Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · Aug 2008
Case Reports[Severe pulmonary hypertension: implications for anesthesia in laparoscopic surgery].
Pulmonary arterial hypertension (PAH), defined by a mean pulmonary arterial pressure greater than 25 mm Hg at rest or greater than 30 mm Hg with exercise, poses a challenge to anesthesiologists during perioperative management. The pathogenesis of PAH is multifactorial and includes genetic factors that explain individual susceptibility and external trigger or risk factors. We report the case of a woman with severe pulmonary hypertension who was waiting for a lung transplant when she was scheduled for laparoscopic cholecystectomy. We discuss the clinical course and monitoring of hemodynamic and respiratory parameters at the different stages of laparoscopic surgery.
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Rev Esp Anestesiol Reanim · Jun 2008
Randomized Controlled Trial Comparative Study[Comparison of intrathecal fentanyl and bupivacaine in combined spinal-epidural obstetric analgesia].
To compare intrathecal injection of the opioid fentanyl to injection of bupivacaine, in terms of their effect of labour in the context within the combined spinal-epidural analgesia. ⋯ Our findings do not support the use of intradural fentanyl with the aim of shortening labor. Fentanyl leads to more pruritus, although this side effect does not affect maternal satisfaction.
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Rev Esp Anestesiol Reanim · Jun 2008
Review Meta Analysis Comparative Study[Combined general-epidural anesthesia compared to general anesthesia: a systematic review and meta-analysis of morbidity and mortality and analgesic efficacy in thoracoabdominal surgery].
We performed a systematic review of randomized controlled trials to compare combined general-epidural anesthesia, followed by postoperative epidural analgesia, and general anesthesia followed by postoperative parenteral analgesia without epidural analgesia in patients undergoing thoracoabdominal surgery. Outcome measures considered were mortality, length of stay in hospital and in the intensive care unit, analgesia, and morbidity. ⋯ Combined anesthesia provides better analgesia and is associated with fewer cases of postoperative respiratory failure. No significant differences were found in mortality, length of stay in hospital, or other morbidity variables.