Revista española de anestesiología y reanimación
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Intranasal drug administration is an easy, well-tolerated, noninvasive transmucosal route that avoids first-pass metabolism in the liver. The nasal mucosa provides an extensive, highly vascularized surface of pseudostratified ciliated epithelium. It secretes mucus that is subjected to mucociliary movement that can affect the time of contact between the drug and the surface. ⋯ We review the literature on intranasal administration of fentanyl, meperidine, diamorphine, and butorphanol to treat acute pain. The adverse systemic effects are similar to those described for intravenous administration, the most common being drowsiness, nausea, and vomiting. Local effects reported are a burning sensation with meperidine and a bad taste.
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Rev Esp Anestesiol Reanim · Dec 2006
Randomized Controlled Trial Comparative Study[Occupational exposure to nitrous oxide and sevoflurane during pediatric anesthesia: evaluation of an anesthetic gas extractor].
To determine the level of occupational exposure to anesthetic gases in the absence of an extractor during pediatric anesthesia and to assess the efficacy of a purpose-built extraction system. ⋯ Gas extraction decreased the level of exposure by up to 94%, achieving levels that were below the recommended limits and greatly reducing occupational risk.
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Rev Esp Anestesiol Reanim · Dec 2006
Randomized Controlled Trial Comparative Study[Comparison of 2 techniques for inhaled anesthetic induction with sevoflurane in coronary artery revascularization].
Our objective was to evaluate efficacy, side effects, and hemodynamic alterations during anesthetic induction with sevoflurane in patients undergoing coronary artery bypass surgery, comparing the techniques of administration with tidal volume breathing and with vital capacity breaths. ⋯ Mean arterial pressure decreased in both groups, with no significant differences. The results indicate that hemodynamic stability seems to be similar with both techniques for providing inhaled anesthetic induction with sevoflurane.
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Rev Esp Anestesiol Reanim · Dec 2006
Randomized Controlled Trial Comparative Study[Femoral nerve block for postoperative analgesia after anterior cruciate ligament reconstruction: comparison of 2 concentrations of bupivacaine with clonidine in 3 modes of administration].
The continuous femoral nerve block is used for postoperative orthopedic analgesia. ⋯ A continuous femoral nerve block is useful for managing pain after anterior cruciate ligament surgery. The application of 5 mL x h(-1) in continuous infusion or in PCA system bolus doses provides excellent postoperative analgesia. Use of 0.0625% bupivacaine decreases overall consumption of analgesic and is not detrimental to quality of analgesia.
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Rev Esp Anestesiol Reanim · Dec 2006
Case Reports[Perioperative respiratory complications in pediatric patients with mediastinal masses: a report of 2 cases].
General anesthesia in patients with mediastinal masses can lead to life-threatening cardiorespiratory complications. We report the cases of 2 pediatric patients with mediastinal masses who developed serious complications during general anesthesia. The first was a 13-year-old boy with a suspected diagnosis of high-grade T-cell non-Hodgkin lymphoma, lymph node disease, and an anterior mediastinal mass. ⋯ The anesthetic difficulties that arise in these cases include acute airway occlusion, superior vena cava syndrome, pulmonary artery or cardiac compression, acute pulmonary edema, and cardiopulmonary collapse. The technique of choice is induction with inhaled anesthetics and maintenance of spontaneous ventilation. Neuromuscular relaxants are avoided.