Revista española de anestesiología y reanimación
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Central neuraxial blocks, which are associated with a low incidence of complications, are safe. When complications do occur, however, the resulting morbidity and mortality is considerable. The reported incidence of complications in all series is under 4 per 10000 patients, but given the absence of formal registries and notification procedures, which have legal implications, the real rate of occurrence of these rare events is uncertain. ⋯ When a complication occurs, factors related to the technique will have interacted with pre-existing patient-related conditions. Various scientific societies have published guidelines for managing the complications of regional anesthesia. Recently published clinical practice guidelines recommend ultrasound imaging as a useful tool in performing a central neuraxial block.
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Rev Esp Anestesiol Reanim · Aug 2011
Randomized Controlled Trial Comparative Study[Ephedrine vs. phenylephrine by intravenous bolus and continuous infusion to prevent hypotension secondary to spinal anesthesia during cesarean section: a randomized comparative trial].
Subarachnoid spinal anesthesia for cesarean section is associated with a high incidence of hypotension, which can require the use of vasoconstrictors. The aim of this trial was to compare ephedrine to phenylephrine for the prevention of secondary hypotension and to assess the adverse effects on both mother and newborn. ⋯ At the doses of ephedrine and phenylephrine administered in this trial, the ability of these drugs to prevent hypotension during cesarean section proved to be similar. Higher incidences of adverse events (hypertension and bradycardia) were observed in the phenylephrine group. No differences were observed in neonatal effects.
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Rev Esp Anestesiol Reanim · Aug 2011
[An established anesthesia team-care model: over 12000 cases in a digestive endoscopy unit].
The growing demand for digestive and other endoscopic procedures outside the operating room, both in terms of type of endoscopy and number of patients, requires reorganization of the anesthesiology department's workload. We describe 2 years of our hospital digestive endoscopy unit's experience with a now well-established care model involving both anesthesiologists and nurse anesthetists. ⋯ The results suggest that this care model can safely accommodate a large caseload in anesthesia at an optimum level of quality.
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Rev Esp Anestesiol Reanim · Aug 2011
Comparative Study[Estimating the angle of left lateral decubitus position during cesarean section: observational study of anesthesiologists' estimates and of midwives and nurses' level of understanding].
To determine the difference between the estimated and measured values of the left lateral decubitus (LLD) angle in the positioning of patients for scheduled cesarean section; to determine whether the accuracy of estimates differs between staff anesthesiologists and residents; and to assess the angle estimates of midwives and surgical nurses as well as their level of knowledge with respect to the utility of the LLD position. ⋯ The DLL position angle is overestimated by resident anesthesiologists and midwives. It seems that the use and understanding of DLL positioning could be improved.