Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · Apr 1999
[Ondansetron in the prophylaxis of postoperative nausea and vomiting in ambulatory cataract surgery].
Postoperative nausea and vomiting (PONV) are potentially serious complications of ophthalmic surgery. We assess the efficacy of ondansetron for antiemetic prophylaxis in outpatient unilateral cataract surgery under retrobulbar blockade. ⋯ We found a high incidence of PONV, although the administration of ondansetron reduced PONV significantly.
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Rev Esp Anestesiol Reanim · Apr 1999
Randomized Controlled Trial Clinical Trial[Comparative study of 3 techniques for total intravenous anesthesia: midazolam-ketamine, propofol-ketamine, and propofol-fentanyl].
To compare the characteristics of induction, maintenance and awakening for three techniques of combined total intravenous anesthesia (TIVA): propofol-ketamine, midazolam-ketamine and propofol-fentanyl. ⋯ TIVA with ketamine and propofol is comparable to the most commonly used combination of propofol and fentanyl and may be an appropriate choice when hemodynamic stability is of great importance; withdrawal 15 min before ending surgery prevents prolonged awakening. Perfusion of midazolam-ketamine is not recommendable for scheduled surgery because it induces too many hypertensive peaks. Although neither midazolam nor propofol completely prevents the psychomimetic effects of ketamine, such effects are not so severe that patients reject the anesthetic technique used.
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Rev Esp Anestesiol Reanim · Apr 1999
Randomized Controlled Trial Clinical Trial[Conditions of intubation and neuromuscular block induced by mivacurium: comparison with succinylcholine].
To compare the clinical conditions for intubation and neuromuscular parameters after a high dose of mivacurium (0.25 mg/kg; 3 x SD95) administered in 30 s to those obtained after use of the usual dose of succinylcholine (1 mg/kg). ⋯ Given the moderate conditions of intubation achieved at 60 s, mivacurium can not be recommended as a relaxant in situations that require a rapid induction sequence. In elective surgery, 0.25 mg/kg of mivacurium can, however, be considered an alternative to succinylcholine.
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Transesophageal echocardiography is being used increasingly by anesthesiologists for monitoring and diagnosis. Real-time imaging provides valuable information about anatomy, preloading and cardiac contractility. Its use is mandatory in valve repair surgery and it has been shown to detect cardiac ischemia before any other monitoring tool. Programs to teach transesophageal echocardiography to anesthesiologists should be implemented; the availability of backup support staff from the echocardiography unit is of great value.