Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · Apr 2007
Randomized Controlled Trial Comparative Study[Stress response under continuous infusion of remifentanil compared to bolus doses of fentanyl assessed by levels of cytokines, C-reactive protein, and cortisol during and after abdominal hysterectomy].
Surgery and anesthetic method have immunomodulating effects on hemodynamic response and stress. We compared the effects of 2 intraoperative analgesic regimens on patients undergoing abdominal hysterectomy. ⋯ Unlike other clinical trials, our study detected no differences between the 2 techniques in response to surgical stress evaluated by analyzing concentrations of pro- and anti-inflammatory cytokines, cortisol, and C-reactive protein.
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Rev Esp Anestesiol Reanim · Apr 2007
Randomized Controlled Trial Comparative Study[Cost-effectiveness analysis of patient-controlled analgesia compared to continuous elastomeric pump infusion of tramadol and metamizole].
Little information is available on the cost-effectiveness of postoperative patient-controlled analgesia (PCA). The present study compared PCA to continuous infusion by elastomeric pump. ⋯ The analgesic efficacy of the 2 regimens was similar. However, patient satisfaction was greater with PCA and use of an elastomeric pump was more expensive. In the setting of the present study, postoperative PCA proved to be more advantageous than continuous elastomeric pump infusion.
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Rev Esp Anestesiol Reanim · Apr 2007
Multicenter Study Comparative Study[The Color Analog Scale: a valid instrument for measuring pain intensity in Catalan-speaking children?].
To evaluate the validity of the Color Analog Scale (CAS) for assessing pain intensity in a Catalan-speaking pediatric population. ⋯ The results of the present study provide preliminary evidence of the convergent, discriminant, and criterion validity of the CAS in this setting. The CAS appears to be valid for measuring pain intensity in Catalan-speaking children and adolescents between the ages of 7 and 15 years.
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Rev Esp Anestesiol Reanim · Apr 2007
Review[Anesthetic and physiologic implications of neurophysiologic monitoring with evoked potentials during spinal surgery].
Neurophysiologic monitoring with somatosensory and motor evoked potentials in spinal surgery is now widely applied in order to reduce the risk of neural injury and facilitate intraoperative decision making. Most anesthetics affect such monitoring by altering both somatosensory and motor evoked responses and these effects may place constraints on the choice of anesthetic. Intraoperative management includes maintaining stable physiologic conditions, which involves adjusting hemodynamic parameters, maintaining normal blood flow to promote proper oxygen exchange, ensuring proper ventilation, and avoiding variations in temperature. Close collaboration between the anesthetist, the surgeon, and the neurophysiologist will ensure the success of intraoperative monitoring and make it possible to avoid neural injury by making timely changes in the surgical approach.