine before cesarean section, and a healthy baby was delivered. Although subdural injection is uncommon, this case emphasizes the importance of anesthesiologists monitoring patients for a sufficient period after epidural labor analgesia, and being prepared to perform maternal or fetal resuscitation.

Airway obstruction in heat & moisture exchanger filter: A case report

Heat and moisture exchanger filters (HMEF), used for humidification of patient respiratory gas and filtering microorganisms can cause airway obstruction. We experienced serious airway obstruction in a HMEF after making hydrothorax for high intensity focused ultrasound (HIFU) procedure. The airway obstruction was difficult to differentiate from severe bronchospasm irresponsive to bronchodilator therapy. It was relieved dramatically after we removed the filter from the breathing circuit as soon as we detected air-fluid meniscus in it.