Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · Aug 2003
Randomized Controlled Trial Comparative Study Clinical Trial[Postoperative patient-controlled analgesia is more effective with epidural methadone than with intravenous methadone in thoracic surgery].
To compare the efficacy and side effects of epidural and intravenous methadone for postoperative patient-controlled analgesia (PCA) after thoracic surgery. ⋯ The results suggest that epidural methadone has an intrinsic spinal effect regardless of whether or not there is extra-spinal action arising from syste mic absorption. Epidural methadone provides a more adequate analgesic effect in less time and at a lower dose. Both approaches provide good postoperative analgesia with few side effects.
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Rev Esp Anestesiol Reanim · Aug 2003
Comparative Study[Precision and accuracy of the immediate determination of hemoglobin using HemoCueB Hemoglobin in urgent, surgical, and critical patients].
The prevalence of anemia among emergency, surgery and critically ill patients is high. As a consequence, many of these patients receive transfusions of packed red cells, with hemoglobin (Hb) concentration being one of the most widely applied criteria for prescription. Accordingly, this study was undertaken 1) to ascertain the accuracy and precision of point-of-care Hb measurements obtained with the portable photometric HemoCue B-Hemoglobin analyzer (HBH) in comparison those performed with the reference cell counter Pentra 120 Retic (ABX), and 2) to evaluate the potential clinical utility of the HCB. ⋯ Based on the reliable results obtained for venous and arterial blood samples, Hb concentrations determined with the portable HBH analyzer may be highly useful for point-of-care monitoring of anemia and evaluating the transfusion requirements of ER, PRU, and ICU patients. However, the degree of inaccuracy and variability of Hb measurements in capillary blood samples would discourage us from using it in these patients.
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Rev Esp Anestesiol Reanim · Aug 2003
[Sciatic nerve block by the lateral route at the level of the popliteal fossa with 0.75% ropivacine: advantages of a more proximal approach].
To assess the efficacy of a sciatic nerve block using a lateral approach 11 cm cephalad to the lateral femoral epicondyle for providing surgical anesthesia and postoperative analgesia in scheduled foot surgery (hallux valgus) after a single injection of 30 mL of 0.75% ropivacaine. ⋯ The sciatic nerve block from a lateral approach 11 cm cephalad to the lateral femoral epidondyle is an appropriate anesthetic technique for foot surgery. It is safe, effective and easy to perform. Infusion of 30 mL of 0.75% ropivacaine provided adequate anesthesia and long-lasting postoperative analgesia for our patients.
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Rev Esp Anestesiol Reanim · Aug 2003
[Anesthesia with propofol, remifentanil and cisatracurium in renal transplantation].
A 41-year-old woman with end-stage renal insufficiency in peritoneal dialysis for 3 years received a kidney transplant under anesthesia with remifentanil, propofol, and cisatracurium. She had a history of hypertension and was being treated with enalapril, metoprolol and erythropoietin. ⋯ Anesthetics with minimal residual effects and as little renal toxicity as possible are ideal for use in kidney transplantation. The drugs used in this case had pharmacokinetic and pharmacodynamic properties that make them particularly appropriate for such patients.