Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · Jun 2008
Case Reports[Total intravenous anesthesia for repositioning an implantable defibrillator in a patient with long QT syndrome].
We report the case of a 27-year-old woman with congenital long QT syndrome (LQTS) who was scheduled for surgery to reposition an implantable defibrillator. Given the risk of sudden death due to fatal ventricular arrhythmia, the woman required implantation of a defibrillator with pacemaker capability. ⋯ Anesthesia was maintained with an infusion of propofol and remifentanil. We describe the pathophysiology and treatment of LQTS and discuss anesthetic management for repositioning a defibrillator in a patient with congenital LQTS.
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Rev Esp Anestesiol Reanim · Jun 2008
[Hemodynamic variability caused by pressure-volume plotting and alveolar recruitment maneuvers in patients with adult respiratory distress syndrome].
The plotting of pressure-volume curves and the performance of alveolar recruitment maneuvers are common practices in the care of patients with adult respiratory distress syndrome (ARDS), even though potentially harmful hemodynamic effects are associated with sustaining a high intrathoracic pressure. Our aim was to analyze hemodynamic and ventilatory changes related to these 2 maneuvers and to assess the short-term effectiveness of recruitment. ⋯ The hemodynamic disturbances associated with the alveolar recruitment maneuver based on sustaining a high end-expiratory pressure and the minor improvement in oxygenation achieved as a result suggest that the routine use of that maneuver in ARDS patients is of questionable value.
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Rev Esp Anestesiol Reanim · May 2008
Randomized Controlled Trial Comparative Study[Intrathecal but not systemic sufentanil reduces the consumption of propofol for bispectral index-guided sedation].
The addition of opioids to local anesthetics in spinal anesthesia modulates some aspects of anesthesia and analgesia. We evaluate the effect of adding different doses of intrathecal and subcutaneous sufentanil on propofol requirements for sedation during spinal anesthesia. ⋯ The addition of 2.5 microg or 5 microg of intrathecal sufentanil to HBB reduces MID, TPD, and consumption of propofol in patients undergoing spinal anesthesia; the addition of 5 microg of subcutaneous sufentanil does not produce this effect.