Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · Jan 1999
Historical Article[Obstetric anesthesia/analgesia in Spain. Study notes on its historical evolution during the 1st half of this century].
This historical review of obstetric analgesia-anesthesia in Spain covers the first half of the twentieth century. Following usual practice for researching medical history, we have performed an exhaustive review of Spanish medical literature published during the study period, followed by classification, study and critical analysis. We found that the first half of the century saw considerable change in the application of analgesic-anesthetic techniques for childbirth and obstetric procedures, indicating that practitioners were far from apathetic as had been obstetricians of the second half of the nineteenth century, who generally rejected any type of analgesia for use during labor and birth. The numerous techniques in vogue during that period under study are described, although analgesia-anesthesia by inhaled ether and chloroform was undoubtedly the most widely used by obstetricians until well into the 1950's.
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Rev Esp Anestesiol Reanim · Jan 1999
Case Reports[Prolonged neuromuscular block after a single dose of vecuronium in a patient with undiagnosed polyneuropathy and steroid myopathy].
We report the case of a patient who had been receiving long-term corticoid therapy with undiagnosed polyneuropathy and steroid-related myopathy before experiencing prolonged neuromuscular blockade (lasting longer than 4 hours) after administration of a single dose of 0.08 mg/kg of vecuronium. Neuromuscular function was monitored by accelerometry with four-stimuli series. ⋯ After electromyography and muscle biopsy, polyneuropathy and steroid-related myopathy were diagnosed. We conclude that neuromuscular blockers should be administered with extreme caution to patients with polyneuropathy and those undergoing long-term corticoid therapy, in order to prevent prolonged neuromuscular blockade.
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Rev Esp Anestesiol Reanim · Jan 1999
Randomized Controlled Trial Clinical Trial[Preloading with 500 ml of Hartmann's solution lessens the incidence and severity of hypotension and reduces the need for ephedrine after epidural anesthesia in ambulatory patients].
Fluid preloading to prevent hypotension after epidural anesthesia has been widely questioned, although few studies have been performed in outpatients. ⋯ For patients undergoing outpatient surgery, fluid preloading with 500 ml of Hartman's solution decreases both the incidence and severity of hypotension, as well as the need for vasoactive drugs after epidural anesthesia.