Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · Nov 2002
Case Reports[Cauda equina hemisyndrome after intradural anesthesia with bupivacaine for hip surgery].
A 68-year-old man underwent hip surgery under subarachnoid anesthesia with bupivacaine and fentanyl to replace an acetabular component. Two days after surgery the patient developed unilateral cauda equina syndrome, affecting five nerve roots (L4 to S3), with no sphincter involvement. Two and a half years later, the lesion had become permanent. We discuss the possible origin of the condition, suggesting differential diagnoses such as mechanical problems (position-mobilization) and anesthetic toxicity.
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Rev Esp Anestesiol Reanim · Nov 2002
[Course of postoperative pain in laparoscopic cholecystectomy under multimodal anesthesia-analgesia in ambulatory care].
To evaluate the evolution of postoperative pain and convalescence in a group of patients undergoing elective laparoscopic cholecystectomy under a multimodal anesthesia-analgesia treatment protocol. ⋯ The multimodal analgesia-anesthesia treatment proposed allows a high percentage of laparoscopic cholecystectomies to be performed on an outpatients basis. The protocol provides good control of postoperative pain and nausea and rapid return to habitual activity.
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Rev Esp Anestesiol Reanim · Nov 2002
Practice Guideline Guideline[Locoregional anesthesia and drugs that affect hemostasis. Suggestions of the expert meeting in the ESRA Congress in Barcelona].
Growing interest in the effect of hemostasis-altering medications on regional anesthetic techniques was analyzed recently in a review article suggesting certain safety measures, by Llau and colleages in Revista Española de Anestesiología y Reanimación. Since that review, however, it has become necessary to extend the discussion of clinical issues, based on information presented at the Eighth Local Meeting of the European Society for Regional Anesthesia (ESRA) of May 2002. ⋯ This paper faithfully presents the suggestions made by participants at the meeting. As most anesthesiologists expressed the need to set guidelines for fibrinolytics, the main issues related to those drugs in regional anesthesia are reviewed.
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Rev Esp Anestesiol Reanim · Nov 2002
Letter Historical Article[19th century concepts of anesthesiology in a work on 21st century surgery].
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Rev Esp Anestesiol Reanim · Nov 2002
Review Randomized Controlled Trial Comparative Study Clinical Trial[Comparison of efficacy and complications of 27G and 29G Sprottte needles for subarachnoid anesthesia].
Post-dural puncture headache and lumbar backache are related to needle gauge and type of point used. We aimed to determine whether the incidence of post-dural puncture headache and lumbar backache could be reduced by using fine gauge pencil-point Sprotte 27G and 29G needles. We also studied increases in technical difficulty with these needles and whether or not reducing needle gauge affected anesthetic quality. ⋯ The use of 29G pencil-point needles can be recommended to reduce the incidence of headache and lumbar backache in the postoperative period, in spite of the greater technical difficulty involved, given that quality of anesthesia is maintained.