Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · Jun 2010
Case Reports[Cerebral oximetry monitoring during bypass surgery: can the approach be changed?].
We describe the detection of postoperative neurologic complications by means of monitoring cerebral oximetry during cardiac surgery. A 54-year-old man underwent emergency surgery for aortic dissection, type A. Cerebral oximetry was monitored by near-infrared spectroscopy. ⋯ Improvement came only when the recently inserted arterial cannula was switched to the ascending aortic prosthetic graft. After surgery, the patient was diagnosed with anoxic brain injury. We believe that the detected fall in cerebral oxygen saturation during axillary artery cannulization probably coincided with the occurrence of anoxic brain injury.
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Rev Esp Anestesiol Reanim · Jun 2010
Randomized Controlled Trial Comparative Study[Comparison of hemostatic markers under different techniques for anesthesia-analgesia in total hip or knee replacement].
Surgery promotes a state of hypercoagulability, predisposing to the possibility of postoperative thromboembolic complications. Our aim was to determine whether certain combinations of techniques (neuraxial, intravenous or both) for anesthesia and analgesia might be associated with attenuation of the prethrombotic state following total hip or knee replacement. ⋯ The anesthetic technique used during surgery did not affect hemostasis. However, continuous epidural analgesia in the postoperative recovery period attenuated some markers of hypercoagulability.
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Rev Esp Anestesiol Reanim · Jun 2010
Review[Near-infrared spectroscopy in the postanesthesia recovery care unit: noninvasive monitoring of peripheral perfusion].
Clinical signs of recovery, such as blood pressure or heart rate, do not accurately reflect the perfusion of organs and tissues in patients in critical condition. Of the various means for monitoring perfusion, regional monitors are the most sensitive. ⋯ In patients with sepsis or multiple injuries, tissue oxygen saturation can be useful as an early indicator of shock, as a marker of recovery or need for transfusion, or as a prognostic factor. In spite of widespread interest in NIRS, however, there are gaps to fill in our understanding of clinical signs and physiology in relation to this technique before peripheral tissue monitoring can become routine in postanesthesia recovery care units.
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Rev Esp Anestesiol Reanim · Jun 2010
Clinical Trial[Multiple-injection thoracic paravertebral block for reconstructive breast surgery].
To describe the use of multiple-injection thoracic paravertebral blockade, with intravenous sedation, for anesthesia during reconstructive breast surgery. ⋯ Triple-injection paravertebral blocks, in which 3 fractions of the total anesthetic dose are delivered to block dermatomes T3-5 is an effective technique that is easy to perform and leads to few complications. Most patients express a high degree of satisfaction with this anesthetic technique.