Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · May 2009
Randomized Controlled Trial Comparative Study[Bolus administration of fentanyl vs continuous perfusion of remifentanil for control of hemodynamic response to laryngoscopy and orotracheal intubation: a randomized double-blind trial].
To compare the efficacy and safety of fentanyl and remifentanil in the prevention of hemodynamic responses to direct laryngoscopy and orotracheal intubation, and to compare the effects of these techniques on peripheral blood oxyhemoglobin saturation in normotensive women undergoing scheduled gynecologic surgery. ⋯ Remifentanil provides greater hemodynamic control than fentanyl at the doses utilized. No adverse effects attributable to these opioids were observed in either group.
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Rev Esp Anestesiol Reanim · May 2009
Review[Repercussions and management of perioperative hyperglycemia in cardiac surgery].
Surgery produces a neuroendocrine stress response that affects resistance to insulin, reduces insulin secretion, and increases the release of glucose from the liver. This situation can trigger hyperglycemia in both diabetics and nondiabetics. ⋯ This review discusses various aspects of hyperglycemia, particularly the evidence supporting stricter control of this condition in patients undergoing cardiac surgery. Furthermore, based on the available data and recommendations, and our clinical experience, we suggest therapeutic strategies to improve the control of hyperglycemia in these patients.
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Rev Esp Anestesiol Reanim · May 2009
Comparative Study[Effect of posture on spinal cord stimulation in patients with chronic pain syndromes: analysis of energy requirements in different patient postures].
Patients being treated with spinal cord stimulation for chronic pain complain of variable paresthesias, particularly in relation to changes in posture. Such changes affect the great majority of patients with implantable pulse generators, requiring them to use the external programmer for avoidance of painful paresthesias or even to disconnect the generator, leading to loss of pain relief. The aim of this study was to determine the relationship between the pulse charge needed for stimulation and the patient's different postures. ⋯ Stimulation systems are not currently designed to adapt to changes in distance between the electrodes and nerve fibers. Improvements are required in this respect.