The pathophysiologic underpinnings of idiopathic hypersomnia and its interactions with anesthetic medications remain poorly understood. There is a scarcity of literature describing this patient population in the surgical setting. This case report outlines the anesthetic considerations and management plan for a 55-year-old female patient with a known history of idiopathic hypersomnia undergoing an elective shoulder arthroscopy in the ambulatory setting. In addition, this case offers a unique set of considerations and conflicts related to the patient having a family history of malignant hyperthermia. A combined technique of general and regional anesthesia was used. Anesthesia was maintained with total intravenous anesthesia via the use of propofol and remifentanil. The depth of anesthesia was monitored with entropy. There were no perioperative complications.

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Amniotic fluid embolism (AFE) is a catastrophic, sudden-onset event that must be recognized immediately. Despite the rarity of this condition, both maternal and perinatal morbidity and mortality are significant with AFE, even in cases ideally managed. In this article, we present five key statements covering the risk factors, clinical presentation, and management of AFE in a clinical setting. The purpose of these tips is to provide clinicians with information that may improve their ability to make a timely diagnosis and establish appropriate supportive treatment to patients suffering from AFE. RésuméL’embolie amniotique est un événement catastrophique d’apparition soudaine qui doit être détecté immédiatement. Malgré la rareté de cette affection, la morbidité et la mortalité maternelles et périnatales sont importantes, même dans les cas où le traitement est idéal. Dans cet article, nous présentons cinq énoncés clés qui portent sur les facteurs de risque, le tableau clinique et la prise en charge de l’embolie amniotique dans un contexte clinique. Ces astuces visent à fournir aux cliniciens de l’information qui pourrait améliorer leur capacité à poser un diagnostic en temps opportun et à assurer un traitement de soutien approprié aux patientes atteintes d’une embolie amniotique.

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