Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · May 2008
Randomized Controlled Trial Comparative Study[Intrathecal but not systemic sufentanil reduces the consumption of propofol for bispectral index-guided sedation].
The addition of opioids to local anesthetics in spinal anesthesia modulates some aspects of anesthesia and analgesia. We evaluate the effect of adding different doses of intrathecal and subcutaneous sufentanil on propofol requirements for sedation during spinal anesthesia. ⋯ The addition of 2.5 microg or 5 microg of intrathecal sufentanil to HBB reduces MID, TPD, and consumption of propofol in patients undergoing spinal anesthesia; the addition of 5 microg of subcutaneous sufentanil does not produce this effect.
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Rev Esp Anestesiol Reanim · May 2008
[Correct placement of left-sided double lumen endotracheal tubes: a simple verification technique].
Double lumen endotracheal tubes (DLTs) are used in thoracic surgery for selective bronchial intubation, which is required for single lung ventilation. Correct placement of the tube is checked by means of fiberoptic bronchoscopy. We present a simple alternative method to help confirm the correct placement of left-sided DLTs. The method consists of passing a suction catheter through the tracheal lumen of the tube. Our hypothesis was that if the catheter can be inserted without difficulty, the tube is correctly placed. The objective was to determine the sensitivity and specificity of that criterion. ⋯ This technique can be very useful in placing left-sided DLTs in situations where fiberoptic bronchoscopy is not available and if the anesthesiologist has a thorough command of the method. Our results support the routine use of this criterion as it is simple and easy to learn. It should be remembered, however, that confirmation of placement by means of fiberoptic bronchoscopy is currently the gold standard technique.
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Rev Esp Anestesiol Reanim · May 2008
[The bispectral index as a predictor of anterograde amnesia caused by premedication with intranasal midazolam].
To determine the ability of the bispectral index (BIS) to predict anterograde amnesia for events occurring between the arrival of patients in the operating theater and anesthetic induction, following premedication with 10 mg of intranasal midazolam. ⋯ A fall in the BIS to below 90 can be used as a predictor for anterograde amnesia following administration of 10 mg of intranasal midazolam.
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Rev Esp Anestesiol Reanim · May 2008
[Portable ultrasound devices in regional anesthesia: the brachial plexus block].
Ultrasonography has received increasing attention in regional anesthesia in recent years because it allows visualization of the nerves, the needle, and the surrounding structures and makes it possible to monitor distribution of the local anesthetic. Ultrasound technology is unfamiliar to most anesthesiologists, unless they work with transesophageal echocardiography. ⋯ Ultrasonography makes it possible to identify the brachial plexus, from the roots to the peripheral nerves of the arm. We describe the main approaches used in providing an ultrasound-guided brachial plexus block and explain the basic principles of ultrasound imaging.