Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · Feb 2001
Case Reports[Malignant hyperthermia in a pig anesthesized with desflurane].
A large-white pig that had not been genetically selected to develop malignant hyperthermia (MH) during anesthesia nevertheless suffered an episode of severe MH after repeated exposure to increasing concentrations of desflurane. MH is a hypermetabolic alteration that may develop in susceptible patients who have inhaled certain drugs or agents that act as triggers. Early identification and appropriate treatment are essential to reduce the likelihood of death associated with this severe alteration. We report a case of late-developing MH triggered by low concentrations of inhaled desflurane.
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Rev Esp Anestesiol Reanim · Feb 2001
Randomized Controlled Trial Clinical Trial[Bupivacaine in continuous epidural infusion using a portable mechanical devise for postoperative analgesia after surgery for hernia of the lumbar disk].
To determine the optimum concentration of bupivacaine administered by continuous epidural infusion, using a Baxter Single Day elastomeric infusor at a rate of 2 ml/h, to treat pain during the first 24 h after lumbar laminectomy. ⋯ Continuous epidural infusion of 0.125% and 0.25% bupivacaine through an elastomeric infusor gives excellent analgesia during the first 24 h after surgery. Administration of 0.25% bupivacaine is associated with a higher incidence of urinary retention. We therefore think that the most recommendable concentration of bupivacaine for infusion is 0.125%.
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Rev Esp Anestesiol Reanim · Feb 2001
Randomized Controlled Trial Clinical Trial[Prevention of postoperative nausea and vomiting in gynecologic surgery with 3 fixed doses of metoclopramide, droperidol or placebo].
To compare the efficacy and side effects of three doses of metoclopramide, droperidol or placebo administered every 8 h to prevent nausea and vomiting during the first 24 h after surgery. ⋯ Droperidol at a dose of 1.25 mg every 8 h is effective and safe for preventing postoperative nausea and vomiting and has minimal side effects. Metoclopramide at a dose of 10 mg every 8 h, in our study, was no better for the same purpose than placebo.
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Rev Esp Anestesiol Reanim · Feb 2001
Multicenter Study[Multicenter study on the usefulness of the NasOral system for the denitrogenation and apneic oxygenation in anesthesia].
To study the usefulness of the NasOral system for denitrogenation prior to anesthetic induction for improving pulmonary oxygen storage that maintains SpO2 within the normal range during induced apnea and facilitates apneic oxygenation. ⋯ The NasOral system facilitates denitrogenation before induction of anesthesia in all patients with permeable nasal fossae as well as apneic oxygenation during laryngoscopy.
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Rev Esp Anestesiol Reanim · Feb 2001
Case Reports[Pregnancy and partum in the woman with a spinal cord lesion in chronic phase].
A 34-year-old pregnant paraplegic woman with a T12 medullary lesion in chronic phase underwent cesarean delivery in the thirty-seventh week due to pelvic-cephalic disproportion. After failure of epidural anesthesia related to technical difficulties, general anesthesia was provided. A hypertensive crisis developed during surgery but was resolved within minutes after administration of hydralazine. ⋯ Pregnancy in a patient with medullary lesion in chronic phase is considered high risk, requiring special care due to extraordinary changes in pathophysiology caused by the lesion in addition to changes directly related to gestation. The main complications that arise are decreased respiratory volume and arterial pressure, increased incidence of thromboembolic events, anemia, urinary tract infections, premature birth, unusual progression of delivery and autonomic hyperreflexia, which is the most serious. When a hypertensive peak develops in such patients, the anesthesiologist must first rule out autonomic hyperreflexia, which has an incidence of 85% in lesions over T7 and has also been described in patients with lower lesions.