Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · Aug 2009
[Failure of extension of epidural analgesia to anesthesia for emergency cesarean section].
Epidural analgesia provides effective control of labor pain and allows emergency cesarean section to be performed without recourse to general anesthesia. This technique is subject to failure, however. We sought to determine the incidence of failure of extension of epidural analgesia for labor to epidural anesthesia for emergency cesarean section. ⋯ The relative risk of epidural catheter failure was 2.86-fold higher when rescue analgesia was needed during delivery than in cases when no supplement was required (P=.021). Receiving adequate analgesia during labor seems to be a protective factor (80%) against anesthetic catheter failure during cesarean section (P=.01). We conclude that high demand for rescue analgesia and signs of inadequate analgesia during labor should warn of epidural catheter failure if extension to anesthesia becomes necessary for a cesarean delivery.
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Rev Esp Anestesiol Reanim · Aug 2009
Case Reports[Using the CTrach Laryngeal Mask Airway in the awake patient with an expected difficult airway].
The method of choice for managing the expected difficult airway is tracheal intubation with an awake patient breathing spontaneously. The CTrach Laryngeal Mask Airway (LMA) is a modified version of the Fastrach LMA that incorporates a fiberoptic system that provides a view of the glottis during ventilation and intubation. ⋯ The CTrach LMA facilitates management of the airway in these circumstances. It is well tolerated and enables a clear view of the airway and permits assisted ventilation when necessary.
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Rev Esp Anestesiol Reanim · Aug 2009
Randomized Controlled Trial[Efficacy of a continuous infusion of local anesthetic into the surgical wound for pain relief after abdominal hysterectomy].
To assess the quality of postoperative analgesia provided by intravenous administration of paracetamol and ketorolac plus morphine in bolus doses with or without continuous infusion of local anesthetic into the surgical wound after abdominal hysterectomy. Patient satisfaction was included among the outcomes assessed. ⋯ Postoperative pain is effectively relieved by continuous infusion of local anesthetic into the surgical wound after abdominal hysterectomy. This technique provides good analgesia with less morphine consumption and scarce adverse effects. Patient satisfaction and the sense of receiving quality pain management are high.
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Rev Esp Anestesiol Reanim · Aug 2009
Randomized Controlled Trial[Effects of changes in ion concentrations, osmolarity, and pH on recovery from atracurium- or vecuronium-induced neuromuscular blockade].
To determine changes in sodium, potassium, calcium, magnesium and chloride ion concentrations in blood, osmolarity, and pH during surgery, and to assess the influence of such changes on atracurium- or vecuronium-induced neuromuscular blockade under inhaled or intravenous anesthesia. ⋯ Changes in electrolyte concentrations and pH as a result of standard fluid replacement therapy are moderate, well tolerated, and do not exercise a strong effect on the behavior of the neuromuscular blockade.
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Rev Esp Anestesiol Reanim · Aug 2009
Review[Anesthesia for procedures other than neurosurgery in the adult with epilepsy].
Epilepsy is a common disease affecting between 1% and 2% of the general population. The incidence increases with age. ⋯ This review gives an overview of the etiopathogenesis and pathophysiology of epilepsy and describes the general characteristics of antiepileptic drug therapy. The anesthetic implications of chronic treatment with antiepileptic agents and the interactions between these drugs and common anesthetics are discussed in more detail.