Revista española de anestesiología y reanimación
-
Rev Esp Anestesiol Reanim · Mar 2010
Randomized Controlled Trial Comparative Study[Incidence of cough after desflurane and sevoflurane administration through a laryngeal mask: a controlled clinical trial].
To determine the incidence of cough with the administration of desflurane and sevoflurane through a laryngeal mask. ⋯ The patients who inhaled desflurane through a laryngeal mask had a higher incidence of cough than those who inhaled sevoflurane. The mechanism by which cough is being triggered by desflurane should be studied to determine whether the effect is chemical or mechanical and whether it is acting in the larynx or in the distal portion of the lung.
-
Rev Esp Anestesiol Reanim · Mar 2010
Case Reports[Endotracheal tube fire during laryngeal surgery: analysis of the root cause of a sentinel event].
Endotracheal tube fire during laryngeal surgery is a rare complication but one that has serious consequences. Surgeons, anesthesiologists and others involved with this type of surgery should become familiar with how to manage this difficult situation, which should be considered a sentinel event requiring prompt analysis of the root cause and surrounding circumstances. ⋯ The patient died as a result of the lesions sustained. We report the results of the investigation and the protocols for prevention and response implemented in our surgical department, in the hope that the experience will be of interest to others working in similar settings.
-
Many recent studies have underlined the importance of quantitative neuromuscular monitoring and the high incidence of residual block in clinical practice in spite of the use of nondepolarizing neuromuscular blockers of intermediate duration. Neuromuscular monitoring facilitates the tailoring of the muscular paralysis and appropriate patient recovery at the end of surgery. Monitoring also controls or prevents residual block and serves to guide the use of reversing agents. ⋯ In addition to drawing on their own experience, the authors have reviewed the literature available through evidence-based indexes and other databases up to December 2008. Most references found were case series and reviews. Quantitative monitoring is an evidence-based practice that should be applied in all situations in which a neuromuscular block is established.
-
Rev Esp Anestesiol Reanim · Mar 2010
Case ReportsA new approach to anesthesia management in myasthenia gravis: reversal of neuromuscular blockade by sugammadex.
A neuromuscular blocking drug (NMBD) induced neuromuscular blockade (NMB) in patients with myasthenia gravis usually dissipates either spontaneously or by administration of neostigmine. We administered sugammadex to a patient with myasthenia gravis to reverse a rocuronium-induced profound NMB. ⋯ A rapid and complete recovery from profound NMB was achieved and no adverse events were observed. This case suggests that sugammadex is a safe and effective antagonist of a rocuronium induced NMB blockade in patients with myasthenia gravis.