Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · Mar 1999
Case Reports[A possibility of central diffusion during stellate ganglion blockade: "the sheath of the spinal rachidian nerve"].
Stellate ganglion block is a common treatment for neuropathic pain. The technique is not without potentially severe complications when a paratracheal approach is used. A 33-year-old woman complained of atypical facial pain of 15 years' duration with pain intensity of 6 to 8 on a visual analog scale and no pain-free periods upon use of inadequate analgesia. ⋯ Central spread of a portion of local anesthetic by way of the spinal nerve sheath toward the subarachnoid space may cause partial cervical and basal nuclear blockade. Signs would be apnea, involvement of the upper extremities and facial muscles, although paresthesia during the injection is the only evidence supporting this hypothesis. Bone contact and negative aspiration while performing a stellate ganglion block do not guarantee avoidance of complications.
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Rev Esp Anestesiol Reanim · Mar 1999
Randomized Controlled Trial Comparative Study Clinical Trial[Efficacy of EMLA cream, effect of time and place of application].
To evaluate the anesthetic efficacy of EMLA cream for alleviating pain associated with puncture and pressure in areas where venous catheters are normally inserted. ⋯ The efficacy of EMLA cream varies demonstrably depending on type of stimulus, site of application and time since application.
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Ketamine is an intravenous drug with special properties that make it the only agent that presently serves as anesthetic, sedative, amnesiac and analgesic. Although it is sometimes forgotten, ketamine is still considered a viable drug. Water soluble, stable and non-irritant when administered intravenously, ketamine has rapid onset after intravenous injection and provides acceptable anesthesia when administered in continuous infusion. ⋯ It is probably the anesthetic of choice for patients with hyperreactive airways. Ketamine's strong analgesic effect at subanesthetic doses allows it to be used as an analgesic during postoperative intensive care or as an analgesic-plus-sedative for patients receiving mechanical ventilation. Interest in using ketamine at low doses for cancer and non-cancer patients with chronic pain has grown recently.
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Rev Esp Anestesiol Reanim · Mar 1999
Letter Randomized Controlled Trial Comparative Study Clinical Trial[Our negative experience with meperidine for the prevention of coughing during cataract surgery].