Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · May 2000
Comment Randomized Controlled Trial Comparative Study Clinical Trial[Comparative study between 5% prilocaine and 2% mepivacaine by the subarachnoid route in transurethral resections].
To compare the duration of spinal block with 5% prilocaine and 2% mepivacaine in short procedures for transurethral resection and to assess possible complications in the immediate postoperative period. ⋯ Both local anesthetics offer good surgical conditions with hemodynamic stability and few complications. The duration of sensory and motor blockade is shorter with prilocaine than with mepivacaine, making prilocaine more appropriate for short interventions.
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Rev Esp Anestesiol Reanim · May 2000
Review Historical Article[Subarachnoid anesthesia: 100 years of an established technique].
Over the 100 years since the introduction of spinal anesthesia into clinical practice, this technique, like most others, has enjoyed varying degrees of popularity. The attraction of spinal anesthesia is easy to identify: a relatively simple technique is used to inject a very small amount of drug into a readily identifiable body compartment to provide deep anesthesia. ⋯ In addition to reviewing the history of spinal anesthesia and the local anesthetics and adjuvant drugs administered by this route, we discuss single-dose and continuous spinal injection, combined spinal-epidural technique, and spinal anesthesia for outpatient settings. The problems typical of dural puncture and placement of local anesthetics and adjuvant drugs into the intrathecal space are also reviewed.
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Rev Esp Anestesiol Reanim · May 2000
Review[Combined subarachnoid-epidural technique for obstetric analgesia].
Combined spinal-epidural blockade for labor pain has enjoyed increasing popularity in obstetric anesthesia. The usual procedure is to use a single space and a single needle for dural puncture, inserting a spinal needle through an epidural needle followed by insertion of a catheter. A small dose of one or several substances (usually a lipophilic opioid and a local anesthetic) is first injected in the intrathecal space to provide rapid, effective analgesia with minimal muscle blockade. ⋯ The most widely-recognized advantage of the technique is high maternal satisfaction with rapid and effective analgesia. Mobility of the lower extremities is preserved and the mother is often able to walk. Because opioids are injected into the intrathecal space and because the technique is more invasive than standard epidural analgesia, the potential risk to mother and fetus increases.
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Rev Esp Anestesiol Reanim · May 2000
[Multivariate study of risk factors for arterial hypotension in pregnant patients at term undergoing Caesarean section under subarachnoid anesthesia].
The most common and potentially dangerous complication of spinal anesthesia for cesarean section is arterial hypotension. The aim of this study was to analyze maternal and gestational factors that might affect risk of arterial hypotension in full-term parturients undergoing cesarean section. ⋯ Identifying risk for multiparous parturients with intact amniotic sacs scheduled for elective cesarean can be worthwhile if greater preventive measures are taken in such patients to reduce the incidence and intensity of arterial hypotension.
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Rev Esp Anestesiol Reanim · May 2000
[Isobaric 2% lidocaine in continuous subarachnoid anesthesia using microcatheters].
The objective in the study of the clinical effect of isobaric 2% lidocaine for continuous spinal anesthesia with a microcatheter technique. Nine consecutive patients undergoing lower abdominal surgery under spinal anesthesia were enrolled. We inserted 27 G catheters through 22 G Sprotte (Intralong) needles to administer 20 mg of isobaric 2% lidocaine followed by successive doses of 10 mg until the required level of anesthesia was reached. ⋯ However, the protocol for administering the local anesthetic was suspended in three patients due to difficulty in maintaining the achieved level of anesthesia, as repeated injections were required, with consequent patient discomfort. In these patients relatively high levels of blockade were required and surgery lasted longer than one hour. The protocol followed with isobaric 2% lidocaine was not effective for continuous spinal anesthesia with microcatheters because of difficulty of maintaining level of anesthesia.