Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · Dec 2011
Multicenter Study[Neuromuscular block management during general anesthesia in a cohort of 1545 patients: a multicenter study].
Neuromuscular blockers (NMBs) have traditionally been thought to increase the risk of respiratory complications, although drawing conclusions in this respect would require complex studies in large patient samples. The aim of this study was to analyze data from the ARISCAT study to obtain an overall picture of how NMBs are being used and blocks are reversed in Catalonia, Spain. ⋯ Nondepolarizing NMBs are used in combination with general anesthesia often in Catalonia; their use is associated with duration and type of surgery. A reversal drug is administered relatively more often in Catalonia than in other geographic areas.
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Rev Esp Anestesiol Reanim · Dec 2011
Multicenter Study[Peripheral nerve stimulation in the treatment of various types of headache].
Headache has a great impact on patients' quality of life and in industrialized countries there is economic impact as well. One of the pathophysiologic theories to explain headache is activation of afferent C2-C3 nerve fibers. Afferent peripheral nerve stimulation by occipital nerve provocation at C2-C3 seems to alleviate headache by acting on the trigeminocervical complex, which would largely explain the effectiveness of this modality. The aim of this study was to describe peripheral nerve stimulation as an alternative therapy in patients who do not respond to other headache treatments. ⋯ Of 31 patients, 87% had positive results, with a significant decrease in pain from baseline (P < .001); 85.2% reported sustained improvement of > 50%, and 96.3% reported a decrease of > 2 points on the pain scale. All patients expressed satisfaction during the period of follow-up. Fifty-six percent had no headaches after a year and 47% had stopped taking medication. The most frequent complication was electrode migration.
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Rev Esp Anestesiol Reanim · Dec 2011
[Assessment of neurologic function and complications in a retrospective cohort of patients with acute spinal cord injury due to trauma treated with large-dose methylprednisolone].
Methylprednisolone was used to improve neurologic recovery from spinal cord injury in the National Acute Spinal Cord Injury Studies (NASCIS). Debate over this use led to further research and a 2002 report stating that there was insufficient evidence to support this application as a standard therapy. Our aim was to retrospectively assess this application in a cohort of patients with spinal cord injury. ⋯ In this retrospective study, methylprednisolone was unrelated to improvement in neurologic outcome after acute spinal cord injury on ICU discharge although the patients treated with this drug were at greater risk of metabolic complications.
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The anesthesiologist's chief responsibility is to ensure ventilation of the patient who is undergoing surgery or to apply resuscitation measures in life-threatening situations. Cricothyrotomy is one among many options available for maintaining airway patency. Usually it is the last resort but can be a lifesaving maneuver in the cannot-intubate, cannot-ventilate patient. The various types include cannula insertion, percutaneous puncture and dilatation, and surgical cricothyrotomy; techniques may be combined, as in the case of surgically inserting a cannula over a trocar.
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Rev Esp Anestesiol Reanim · Dec 2011
Letter Case Reports[Sugammadex in a patient with Takotsubo cardiomyopathy].