Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · May 2009
Review[Repercussions and management of perioperative hyperglycemia in cardiac surgery].
Surgery produces a neuroendocrine stress response that affects resistance to insulin, reduces insulin secretion, and increases the release of glucose from the liver. This situation can trigger hyperglycemia in both diabetics and nondiabetics. ⋯ This review discusses various aspects of hyperglycemia, particularly the evidence supporting stricter control of this condition in patients undergoing cardiac surgery. Furthermore, based on the available data and recommendations, and our clinical experience, we suggest therapeutic strategies to improve the control of hyperglycemia in these patients.
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Rev Esp Anestesiol Reanim · Apr 2009
Review Comparative Study[Intravenous remifentanyl for labor analgesia].
Intravenous remifentanil may be the preferred analgesic when regional techniques are contraindicated. ⋯ Analgesia with intravenous remifentanil is more effective and safer than other alternatives to regional analgesic techniques in obstetrics. Nevertheless, the optimum system for infusing the drug must b e established and further studies of maternal and fetal safety should be carried out.
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Rev Esp Anestesiol Reanim · Mar 2009
Review[Pediatric complex regional pain syndrome affecting an upper limb: 7 cases and a brief review of the literature].
To review the clinical, psychiatric, and social characteristics of complex regional pain syndrome in children and adolescents treated in the last 4 years at our pediatric pain clinic. ⋯ The clinical course was satisfactory for all but 1 patient, who developed severe disability. Complex regional pain syndrome affecting an upper limb is uncommon in children but not rare.
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Rev Esp Anestesiol Reanim · Feb 2009
Review[Implantable pacemakers and defibrillators: implications for anesthesia and perioperative management].
The technological complexity of implantable devices for managing arrhythmias, specifically pacemakers and defibrillators, has increased spectacularly since their introduction a few decades ago. A growing number of patients with these devices are undergoing surgery and it is therefore essential to understand how they work and what the real associated risks are. ⋯ It is no longer satisfactory to place a magnet over these devices during surgery and assume that this action will protect the patient from the possible effects of electromagnetic interference. This review examines the basic principles and operation of implantable pacemakers and defibrillators, the relevant nomenclature, and the sources and effects of electromagnetic interference; the current recommendations for the perioperative management of patients fitted with these devices are also discussed.
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Rev Esp Anestesiol Reanim · Feb 2009
Review Case Reports[Acute renal failure secondary to hemolytic uremic syndrome in a pregnant woman with pre-eclampsia].
Acute renal failure is a serious complication of pregnancy associated with a high rate of morbidity and mortality; the incidence is currently 1 per 10,000 pregnancies. The most common causes are gestational hypertension, bleeding, sepsis, and intrinsic renal disease. ⋯ The classic symptoms are fever, hemolytic microangiopathic anemia, thrombopenia, neurologic dysfunction, and kidney abnormalities. When renal involvement is the predominant manifestation, the diagnosis is usually hemolytic uremic syndrome.