Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · Jun 2003
Case Reports[Usefulness of transesophageal echocardiography in monitoring pulmonary artery catheter progression in a case of tricuspid annuloplasty].
A 47-year-old man with mitral and aortic valve prostheses and a tricuspid valve annuloplasty required emergency substitution of both valves because of infectious endocarditis on the aortic valve prosthesis. The tricuspid ring initially impeded insertion of the pulmonary artery catheter toward the right ventricle. With the aid of transesophageal echocardiographic visualization, the catheter could be maneuvered to reach the pulmonary artery without damage to valvular or prosthetic structures. Transesophageal echocardiography, a monitoring technique with specific indications, is becoming increasingly useful as an aid in procedures related to cardiac surgery.
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Rev Esp Anestesiol Reanim · Jun 2003
[Possibility of nerve lesions related to peripheral nerve blocks. A study of the human sciatic nerve using different needles].
When a needle tip comes too close to a nerve axon, the mechanical effect over the nerve membrane produces paresthesia. We examined the hypothetical mechanical damage of short bevel and long bevel needles over sciatic nerve bundles under scanning electron microscopy. ⋯ Lesions that affect superficially the epineurum can cause paresthesia by compression of nerve fascicles without damaging the axons. If the perineurm is damaged, the lession will also affect the blood-nerve barrier, leading probably to posterior sequels.
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Rev Esp Anestesiol Reanim · Jun 2003
[Effect of sevoflurane on the neuromuscular blockade produced by continuous mivacurium infusion ].
To evaluate the effect of sevoflurane on a neuromuscular block from mivacurium in continuous infusion. ⋯ Sevoflurane causes a significant increase in the neuromuscular block maintained by mivacurium in continuous infusion and the increase lasts at least 15 minutes after the halogenated agent is cleared from blood.
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Regional anesthesia for ophthalmic procedures has changed significantly in the past ten years. Phacoemulsification for cataract surgery through corneal microincisions, soft foldable lenses and topical anesthesia simplify surgery such that most operations can be performed on an outpatient basis. Some anesthetic blocks are performed by either anesthesiologists or ophthalmologists, who should understand the advantages and disadvantages for each patient. This review discusses anatomical aspects of interest to the anesthesiologist, the main techniques used and anesthetic innovations, complications and certain controversies such as management of the patient who is taking medications that alter hemostasis, the withdrawal of hyaluronidase in some countries and the systematic ordering of tests before the procedure.