Revista española de anestesiología y reanimación
-
Rev Esp Anestesiol Reanim · Dec 2009
Randomized Controlled Trial Comparative Study[Efficacy of obturator and femoral cutaneous nerve blocks for postoperative analgesia in hip surgery].
The treatment of pain after surgery to repair a hip fracture is essential for an early start of rehabilitation and for reducing morbidity and mortality. Given that patients are elderly and have multiple medical conditions, local-regional analgesia can be an effective approach. Our aim was to compare the efficacy of obturator and femoral cutaneous nerve blocks and total intravenous analgesia in terms of level of patient satisfaction, complications, start of rehabilitation, and cost. ⋯ The nerve blocks were effective, easy to perform, and safe. They afforded numerous advantages: extended period of postoperative analgesia, fast recovery, lower costs, and no complications.
-
Rev Esp Anestesiol Reanim · Dec 2009
Comparative Study[Assessment of training in the control of acute postoperative pain based on analysis of pretraining and posttraining measures].
To assess the efficacy of an acute pain unit's training on postoperative pain control for staff of trauma-orthopedic and general surgery departments. ⋯ The staff training in postoperative pain control did not affect patient satisfaction, though a small improvement in active and resting VAS scores was noted. The training did have an effect on significantly improving overall compliance with the acute pain unit's treatment protocols.
-
Rev Esp Anestesiol Reanim · Dec 2009
Case Reports[Treating severe acute anemia due to vaginal bleeding in the Jehovah's Witness: a report of 2 cases].
For reasons of religious belief, Jehova's Witnesses do not accept blood transfusions or the infusion of blood products. In situations in which severe, life-threatening anemia develops, patient refusal to receive a transfusion can create serious ethical and legal problems. The principle of patient autonomy, which implies the freedom to accept or reject treatment, comes into conflict with the physician's obligation to safeguard the patient's life using all means possible. ⋯ The measures we took were effective in our patients. In the case of menorrhagia, hormone treatment is effective when the woman wishes to preserve the ability to conceive and avoid surgery (endometrial ablation and hysterectomy). In postpartum bleeding refractory to conservative treatment, selective embolization of bleeding vessels may make it unnecessary to resort to more aggressive treatment, such as obstetric hysterectomy.