From the Editor
Case Reports in the June issues teach us that uncommon clinical scenarios challenge our clinical diagnostic and patient management abilities.
The June 1 issue presents a case in which Drobish and colleagues describe postanesthesia emergence delirium including agnosia and expressive aphasia in a pediatric patient displaying excellent anxiolysis from midazolam premedication. Flumazenil effectively reversed the entire symptom complex. Emergence delirium continues to be a common and difficult-to-treat postanesthesia complication. The Authors describe the atypical offset of the midazolam and review its pharmacology and that of its antagonist.
The June 15 issue presents two obstetric anesthesia cases. Beilin and colleagues describe a patient who experienced bacterial meningitis after epidural blood patch to treat postdural puncture headache. The Authors remind us that headache in the obstetric patient may have multiple etiologies. Spitzer and colleagues describe a patient who experienced acute pulmonary hypertension in the peripartum period. Administration of methylergonovine aggravated her rare congenital cardiomyopathy, left ventricular noncompaction. The Authors explain their rationale for selecting cesarean delivery and how treatment of obstetric hemorrhage compromised cardiac function.
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