Revista española de anestesiología y reanimación
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Extubation, like intubation, is a critical moment in general anesthesia. There are no algorithms or ordered sequences of steps for extubation. ⋯ This review will analyze the clinical conditions and pathophysiology associated with extubations at high risk of complications. We will describe strategies for extubating in situations in which a difficult airway is known or suspected.
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Rev Esp Anestesiol Reanim · Nov 2005
Case Reports[Hydroxyethyl starch 130/0.4 can be useful to prevent a hemodynamic response to a single dose of remifentanil].
Intravenous propofol and remifentanil are often used in anesthesia. The combined use of these drugs tends to cause hemodynamic depression. We describe the absence of hemodynamic effects in response to infusion of propofol and remifentanil when hydroxyethyl starch (HES) 130/0.4 was also administered. ⋯ They then received a single dose of 2 microg x kg(-1) of remifentanil during total intravenous anesthesia (TIVA) with propofol and remifentanil before placement of a Mayfield head holder. No changes in mean blood pressure or heart rate were observed in either patient after the remifentanil bolus when they have received HES 130/0.4 during TIVA with propofol and remifentanil HES 130/0.4 may play an active role in preventing a hemodynamic response to remifentanil bolus. This hypothesis should be tested in a randomized controlled trial.
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Rev Esp Anestesiol Reanim · Nov 2005
Case Reports[Anesthetic management of coagulation factor V deficiency].
Factor V deficiency, or Owren's disease, is a rare inherited recessive autonomic disorder that is congenital. The bleeding in patients with this disease depends on plasma levels of factor V. Anesthetic management is similar to that used for patients with other coagulation disorders. ⋯ Plasma and antifibrinolytic drugs such as tranexamic acid should continue to be administered in the first few days after surgery. We report the case of a man with homozygotic factor V deficiency who underwent surgery for colon cancer. This article reviews the main aspects of anesthetic management of this coagulation disorder.
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Rev Esp Anestesiol Reanim · Nov 2005
[Identification of the epidural space: usual practice among Spanish anesthesiologists].
To determine what methods are habitually used by Spanish anesthesiologists to identify the epidural space. ⋯ The procedure used most often by Spanish anesthesiologists to identify the epidural space is the LOR-A technique; however, over a quarter of Spanish users of LOR-A do not recommend it.