Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · Jun 2001
Review[Drugs that alter hemostasis and regional anesthetic techniques: safety guidelines. Consensus conference].
Patients about to undergo surgery are often taking drugs that alter hemostasis and affect anesthesia, particularly when neuroaxial techniques are used for subarachnoid or epidural anesthesia. The aim of this paper is to provide safety guidelines for regional anesthesia in patients receiving hemostasis-altering drugs, in order to reduce the risk of bleeding. ⋯ We also stress that removal of catheters should follow criteria similar to those listed above, that the risk of complications due to bleeding increases considerably in association with these drugs, and that adequate neurological monitoring is essential during postoperative recovery. Overall, the final decision to use regional anesthesia in patients receiving drugs that alter hemostasis must be made on an individual basis after assessment of benefit and risk.
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Rev Esp Anestesiol Reanim · Jun 2001
Randomized Controlled Trial Clinical Trial[The effect of encephalogram bispectral index monitoring during total intravenous anesthesia with propofol in outpatient surgery].
To assess the effect of monitoring the encephalogram bispectral index (BIS) during outpatient surgery. Outcome measures were amount of propofol administered, awakening and discharge. ⋯ BIS monitoring allows for propofol titration that leads to a mean reduction of 32.6% in consumption, shortening the time until eye opening without causing intraoperative awareness or reducing patient satisfaction.
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Rev Esp Anestesiol Reanim · Jun 2001
Case Reports[Anesthetic management for cesarean delivery in a pregnant patient with congenital antithrombin III deficiency and pulmonary thromboembolism].
Antithrombin III (AT III) deficiency is a rare hereditary disease that predisposes a patient to thromboembolic complications. Anticoagulation is essential for preventing recurrence of thrombi. ⋯ This paper describes a woman with congenital AT III deficiency and heparin-treated pulmonary embolism whose pregnancy of 29 weeks had to be terminated by cesarean section upon signs of fetal distress. We discuss the pathophysiology and treatment in such cases.