Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · Feb 2009
Randomized Controlled Trial Comparative Study[Contribution of ultrasound guidance to the performance of the axillary brachial plexus block with multiple nerve stimulation].
To evaluate whether ultrasound imaging of vascular nerve structures improves anesthetic block quality and decreases the incidence of vascular puncture in the performance of an axillary brachial plexus block with multiple nerve stimulation. ⋯ Combining ultrasound guidance with nerve stimulation improves the anesthetic quality of an axillary brachial plexus block, decreases the likelihood of vascular puncture, and slightly increases the amount of time required to perform the procedure.
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Rev Esp Anestesiol Reanim · Feb 2009
Review[Implantable pacemakers and defibrillators: implications for anesthesia and perioperative management].
The technological complexity of implantable devices for managing arrhythmias, specifically pacemakers and defibrillators, has increased spectacularly since their introduction a few decades ago. A growing number of patients with these devices are undergoing surgery and it is therefore essential to understand how they work and what the real associated risks are. ⋯ It is no longer satisfactory to place a magnet over these devices during surgery and assume that this action will protect the patient from the possible effects of electromagnetic interference. This review examines the basic principles and operation of implantable pacemakers and defibrillators, the relevant nomenclature, and the sources and effects of electromagnetic interference; the current recommendations for the perioperative management of patients fitted with these devices are also discussed.
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Rev Esp Anestesiol Reanim · Feb 2009
[Mortality in patients with multiple injuries: analysis using the trauma and injury severity score in a referral hospital].
A growing number of patients with multiple injuries are being treated. Injury severity scales can be used to assess outcomes objectively. This study aimed to assess our hospital's cases on the basis of the Trauma and Injury Severity Score (TRISS) and compare outcomes to those reported in the Major Trauma Outcome Study, as well as to determine preventable mortality and analyze causes of death and associated factors. ⋯ The rate of preventable death in our hospital was higher than expected. Mortality was strongly associated with head injury and age. The TRISS model can identify preventable deaths objectively.