Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · Nov 2001
Randomized Controlled Trial Comparative Study Clinical Trial[Remifentanil or propofol for sedation in subarachnoid anesthesia. Effects on ventilation, hemodynamic stability and bispectral index].
To compare depth of sedation, hemodynamic and respiratory effects, and bispectral index (BIS) in surgical patients under subarachnoid anesthesia with intravenous perfusion of 1 mg/kg/h of propofol or 3 microgram/kg/h of remifentanil or placebo. ⋯ The sedation regimens used were safe and adequate. Propofol is associated with fewer complications than remifentanil.
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The work of an anesthesiologist and that of a flight pilot share certain attributes. As pilots use simulators to obtain risk-free practice in recognizing and controlling situations that might lead to disaster, simulation programs are now emerging as a new way to learn and train anesthesiology is being conceived as a new task that integrates scientific knowledge and human factors. Simulators have been introduced into teaching and training programs as a powerful tools that allow anesthesiologists to learn, practice and train in a multitude of situations without putting human life at risk. ⋯ Two types have been applied in anesthesiology: computer screen and mannequin. The usefulness of simulators ranges from training for situations that require the systematic application of protocols and the understanding of new drugs being introduced into clinical practice to the practice of how to use resources for managing anesthetic emergencies. It is still too early to use simulators for certifying and evaluating clinical performance, as further studies are needed to identify the type of events that reflect typical situations and to determine which procedures should be evaluated.
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To assess the influence of epidural analgesia on the increased rate of cesarean delivery and to analyze associated factors. ⋯ Epidural analgesia increased the likelihood of cesarean delivery in our study. The same factors that most often encourage women to accept epidural analgesia (induced labor, greater pain, prolonged labor, etc.) may predict increased likelihood of cesarean delivery.