Revista española de anestesiología y reanimación
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Anesthesiology societies have issued various guidelines on preoperative fasting since 1990, not only to decrease the incidence of lung aspiration and anesthetic morbidity, but also to increase patient comfort prior to anesthesia. Some of these societies have been updating their guidelines, as such that, since 2010, we now have 2 evidence-based preoperative fasting guidelines available. In this article, an attempt is made to review these updated guidelines, as well as the current instructions for more controversial patients such as infants, the obese, and a particular type of ophthalmic surgery.
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Rev Esp Anestesiol Reanim · Mar 2015
Case ReportsPostoperative analgesia with transversus abdominis plane catheter infusions of levobupivacaine after major gynecological and obstetrical surgery. A case series.
Transversus abdominis plane block has become an important method of postoperative pain management for patients undergoing abdominal surgery but the modest duration is a major limitation. We report the successful use of a novel TAP catheter technique for continuous infusion of levobupivacaine in six gynecologic and obstetric patients. Bilateral TAP catheters were inserted at the end of surgery by ultrasound imaging using a Contiplex® C needle (B. ⋯ Successful analgesia was achieved in all six cases utilizing continuous infusion of levobupivacaine, minimizing the volume required. TAP infusions produce significant opioid sparing and better patient mobility. This technique may be a reliable alternative to neuraxial analgesia in major gynecological and obstetrical surgery.
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Rev Esp Anestesiol Reanim · Mar 2015
Observational Study[Is obesity a risk factor for complications, hospital admissions, and surgical cancellations in ambulatory surgery?].
To determine the incidence of outcomes, unanticipated admissions and cancellations in patients operated in an Ambulatory surgery unit, and to establish the relationships with their body mass index (BMI). ⋯ The results of this study suggest that moderate and severe obesity should be a risk factor for postoperative complications, unplanned admissions, and cancellations in outpatient surgery. Adequate patient selection and preoperative evaluation, as well as strategies for the prevention and control of the most frequents complications in obese patients are the key factors for their integration in major ambulatory surgery programs.