Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · Jan 2018
Randomized Controlled Trial Comparative StudyHaemodynamic response and effectiveness of tracheal intubation with Airtraq® versus Macintosh laryngoscope in paediatric patient undergoing elective surgery: Prospective, randomised and blind clinical trial.
To compare the haemodynamic response and effectiveness of tracheal intubation with Airtraq® device and Macintosh laryngoscope, for airway management of patients between 2 and 8 years undergoing elective surgery. ⋯ Intubation with Airtraq® device is more effective than Macintosh laryngoscope in terms of reduction of haemodynamic changes, SO2, EtCO2, time and number of attempts for intubation and complications in paediatric patients undergoing elective surgery.
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Rev Esp Anestesiol Reanim · Jan 2018
ReviewReview of difficult airway management in thoracic surgery.
The management of difficult airway (DA) in thoracic surgery is more difficult due to the need for lung separation or isolation and frequent presence of associated upper and lower airway problems. We performed an article review analysing 818 papers published with clinical evidence indexed in Pubmed that allowed us to develop an algorithm. ⋯ In both cases, double lumen tubes should be reserved for when lung separation is absolutely indicated. Finally, extubation should be a time of maximum care and be performed according to the safety measures of the Difficult Arway Society.
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The difficult airway constitutes a continuous challenge for anesthesiologists. Guidelines and algorithms are key to preserving patient safety, by recommending specific plans and strategies that address predicted or unexpected difficult airway. However, there are currently no "gold standard" algorithms or universally accepted standards. The aim of this article is to present a synthesis of the recommendations of the main guidelines and difficult airway algorithms.
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Rev Esp Anestesiol Reanim · Dec 2017
Observational StudyUltrasound-guided genicular nerve block for pain control after total knee replacement: Preliminary case series and technical note.
Total knee arthroplasty (TKA) is an operation with moderate to severe postoperative pain. The Fast-Track models employ local infiltration techniques with anaesthetics at high volumes (100-150ml). We proposed a genicular nerve block with low volume of local anaesthetic. The aim of our study is to evaluate the periarticular distribution of these blocks in a fresh cadaver model and to describe the technique in a preliminary group of patients submitted to TKA. ⋯ The administration of 4ml of local anaesthetic at the level of the 4 genicular nerves of the knee produces a wide periarticular distribution. Our preliminary data in a series of 12 patients undergoing TKA seems to be clinically effective. Nevertheless, extensive case series and comparative studies with local infiltration techniques with anaesthetics are needed to support these encouraging results.
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Rev Esp Anestesiol Reanim · Dec 2017
Comparative StudyMonitoring intraoperative neuromuscular blockade and blood pressure with one device (TOF-Cuff): A comparative study with mechanomyography and invasive blood pressure.
The overall objective of the study is to determine the ability of TOF-Cuff device (blood-pressure modified cuff, including stimulation electrodes) to monitor with the same device the non-invasive blood pressure (NIBP) and the depth of a neuromuscular blockade (NMB) induced pharmacologically, by stimulation of the brachial plexus at the humeral level and recording evoked changes in arterial pressure. ⋯ The TOF-Cuff device has been shown to be valid and safe in the monitoring of NMB and in the measurement of NIBP, with no patient presenting any adverse events, skin-level lesions or residual pain. It is not interchangeable with MMG, having a TOF-ratio>0.9 quantified by the TOF-Cuff device, a good correlation with a TOF-ratio>0.7 on MMG.