Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · Dec 2004
Randomized Controlled Trial Comparative Study Clinical Trial[Comparison of 4 techniques for general anesthesia for carotid endarterectomy: inflammatory response, cardiocirculatory complications, and postoperative analgesia].
[corrected] To study the analgesia, hemodynamic stability and inflammatory response in patients undergoing carotid endarterectomy under different types of general anesthesia. ⋯ Increased levels of IL-6 in peripheral blood and of systemic inflammatory response syndrome were found in the early postoperative period in groups that did not receive halogenated gases. Hemodynamic stability and analgesia were similar in all groups, however.
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Rev Esp Anestesiol Reanim · Dec 2004
Multicenter Study Comparative Study Clinical Trial Controlled Clinical Trial[The specific cox-2 inhibitor valdecoxib provides effective analgesia after inguinal hernia surgery].
To compare 3 oral analgesic doses--valdecoxib 20 mg, valdecoxib 40 mg and controlled-release diclofenac 75 mg--to placebo in the treatment of pain after inguinal herniorrhaphy. ⋯ Valdecoxib 40 mg and diclofenac 75 mg provided similar quality of analgesia for treating pain after inguinal herniorrhaphy.
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Rev Esp Anestesiol Reanim · Dec 2004
Review[Effectiveness of epidural administration of saline solutions to prevent or treat postdural puncture headache].
Epidural anesthesia is the most versatile and widely used of the techniques for regional anesthesia. The most common complication of epidural or spinal anesthesia is postdural puncture headache. The loss of cerebrospinal fluid through the hole can be an important causative factor of this cephalalgia. ⋯ The studies had small samples and most did not include a control group. The doses and methods of epidural administration of saline solutions were highly variable and the results were often contradictory. We conclude that using this technique to prevent and/or treat postdural puncture headache is difficult to justify.
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Rev Esp Anestesiol Reanim · Dec 2004
Case Reports[Sedation with remifentanil for tracheostomy in a pediatric patient].
Remifentanil is an ultra-short-acting opioid that is frequently used in adults for surgical anesthesia or conscious sedation, but its use in children is much less common. We report the case of a 7-year-old boy with lateral cervical tumors displacing all cervical and facial structures. An emergency tracheostomy was performed when he developed respiratory difficulty due to partial airway obstruction. ⋯ In the case we report, the patient's risk of complete airway obstruction due to bleeding upon manipulation had to be assessed and compared with the respiratory depression that might possibly have been caused by remifentanil perfusion. We judged that the option of sedation would cause less morbidity and offered greater safety for the patient. The outcome of this case is consistent with reports that remifentanil is a good option for adequately sedating children who are breathing spontaneously.
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Rev Esp Anestesiol Reanim · Dec 2004
Case Reports[Ultrasound-guided posterior approach to block the sciatic nerve at the popliteal fossa].
The recent introduction of ultrasound guidance for locating peripheral nerves and nerve plexi has allowed injection of anesthetic agents to block the sciatic nerve at the popliteal fossa proximal to division, thus preventing damage to adjacent structures, repeated punctures, and multiple nerve stimulations to verify anesthetic diffusion around the nerve. We report the case of a 23-year-old man, ASA I, who underwent reduction and osteosynthesis of a fractured right fibula. Ultrasound was used to guide the needle after identification of the sciatic nerve 10 cm from the knee fold and 3.5 cm deep. ⋯ The motor and sensory block of the sciatic nerve was complete and no adverse events occurred during or after surgery. We conclude that the combination of ultrasound guidance and nerve stimulation allows the sciatic nerve to be located easily. The approach to the point before division of the sciatic nerve can be guaranteed so that puncture of neighboring vessels can be avoided and optimal anesthesia provided.