Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · Nov 2007
Randomized Controlled Trial[Paresthesia in various spinal anesthesia techniques for cesarean section].
To determine the incidence of paresthesia with different spinal puncture techniques using a 27-gauge Whitacre needle. ⋯ Combined epidural-subarachnoid puncture leads to a higher incidence of paresthesia in comparison with simple spinal puncture, probably because the lumbar puncture is performed on a dural sac that has been previously deformed due to the "tent effect" caused by the epidural needle. Fewer cases of paresthesia occur when the subarachnoid puncture is slow and steady and the introducer needle is withdrawn millimeters before it reaches the dural sac.
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Rev Esp Anestesiol Reanim · Nov 2007
Review[Applications for bronchial blockers in thoracic surgery].
One-lung ventilation is commonly used to facilitate visualization of the field during thoracic surgery. New devices for performing this technique that have become available over the past 2 decades include the Univent bronchial blocker incorporated in a single-lumen tube, the Arndt endobronchial blocker, and the Cohen endobronchial blocker. ⋯ The literature search was performed on MEDLINE through PubMed using the keywords bronchial blockers and thoracic surgery. The search span started with 1982-the year the first modern bronchial blocker was described - and ended with February 2006.
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We describe the perioperative treatment of a patient diagnosed with Angelman syndrome, which is usually caused by a deletion in chromosome 15. The patient showed the characteristic signs of psychomotor retardation, epilepsy, lack of speech, frequent laughter and happy demeanor, light skin, blue eyes, and blond hair, hyperactivity, and sleep disturbance. He was scheduled for multiple tooth extractions under general anesthesia. ⋯ The effect of the condition on the response of these agents is unknown. The combined use of propofol, ketamine, and sevoflurane at low doses provided adequate anesthesia for this patient. Other characteristics of the syndrome that may affect the use of anesthesia in these patients are discussed.
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Rev Esp Anestesiol Reanim · Nov 2007
Case Reports[Emergency cesarean in a patient with Coffin-Siris syndrome].
Coffin-Siris syndrome is a rare genetic disease characterized by coarse facial features, sparse scalp hair, hirsutism, hypoplasia of the distal phalanges, hypoplastic nail in the fifth digit, and mental retardation and delayed growth evident in both weight and height. Most cases are sporadic, but the possibility of recessive or dominant autosomal inheritance has been suggested. Facial abnormalities that make intubation difficult and mental retardation that interferes with cooperation are aspects of this disease that can affect the choice of type of anesthesia. We report the case of a parturient with Coffin-Siris syndrome who refused epidural analgesia for labor pain and for whom the obstetrician later decided that an emergency cesarean was necessary due to fetal distress.