Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · Apr 2006
Review[Techniques to block the sciatic nerve by a lateral approach through the popliteal fossa].
Lateral approaches to the sciatic nerve through the popliteal fossa have recently been described as useful for providing adequate anesthesia and postoperative analgesia for foot and ankle surgery. Numerous publications have appeared on the approach in recent years, proposing new anatomical landmarks to facilitate location of the nerve, reduce the rate of complications, and increase the rate of success. ⋯ This review describes the lateral popliteal approach, its main variations, the factors that can affect latency time or success, and the possibility of providing continuous analgesia. We also sought to compare this approach to other techniques for blocking the sciatic nerve.
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Recent years have brought renewed interest in peripheral nerve blocks as new drugs and materials have become available and as the advantages of such blocks over other anesthetic and analgesic techniques have been demonstrated. We conducted a literature search in PubMed, the Cochrane Library Plus (Spanish version), and Healthgate for the period January 1, 2000 through October 15, 2005 using the key words "complication and peripheral nerve block," "complication and peripheral block anaesthesia," and "complication and plexus anaesthesia." Totals of 178, 109, and 145 titles were obtained with each portal. When the search was limited to reviews, clinical trials, and randomized controlled trials, the numbers of articles from each portal became 11, 20, and 10, respectively, for the first string of key words; 0, 8 and 6, respectively, for the second string; and 10, 40 and 16 for the third. ⋯ Most of these publications agree that the overall incidence of complications related to these techniques is low. If practice guidelines and algorithms from experts are followed the incidence can be reduced. The aim of this review is to give an updated report of complications related to peripheral nerve blocks.
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Rev Esp Anestesiol Reanim · Mar 2006
Review[Perioperative management of cardiac arrhythmia: part II].
Cardiac arrhythmias are an important cause of complications throughout the perioperative period. Although our understanding of arrhythmias has increased considerably in recent years, they remain a source of concern for anesthesiologists. Our objective was to review steps to take when diagnosing arrhythmia. Although treatment is still largely influenced by therapies used in nonsurgical patients, we will review the approaches that are most applicable to practice situations in which anesthesiologists must manage patients with arrhythmias or at high risk of developing them.
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Rev Esp Anestesiol Reanim · Jan 2006
Review[Jehovah's Witnesses refusal of blood: religious, legal and ethical aspects and considerations for anesthetic management].
The refusal of Jehovah's Witnesses to agree to blood or blood product transfusion based on religious beliefs is one of the most challenging conflictive issues health care givers have to face today. Such conflict is a by product of the ideological and religious diversity in society today. The perioperative care of such patients constitutes a genuine challenge for anesthesiologists and surgeons from technical, scientific, ethical, and legal perspectives. ⋯ The literature up to August 2005 was reviewed by MEDLINE search. The following search terms were used: Jehovah's Witnesses, anesthesia (and anaesthesia), legislation and jurisprudence, ethics, blood transfusion, alternatives, anemia (and anaemia), erythropoietin, trigger, and critical care. To further cover ethical and legal aspects, we reviewed current laws in Spain and similar practice settings.