Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · Feb 1999
Case Reports[Ventilation in prone decubitus in a patient with respiratory distress during heart surgery].
Acute respiratory failure and adult respiratory distress syndrome are serious complications after heart surgery and are associated with a high mortality rate. We report the case of a 50-year-old man who developed severe respiratory distress after heart surgery with extracorporeal circulation and for whom oxygenation was possible with ventilation in prone decubitus position only after other therapeutic measured had failed. The physiological bases of ventilation in prone decubitus position, as well as the indications and contraindications of the technique are discussed. Early treatment, which is fundamental for managing these patients, facilitates a favorable outcome as is illustrated by the case we report.
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Remifentanil is a new opioid in the fentanyl family. Developed and marketed by Glaxo Wellcome Inc., it was approved by the U. S. ⋯ Remifentanil is an analog of fentanyl (4-piperidyl anilide) with a methyl-ester group that allows the molecule to be hydrolyzed by esterases in plasma and tissues. Rapid onset and metabolism make it an easy drug to control for achieving the desired depth of anesthesia, although these aspects are also the drug's main drawbacks given that the anesthesiologist must plan and initiate postoperative analgesia before surgery ends. Rapid onset and potency also mean that the use of this drug for either postoperative analgesia or monitored sedation in awake state with spontaneous breathing needs further study to assess safety.
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Rev Esp Anestesiol Reanim · Feb 1999
Letter Case Reports[Use of rocuronium in a pateint with myasthenia gravis].
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Rev Esp Anestesiol Reanim · Feb 1999
Letter Case Reports[Rupture of the obturator stylet of an intradural needle].