Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · May 1997
Randomized Controlled Trial Clinical Trial[Postoperative analgesia with epidural methadone in patients operated for hernia of the lumbar disc].
To determine whether the direct application of a single dose of methadone on the dura mater at the end of surgery to repair a lumbar disk hernia provides effective analgesia over the next 24 hours. ⋯ Topical administration of 5 mg of methadone on the dura mater at the end of herniated lumbar disk repair is an easy, safe and effective technique for providing postoperative analgesia.
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Although postoperative behavioral anomalies were first reported more than one hundred years ago, only in the past ten years has the profile for postoperative cognitive dysfunction (POCD) been defined. POCD is reversible and it has been suggested that the disorder has implications for increased mortality and morbidity if it is not diagnosed and treated early. At present the clinical presentation of POCD is thought to be variable and fluctuating, ranging from slight disorientation to coma. ⋯ Once symptoms have developed,whether in the recovery unit or later, it is important to eliminate organic factors and begin treating the cause. The most important drugs for treatment are neuroleptics and benzodiazepines. We review the definition, epidemiology, etiology, pathophysiology and treatment of POCD and include a list of diseases and drugs associated with its development, as well as a description of psychological tests used for diagnosis.
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Rev Esp Anestesiol Reanim · May 1997
Case Reports[Late ischemia and carpal tunnel syndrome secondary to catheterization of the radial artery].
Invasive measurement of blood pressure has many advantages. Although arterial canalization is a low-risk technique of great benefit to the patient, complications must be looked for. ⋯ Two weeks after the procedure the patient showed signs of hand ischemia and acute carpal tunnel syndrome, which evolved favorably after treatment with heparin sodium and prostaglandin E1. We emphasize the importance of an earlier wrist fracture as the predisposing factor for both conditions and the need to examine collateral circulation in the hand and look for carpal tunnel syndrome before canalization.