Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · Feb 2007
Review[Analysis of resident anesthesiologists' difficulties with epidural analgesia for labor and childbirth and complication rates].
To analyze the number of attempts to provide an epidural or spinal-epidural block for labor and complication rates when the procedures are performed by resident or staff anesthesiologists. ⋯ The number of attempts needed was 1.28 for staff anesthesiologists and 1.52 for residents (P = .02). The differences between the 2 groups in the incidences of complications (blood noted during puncture, accidental dural puncture, pain during expulsion, repeat epidural or spinal puncture, nausea, or back pain) were not significant.
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Rev Esp Anestesiol Reanim · Feb 2007
Case Reports[Airway management in a man with ankylosing spondylitis].
We report a case of difficult airway management in a 41-year-old man with ankylosing spondylitis who was scheduled for total left hip replacement surgery. After several failed attempts to achieve regional anesthesia, we converted to general anesthesia with orotracheal intubation using a fiberoptic bronchoscope. Ankylosing spondylitis leads to fibrosis, ossification, and ankylosis along the spinal column and sacroiliac articulations. ⋯ We report the case of a patient with ankylosing spondylitis with fixation along the entire spine. The airway was managed by intubation with a fiberoptic bronchoscope. Spontaneous ventilation was maintained during the maneuver, and sedation was achieved with perfusion of remifentanil as the only anesthetic agent following failure of intradural anesthesia.
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Rev Esp Anestesiol Reanim · Feb 2007
Review[Pulmonary hypertension: pathophysiology, diagnosis, treatment and anesthetic considerations].
Pulmonary artery hypertension is a rare entity but one that presents genuine challenges during anesthesia mainly because of the high risk of exacerbation and right heart failure during and after surgery. This review covers currently available treatments, the battery of diagnostic procedures at our disposal, and the basic precepts for the perioperative management of patients with this condition. Adequate hemodynamic control and the early use of selective pulmonary vasodilators are absolutely essential.
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Rev Esp Anestesiol Reanim · Feb 2007
Randomized Controlled Trial Comparative Study[Haloperidol or droperidol with dexamethasone for antiemetic prophylaxis in laparoscopic cholecystectomy].
To compare haloperidol to droperidol, both with dexamethasone, for antiemetic prophylaxis in elective laparoscopic cholecystectomy. ⋯ Either haloperidol or droperidol in combination with dexamethasone is more effective than dexamethasone alone for antiemetic prophylaxis after laparoscopic cholecystectomy.