Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · Oct 2004
Review[Anesthesia and postoperative care of 11 patients undergoing peritonectomy and hypothermic intraperitoneal chemotherapy].
Peritoneal carcinomatosis is the final stage of certain malignant tumors located both inside and outside the abdomen. Mortality is high with conventional treatments and the best mean survival rates reported have reached up to 6 months. One technique tried in recent years involves resection of macroscopic parietal and visceral peritoneal lesions (peritonectomy) combined with intra- and postoperative perfusion of the abdominal cavity with hyperthermic chemotherapy to treat residual microscopic lesions. ⋯ The main complications are related to the long duration of surgery, bleeding secondary to the many surgical resections, and hyperthermia caused by the chemical agents. The therapeutic process, therefore, is not risk-free and involves high rates of morbidity and mortality. We describe the anesthetic and postoperative management of the first 11 cases in which this procedure was carried out at our hospital, analyzing the main complications arising.
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Rev Esp Anestesiol Reanim · Oct 2004
Review Case Reports[Horner's syndrome following epidural analgesia for labor].
Horner's syndrome is a disorder of the sympathetic nerve supplying the eye. Infrequently, Horner's syndrome can arise as a complication of epidural anesthesia, but its clinical course is favorable. The incidence increases when epidural analgesia is used in obstetrics because of physiological and anatomic changes in obstetric patients that favor spread of the local anesthetic. ⋯ The case we report was the only one in our hospital over a period of 4 years during which 12,796 epidural procedures were performed. These data suggest to us that Horner's syndrome often passes undetected because clinical manifestations are not remarkable. Nevertheless, the diagnosis should be kept in mind so that unnecessary treatment is avoided, given that the clinical course is favorable with spontaneous resolution.
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Rev Esp Anestesiol Reanim · Oct 2004
Clinical Trial[Combined sciatic and inguinal paravascular nerve block: a valid alternative for arthroscopic knee surgery].
To assess the effectiveness of a combined transgluteal sciatic and inguinal paravascular nerve block for arthroscopic knee surgery. ⋯ The combined sciatic and inguinal paravascular block is effective for arthroscopic knee surgery and offers an alternative when other anesthetic techniques cannot be used. Use of a pressure cuff may require complementary sedation.
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Rev Esp Anestesiol Reanim · Oct 2004
Case Reports[Two cases of postpartum pubis diastasis mistaken for neurological complications of epidural analgesia].
Two healthy 31- and 34-year-old parturients received uncomplicated epidural analgesia for labor and delivery using standard techniques. Twenty-four and 12 hours postpartum, respectively, they developed severe lower back pain and difficulty moving their lower extremities. At first the symptoms were attributed to neurological complications of epidural analgesia and for this reason the anesthetist was called. ⋯ In the most severe cases it may be accompanied by urinary dysfunction and inability to walk. If the clinical features are not recognized, it can be difficult to differentiate pubis diastasis from severe neurological complications in women who have received a central nervous system block. We report two cases of peripartum pubis symphysis diastasis that were both initially mistaken for neurological complications of epidural analgesia for labor.
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Rev Esp Anestesiol Reanim · Oct 2004
[Analysis of bibliographic citations received by Spanish anesthesiologists for work indexed by Science Citation Index, 1988-2002].
To analyze the international impact of articles published by authors in Spanish anesthesiology departments. ⋯ This citation analysis shows the international impact of publications by Spanish anesthesiologists.