Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · Feb 1997
Case Reports[Indication for spinal anesthesia for cesarean section in HELLP syndrome coagulopathy].
We describe the relation between coagulation and local-regional anesthesia in two women with HELLP syndrome who required emergency cesarean delivery. HELLP syndrome involves hemolysis, elevated liver enzyme levels and thrombopenia complicating the hypertension of pregnancy. Regional anesthesia presents advantages for mother and fetus in this context but also involves the risk of coagulopathy. ⋯ The patient's condition must be watched closely until coagulation becomes normal. Removal of the epidural catheter must wait until coagulopathy is resolved. When coagulopathy is evident before surgery, intradural anesthesia is a safe option provided hemodynamic stability is assured, as demonstrated by the second case we report.
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Rev Esp Anestesiol Reanim · Feb 1997
Randomized Controlled Trial Comparative Study Clinical Trial[Changes in the concentrations of catecholamines and cortisol in balanced anesthesia and total intravenous anesthesia].
To compare hormone response to stress caused by surgery performed under balanced general anesthesia and total intravenous anesthesia. ⋯ Hormone levels are significantly higher during intravenous anesthesia than during balanced anesthesia, and the difference is evident from the earliest measurement performed.
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Rev Esp Anestesiol Reanim · Feb 1997
Letter Case Reports[Continuous axillary plexus block in pediatrics].
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Rev Esp Anestesiol Reanim · Feb 1997
Randomized Controlled Trial Clinical Trial[Air-convection heater for abdominal surgery. Study of the relation between surgical time and the efficacy of body temperature maintenance].
1) To quantify the efficacy of forced air warming for maintaining body temperature during general anesthesia of adults, and 2) to study the relation between the duration of surgery and the level of thermal protection provided by the device used. ⋯ The Bair Hugger heater is effective during abdominal operations lasting two or more hours. The device not only prevented hypothermia from deepening during surgery, but also reversed hypothermia in spite of being used after anesthetic induction and in spite of the loss of heat produced by secondary vasodilation.
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Rev Esp Anestesiol Reanim · Feb 1997
Comparative Study[Electron microscopy of the lesions produced in the human dura mater by Quincke beveled and Whitacre needles].
Comparisons of Quincke needles and non traumatic "pencil point" needles in recent years have reported lower rates of post dural puncture headache using the later type. Our new understanding of the morphology of the human dura mater motivated us to study dural lesions caused by the Whitacre 25 G and Quincke 26 G needles, using scanning electron microscopy with the aim of determining whether there is an anatomic basis for the different outcomes. ⋯ Non traumatic beveled dural needles, termed "pencil point needles", only partially separate dural fibers, and lesions caused by these needles develop in a more complex way. The Quincke 26G needle produced a puncture that is morphologically different from that caused by the Whitacre 25G needle, although lesions produced by both types close more than 94% after 15 min. We believe the size of the lesion caused by these needles does not explain the difference in post dural puncture headache due to loss of spinal fluid.