Real-time measurement of blood pressure with Nexfin in a patient with thalidomide-related phocomelia

Earle, Rosie; Vaghadia, Himat; Shanahan, Enda; Tang, Raymond; Sawka, Andrew

doi:10.1016/j.jclinane.2016.04.035

Cited by 3 publications

(1 citation statement)

References 7 publications

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“…The use of bioreactance cardiac output monitoring in conjunction with serial bed‐side echocardiograms and more traditional methods of volume status assessment such as urine output and central venous saturations provided a basis for fluid management. One case report has described the successful use of continuous blood pressure and cardiac output monitoring via photoplethysmographic technology as used by the Nexfin monitor (BMEYE, Amsterdam, The Netherlands) in a patient with phocomelia [8]. We elected not to use this intra‐operatively due to the possibility of digit ischemia and the inability of the patient to express discomfort while under anaesthesia, but this could have been used as an alternative method of monitoring postoperatively.…”

Section: Discussionmentioning

confidence: 99%

Peri‐operative management of an adult with tetra‐amelia undergoing major abdominal surgery

Loughnan

Milan

2020

Anaesthesia Reports

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Summary Tetra‐amelia is a rare birth defect characterised by the complete absence of all four limbs. Affected infants are often stillborn or die shortly after birth. There is therefore limited experience in the management of this condition in surviving adults, and published guidelines on peri‐operative and anaesthetic management do not exist. We present a 34‐year‐old woman with tetra‐amelia who underwent an elective distal pancreatectomy and splenectomy for a mucinous tumour of the body and tail of the pancreas. The anaesthetic challenges highlighted by this case include difficult intravenous access, unachievable blood pressure monitoring, management of fluid balance status peri‐operatively, effective drug dose titration and temperature management. In the absence of intra‐operative blood pressure monitoring, other modalities were used to monitor haemodynamic and volume status peri‐operatively. As drug dosing guidelines do not exist for this condition and drug pharmacodynamics may be unpredictable, we recommend careful dose titration and bespoke multimodal analgesia, which is best achieved in a high dependency setting.

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Section: Discussionmentioning

confidence: 99%

Peri‐operative management of an adult with tetra‐amelia undergoing major abdominal surgery

Loughnan

Milan

2020

Anaesthesia Reports

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Managing a Pregnancy With Maternal Amelia

Siwatch

Gainder

Prasad

et al. 2019

Obstetrics &Amp; Gynecology

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INTRODUCTION: Amelia, the complete absence of a limb, presents various management issues in pregnancy and delivery. CASE: A woman with amelia of both lower limbs and flipper-like upper limb buds (phocomelia) presented in her first pregnancy at 19 weeks of gestation. Challenging issues encountered in the care of the patient included venous access, reliable blood pressure measurement, recommendations regarding mode of delivery, and preparation for caring for the child. The patient had abnormalities of the pelvis but an adequate midpelvis, so she was able to deliver vaginally without complication. CONCLUSION: Careful planning to allow necessary modification of intrapartum management can allow for normal vaginal birth for a patient with severe limb reduction abnormalities such as amelia and phocomelia.

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Collaborative Establishment of Difficult Vascular Access for General Anesthetic Management of an Adult With Tetra-Amelia: A Case Report

Horn¹,

Khaja

Stucken

et al. 2018

A&A Practice

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Tetra-amelia is a rare congenital disorder characterized by the absence of limbs. We describe the anesthetic management of a 29-year-old woman with tetra-amelia who underwent general anesthesia for tympanomastoidectomy with meatoplasty for an extensive right ear cholesteatoma. Anesthetic challenges related to tetra-amelia include difficult intravenous access, lack of sites for blood pressure monitoring, and possible difficult airway management due to craniofacial anomalies. Our case report focuses on the complex establishment of iliac artery access for invasive blood pressure monitoring by initially cannulating the carotid artery.

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Real-time measurement of blood pressure with Nexfin in a patient with thalidomide-related phocomelia

Cited by 3 publications

References 7 publications

Peri‐operative management of an adult with tetra‐amelia undergoing major abdominal surgery

Peri‐operative management of an adult with tetra‐amelia undergoing major abdominal surgery

Managing a Pregnancy With Maternal Amelia

Collaborative Establishment of Difficult Vascular Access for General Anesthetic Management of an Adult With Tetra-Amelia: A Case Report

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