Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · Feb 2005
Letter Case Reports[Spontaneous kinking of an epidural catheter].
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Rev Esp Anestesiol Reanim · Feb 2005
Randomized Controlled Trial Comparative Study Clinical Trial[Randomized controlled trial comparing a low dose to a conventional dose of hyperbaric bupivacaine for scheduled cesarean section].
Spinal anesthesia is the technique most often applied in cases of scheduled cesarean section. Many authors have tried decreasing the local anesthetic dose by adding opioids to achieve adequate analgesia with greater hemodynamic stability, although the ideal dose remains to be established. Our aim was to analyze hemodynamic stability and quality of analgesia with 2 different regimens for administering spinal hyperbaric bupivacaine. ⋯ Spinal anesthesia with low doses of bupivacaine and fentanyl provides acceptable intraoperative conditions for a high percentage of patients undergoing cesarean section, with a similar incidence of hypotension. The low dose generates a less intense intraoperative motor blockade with similar spread of the sensory block. The low dose was not efficacious for 10% of the patients who received it.
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Endotracheal intubation and mechanical ventilation have traditionally been employed in patients with acute respiratory insufficiency. However, this form of management can have serious adverse effects, mainly infections and barotrauma. ⋯ It is also commonly applied in patients with asthma, pneumonia, and acute cardiogenic pulmonary edema. Correct indication and training in use of NIV equipment is necessary to ensure success and facilitate patient tolerance.