Revista española de anestesiología y reanimación
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Few pharmacologically new anesthetics have appeared in recent years, but great progress has been made toward improving some existing ones. Such is the case with propofol. New formulations have been developed to reduce or avoid adverse side effects associated with the original drug produced by Astra-Zeneca. ⋯ Some new formulations contain excipients with bactericidal action, such as propofol with ethylenediaminetetraacetic acid or metabisulfite, and others use lipuro rather than intralipid. Other more advanced products are propofol in cyclodextrin or IDD-D propofol, which makes use of nanoparticle technology. A grasp of the pharmacokinetics and pharmacodynamics of the original formulation must be the basis for understanding the differences between these new products.
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Rev Esp Anestesiol Reanim · Aug 2006
[Ultrasound-guided supraclavicular brachial plexus block with small volumes of local anesthetic: technical description and analysis of results].
To assess the use of ultrasound guidance to enable injection of 10 mL of 2% mepivacaine into the brachial plexus to maintain an effective block and surgical conditions comparable to those that can be provided with larger volumes and higher doses. ⋯ Ultrasound guidance enables use of less local anesthetic for supraclavicular brachial plexus blocks. The surgical conditions possible are comparable in quality to those achieved at higher volumes and doses. The incidence of complications is minimal.
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Rev Esp Anestesiol Reanim · Aug 2006
Case Reports[Anesthesia with sevoflurane for tonsillectomy in a boy with Duchenne muscular dystrophy].
A 6-year-old boy with Duchenne muscular dystrophy (DMD) and foreseen difficult tracheal intubation underwent tonsillectomy under general inhaled anesthesia with sevoflurane. No neuromuscular blockers were administered and no perioperative complications emerged. In spite of advances in genetic diagnosis there continue to be patients with DMD because of spontaneous mutation of the dystrophin gene. ⋯ Inhaled anesthesia is an alternative. Although halogenated agents can lead to rhabdomyolysis and malignant hyperthermia, the frequency seems low if we bear in mind that the use of sevoflurane is widespread in pediatrics. In this case sevoflurane induction facilitated safe tracheal intubation.