Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · Apr 2012
Case Reports[Detection of a cerebral ischaemia episode during surgery by monitoring the brain tissue oxygen pressure].
The detection and treatment of cerebral ischaemia and tissue hypoxia for the prevention of secondary injury are the basic objectives during anaesthesia for neurosurgical procedures. The monitoring of the tissue oxygen pressure is direct and can enable potentially harmful situations to be detected in real time. ⋯ The finding of an episode of cerebral tissue hypoxia during closure of the craniotomy determined the treatment of the patient. We highlight the possible use of this neuromonitoring for the rapid detection of regional cerebral hypoxia events in the peri-operative period of vascular neurosurgery, procedures that have a significant risk of, mainly ischaemic, hypoxia episodes.
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Rev Esp Anestesiol Reanim · Apr 2012
Randomized Controlled Trial Comparative Study[Control of postoperative pain in knee arthroplasty: single dose femoral nerve block versus continuous femoral block].
To compare the efficacy of a multimodal analgesia with 2 different techniques (femoral nerve block with a single dose and continuous femoral nerve block) in the control of pain, use of opioids, and secondary effects in patients subjected to total knee replacement. ⋯ The use of peripheral nerve block is accepted practice for analgesia after knee replacement surgery. Continuous femoral block is a valid alternative, decreasing the use of rescue opiates and pain intensity (particularly at 48h) compared to isolated femoral block.
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Rev Esp Anestesiol Reanim · Apr 2012
Randomized Controlled Trial Comparative Study[Comparison of the post-surgical analgesic effectiveness of tibial (at internal malleolus level) and common peroneal nerve block with infiltration of the surgical wound in Outpatient Surgery of the hallux valgus].
To compare the post-operative analgesic effectiveness of blocking the posterior tibial and the common peroneal nerves against that of wound infiltration using local anaesthesia, in ambulatory surgery of hallux valgus. ⋯ The peripheral nerve block and wound infiltration are valid techniques for controlling pain at home after ambulatory surgery of hallux valgus, therefore both methods appear to be safe in an outpatient setting.
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Rev Esp Anestesiol Reanim · Apr 2012
Randomized Controlled Trial Comparative Study[Influence of femoral catheter stimulation intensity on post-surgical analgesia after total knee replacement].
Stimulating catheters allow the catheter point to be positioned near the nerve, thus reducing the amount of local anaesthetic required for a successful block. There is currently a debate on what is the stimulation intensity required to provide adequate analgesia, although it does seem that if it is obtained with 1mAmp or less the block is more effective. The objective of the study was to demonstrate whether different neurostimulation intensities with the stimulating catheter at femoral nerve level, had an influence on the adequacy of post-surgical analgesia during the 48h after total knee arthroplasty. ⋯ In our study, no influence was found on the level of analgesia provided after knee replacement surgery with the neurostimulation intensity to which the neuromuscular system involved responded when a stimulating catheter is inserted at femoral level.