Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · Feb 2003
Randomized Controlled Trial Comparative Study Clinical Trial[Epidural anesthesia with ropivacaine vs. bupivacaine in continuous perfusion for the treatment of labor pains].
To compare the analgesic efficacy and extent of motor block when 0.125% ropivacaine or 0.125% bupivacaine were given in continuous perfusion through an epidural catheter during labor. ⋯ Both drugs were equally effective for controlling the pain accompanying labor, such that ropivacaine offered no advantage over bupivacaine in that regard. Ropivacaine's reduced motor block effect at the doses administered may offer an advantage in some situations, such as when a walking epidural is provided.
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Rapid-sequence induction (RSI) techniques are designed to reduce the risk of aspiration in cases where risk is high. ISR is often for surgery, particularly under emergency conditions, but is also found in procedures requiring emergency tracheal intubation inside and outside the hospital. ISR techniques have proven safe for reducing the risk of aspiration and providing good conditions for intubation in such situations. ⋯ Precisely because of this last factor and the good results obtained with short-acting opiates, great interest has developed in recent years in RSI that does not use neuromuscular blocking agents. However, conclusive data are unavailable. Studies are often difficult to compare because of small differences in the combination of drugs, the dosing of one or more of them, the route of administration, or because the criteria used to define ideal intubation conditions are different.
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Rev Esp Anestesiol Reanim · Feb 2003
[Evaluation of a formula for optimal positioning of a central venous catheter through the right internal jugular vein].
To evaluate the efficiency of a formula for predicting the optimal length of catheter inserted through the right internal jugular vein. ⋯ The aforementioned formula predicted appropriate placement of the catheter tip in 94.54% of the patients.
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Rev Esp Anestesiol Reanim · Feb 2003
[Early extubation with caudal morphine after pediatric heart surgery].
To analyze the viability of immediate extubation of children after corrective surgery for congenital heart defects with extracorporeal membrane oxygenation using an anesthetic technique involving caudal morphine, and to study the effect on length of stay in the pediatric intensive care unit (PICU) or elsewhere in the hospital. ⋯ Of patients undergoing simple corrective heart surgery with extracorporeal membrane oxygenation immediate extubation did not increase postoperative morbimortality and shortened the hospital stay. A single dose of caudal morphine provided optimum conditions for extubation and good control of postoperative pain. Strict measures must be taken, however, to avoid postpuncture bleeding.