Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · Feb 1999
Comparative Study[Comparative study of percutaneous tracheotomy and conventional surgical tracheotomy in patients with prolonged intubation].
Percutaneous tracheotomy (PT) has become an alternative to conventional surgical tracheotomy (CST) in recent years. Our aim was to compare the advantages and disadvantages of the two techniques in our intensive care unit (ICU). ⋯ PT is a fast, simple procedure that is easy to manage and requires fewer resources (operating theater, personnel and equipment) and causes fewer medium-term complications than does CST.
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Rev Esp Anestesiol Reanim · Feb 1999
Randomized Controlled Trial Clinical Trial[Utility of double burst stimulation in the detection of residual neuromuscular blockade].
To assess the usefulness of double burst stimulation (DBS) for detecting neuromuscular blockade caused by atracurium and vecuronium. ⋯ Assuming that DBS reduces the risk of residual curarization and that a TOF-ratio greater than 0.75 indicates adequate recovery from neuromuscular blockade, manual assessment of DBS response as obtained in this study indicates curarization and equal responses do not guarantee its absence. The most reliable index of recovery from neuromuscular blockade is the TR obtained by electromyographic monitoring.
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Rev Esp Anestesiol Reanim · Feb 1999
Comparative Study[Electron microscopic analysis of particles from surgical gloves and their possible introduction into the epidural space during epidural anesthesia].
Many publications have linked surgical glove powder to inflammatory reactions of the peritoneum, pleura, pericardium and meninges. Accidental contamination may also increase the likelihood of complications after spinal and epidural anesthesia. We aimed to analyze the morphological characteristics of microscopic particles adhering to surgical gloves and to analyze how likely such particles are to enter the epidural space during catheterization. ⋯ Particles adhering to gloves can be drawn into the epidural space during continuous epidural anesthesia. All unnecessary manipulation should therefore be avoided, and the portion of the catheter to be inserted into the epidural space should not be touched in order to prevent possible nonspecific meningeal inflammatory responses.
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Rev Esp Anestesiol Reanim · Feb 1999
Case Reports[Impossibility of intubation due to angioedema secondary to an angiotensin-converting enzyme inhibitor].
Angioedema secondary to treatment of one year's duration with angiotensin converting enzyme inhibitor (ACEI) (lisinopril) in a 56-year-old man scheduled for elective cardiac surgery led unexpectedly to impossible intubation. Surgical access (tracheostomy) was required when airway control was threatened. We review the clinical course, etiology and treatment of angioedema secondary to ACEI therapy. This is a life threatening complication which, though rare, is becoming increasingly frequent with increased use of such drugs.