Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · Mar 2013
Multicenter Study[Haemorrhage and morbidity associated with the use of tranexamic acid in cardiac surgery: a retrospective, multicentre cohort study].
Postoperative bleeding is common complication, affecting up to 20% of patients, after cardiac bypass surgery. Fibrinolysis is one of the causes of this excessive bleeding, and for this reason the use of tranexamic acid is recommended. The problem with using this is that there are numerous guidelines and differences in the dose to be administered. Our aim was to evaluate whether there were any differences in postoperative bleeding and morbidity after cardiac surgery with the administering of different tranexamic acid doses in three university hospitals. ⋯ Elevated doses of tranexamic acid in cardiac bypass surgery appear to significantly reduce bleeding in the first hours after surgery compared to low doses. However, this decrease did not lead to a reduction in the needs for blood products.
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Rev Esp Anestesiol Reanim · Mar 2013
Randomized Controlled Trial Comparative Study[Comparison between VAMA(®) and Berman(®) cannulas for fibroscopic orotracheal intubation in anaesthetised patients].
In fibroscopic intubation, the fact of achieving a direct view in real time does not guarantee the correct advance of the endotracheal tube (ET) to its intratracheal position. The use of oral cannulas helps in achieving a free airway in order to pass the fibroscope and the ET. This study compares the VAMA(®) (V) and Berman(®) (B) cannulas as regards the time required for the intubation, fibroscopic view, and the ease in positioning the ET. ⋯ The VAMA(®) cannula is an effective alternative to the classic cannulas for fibreoptic assisted intubation. Furthermore, the novel design provides advantages for the correct orientation of the fiberscope and the withdrawal of the cannula after intubation.
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Rev Esp Anestesiol Reanim · Mar 2013
Randomized Controlled Trial[Contribution to post-caesarean analgesia of ultrasound-guided transversus abdominis plane block].
The aim of this study was to evaluate the contribution made by ultrasound-guided transversus abdominis plane block (TAP) to the quality of the analgesia with intrathecal opioids obtained in patients undergoing elective caesarean delivery. ⋯ Ultrasound (US)-guided TAP block improves spinal opioid analgesia, with a decrease in VAS scores in the first 24h, and reduces opioid requirement and secondary effects after caesarean delivery.
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Rev Esp Anestesiol Reanim · Mar 2013
[Ultrasound-guided block at the antecubital fossa for carpal tunnel syndrome surgery].
There are various anaesthetic techniques for ambulatory surgery of carpal tunnel release. The ultrasound-guided nerve blocks offer advantages compared to other techniques. The purpose of this study was to evaluate the efficacy using ultrasound-guided block at the antecubital fossa, as well as to evaluate complications, patient satisfaction and surgeon satisfaction with the block. ⋯ A selective block of the medial, ulnar and medial and lateral cutaneous nerves of the forearm are effective and satisfactory anaesthetic techniques for carpal tunnel release in a one-day case unit. It allows early mobilization, minimises risks and amount of local anaesthetic used.
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Rev Esp Anestesiol Reanim · Mar 2013
[Prevention, diagnosis and treatment of bleeding in cardiac surgery].
Patients undergoing cardiac surgery are at high risk of bleeding and transfusion. This risk has increased in recent years and is associated with increased morbidity and mortality. ⋯ On the other hand, the emergence of new drugs and the use of point of care coagulation monitoring systems, is changing our diagnostic and therapeutic options. This paper reviews several aspects related to the causes, diagnosis and treatment of bleeding associated with cardiac surgery and presents an algorithm for its management.