Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · Mar 1994
Randomized Controlled Trial Comparative Study Clinical Trial[Premedication with clonidine in the neurosurgical patient: sedation, anesthetic requirements and hemodynamic perfusion].
To analyze the effect of premedication with clonidine on postoperative sedation, anesthetic requirements and hemodynamic repercussions in patients undergoing craniotomy due to supratentorial intracranial pathology. ⋯ Premedication of neurosurgical patients with clonidine offers no advantages over lorazepam with respect to sedation. Nevertheless, clonidine may offer advantages with respect to the amount of alfentanyl required and attenuation of perioperative adrenergic response.
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Rev Esp Anestesiol Reanim · Mar 1994
Case Reports[Severe accidental hypothermia: rewarming by total cardiopulmonary bypass].
We present a case of a 20-year-old male with a history of habitual drug use who suffered extreme hypothermia (26 degrees C) after several hours' accidental exposure to low ambient temperature. The patient presented in deep coma with recurring ventricular fibrillation that yielded to electrical defibrillation once a central temperature of 27.4 degrees C was reached through internal rewarming with intravenous liquids and gastric lavage with warm water. ⋯ Emergency room staff have available the means for recognizing hypothermia and a protocol for its management. Extracorporeal circulation is an effective method for internal rewarming and must be used when the patient requires cardiopulmonary resuscitation or presents signs of severe hemodynamic instability.
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Rev Esp Anestesiol Reanim · Mar 1994
Historical Article[Importance of the daily and political newspapers in Madrid on the introduction, popularization and awareness of anesthesia].
The introduction of surgical anesthesia in Spain and its spread throughout the country between 1847 and 1848 was facilitated by several medical journals and new daily and political newspapers in existence at the time, particularly in Madrid. This study was undertaken to determine the possible impact of articles reporting the discovery of anesthesia that were published in the contemporary daily press. ⋯ Analysis of the articles revealed how the daily press contributed to the rapid dissemination of information about the discovery. The press provided an important means of spreading news about and popularizing anesthesia and was also an instrument for exchanging scientific opinion for Spanish surgeons of the day.
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Certain parts of Spain continue to have a high incidence of hydatid disease. Anaphylaxis mediated by IgE, due to the high concentration of antigens in the blood stream, is a serious but fortunately infrequent complication of surgery. We present two cases of anaphylactoid reaction in patients undergoing surgery for excision of hydatid cysts and one case of a patient scheduled for cholecystectomy with unsuspected hydatid disease. ⋯ Hydatid disease must be considered as a differential diagnosis in cases of shock during surgery in areas where it is endemic. Although infrequent, the possibility of anaphylaxis must be kept in mind whenever there is sudden hemodynamic deterioration during surgery for removal of a hydatid cyst. Early diagnosis and appropriate treatment are essential for a favorable outcome.