Revista española de anestesiología y reanimación
-
Rev Esp Anestesiol Reanim · Mar 1991
Historical Article[History of the introduction of ether anesthesia in Spain. A new contribution to its study].
Ether anesthesia was introduced in Spain on January 13, 1847. Dr. Diego de Argumosa y Obregón, from Madrid, was the first Spanish surgeon who operated with the help of sulphuric ether. ⋯ We have in some occasions defended that thesis; however, we were not satisfied with it and we decided to reinvestigate the facts. We had access to other sources and we concluded that anesthetics were really used a very early phase in Santiago de Compostela, but in the case of ether it was later than Argumosa and Oliverio Machechan used it in Madrid and Mendoza in Barcelona. In the present article we analyze these facts in detail, with emphasis on those that we consider historically relevant and that had not been previously dealt with by any other author addressing these issues.
-
Rev Esp Anestesiol Reanim · Mar 1991
Letter Historical Article[Ether anesthesia by the rectal route].
-
Rev Esp Anestesiol Reanim · Mar 1991
Randomized Controlled Trial Comparative Study Clinical Trial[Comparative study of peridural anesthesia with bupivacaine alone and combined with fentanyl during vaginal delivery].
Two groups of primiparous women with single fetus in cephalic presentation were prospectively randomized at the end of pregnancy to receive epidural analgesia with 0.25% bupivacaine, either single (n = 102) or associated with 0.05 mg of phentanyl (n = 102). Phentanyl significantly reduces the period of development of analgesia and increases the interdose period. ⋯ The evolution of delivery (dilatation and expulsion) and the perinatal results (cord pH and vitality of the newborn as assessed by the Apgar test) were similar in both groups. We conclude that the association of phentanyl with bupivacaine has advantages for epidural analgesia during delivery, as the quality of analgesia is improved, its duration is prolonged and there are no adverse effects on the evolution of delivery or on the newborn.
-
Rev Esp Anestesiol Reanim · Mar 1991
Case Reports[Use of a new inotropic agent, enoximone, in heart surgery].
We report our experience with the use of enoximone in 5 patients with severely depressed preoperative myocardial function who underwent cardiac surgery. In patients 1 and 2, enoximone was administered as the inotropic of choice before cardiopulmonary bypass (CPB) and a substantial improvement of cardiac index was achieved; in these patients, enoximone administration after CPB permitted to overcome low cardiac output which persisted after high dose dobutamine in patient 1, and in patient 2 right ventricular contractility improved. In patient 3 the use of enoximone permitted the discontinuation of CPB, which had not been previously possible with the association of dopamine and dobutamine. ⋯ However, in patient 4 the administration of enoximone during pre-CPB did not improve in a reduction in filling pressures without an increase in the cardiac index because the patient was hypovolemic. In patient 5, the administration of enoximone permitted to interrupt the infusion of dobutamine and to reduce the dose of sodium nitroprusside, which had resulted in significant tachycardia, with increased myocardial contractility and a reduction of vascular peripheral and pulmonary resistances. We conclude that enoximone, single or in association with other inotropics, should be considered a drug of choice in patients undergoing cardiac surgery who develop a low cardiac output syndrome.
-
Rev Esp Anestesiol Reanim · Mar 1991
Letter Historical Article[Ether by the rectal route for the treatment of cholera].