Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · Apr 2010
Comparative Study[Thoracic epidural analgesia vs patient-controlled analgesia with intravenous fentanyl in children treated for pectus excavatum with the Nuss procedure].
Thoracic epidural analgesia and patient-controlled analgesia (PCA) with intravenous fentanyl have both been shown to be effective in pediatric patients treated surgically for pectus excavatum using the Nuss procedure. We compare the efficacy and safety of these techniques. ⋯ The efficacy and safety of thoracic epidural analgesia is similar to that of PCA with intravenous fentanyl, although the use of epidural analgesia is associated with a markedly shorter duration of requirement for postoperative analgesia.
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Rev Esp Anestesiol Reanim · Apr 2010
[First-year medical residents' self-assessment of skill in basic life support and automatic external defibrillation].
To determine first-year medical residents' perception of their competence in basic life support (BLS) and the use of automatic external defibrillation (AED). ⋯ The residents perceived themselves as competent to give BLS and AED immediately after the course and 8 months after training, although fewer felt as competent at the second assessment. Bag-mask ventilation was considered the most difficult skill.
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Rev Esp Anestesiol Reanim · Apr 2010
Case Reports[Phase II blockade after a subclinical dose of succinylcholine: importance of neuromuscular monitoring].
Neuromuscular monitoring is not a routine practice in clinical settings worldwide. The little interest expressed is mainly because clinicians lack information and documentation, even though the literature on the subject is vast and experts agree that routine monitoring reduces morbidity related to the use of neuromuscular blockers. ⋯ The blockade lasted longer than expected in a patient with diminished plasma cholinesterase activity. We emphasize that monitoring neuromuscular function aided diagnosis and observation of the block during emergency surgery.
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To conduct a survey to profile the practice of regional anesthesia in Chile and determine the limitations on its use. ⋯ Although regional anesthesia is commonly used in Chile, neuraxial blocks remain the most frequently used types. Peripheral nerve blocks are used fairly often, mostly on an upper limb. Training should stimulate attempts to promote more widespread use of all forms of regional anesthesia.
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Rev Esp Anestesiol Reanim · Apr 2010
Case Reports[Epidural blood patch to treat severe postdural puncture headache after ambulatorysurgery].
We report a case of postdural puncture headache (PDPH) after outpatient hysteroscopy under spinal anesthesia in which a 25-gauge Whitacre needle was used. Symptoms of PDPH appeared 6 hours after surgery. The headache improved with oral caffein and intravenous corticosteroids and the patient was discharged after 24 hours. ⋯ Within 12 hours the incapacitating symptoms had improved markedly and resolution was complete 2 months after surgery. PDPH worthy of blood patch treatment is a rare complication of spinal anesthesia with pencil-point needles. Clear diagnostic protocols are required if satisfactory treatment is not to be delayed and unnecessary suffering is to be prevented.