Revista española de anestesiología y reanimación
-
Rev Esp Anestesiol Reanim · May 2003
Case Reports[Obstetric analgesia and anesthesia with remifentanyl in a patient with von Willebrand disease].
A 30-year-old woman with von Willebrand's disease was admitted in labor. As epidural analgesia was ruled out due to risk of spinal hematoma, a pump for patient-controlled analgesia (PCA) was provided with boluses of remifentanil and set for intravenous infusion of 24 micrograms with a lockout time of 5 minutes. The patient reported analgesia to be satisfactory. ⋯ It is the most common genetic hemostatic disorder affecting obstetric procedures, and although epidural analgesia has been used with strict hematologic monitoring, that technique carries a risk of hematoma. PCA is useful in patients for whom regional techniques are contraindicated. With adequate fetal and maternal monitoring, remifentanil in PCA is safe and more effective than other opiates for labor pain.
-
Rev Esp Anestesiol Reanim · Apr 2003
Randomized Controlled Trial Comparative Study Clinical Trial[Comparison of two 27-G-caliber needles for spinal anesthesia. Study of 1,555 patients].
The purpose of this study was to compare two 27-gauge anesthesia needles with different points (a Whitacre-type point and a Quincke-type point) and to assess the incidences of postdural puncture headache (PDPH), puncture difficulty and failed anesthesia. ⋯ When a 27-gauge Whitacre-point needle is used, fewer cases of PDPH develop and the puncture is easier to accomplish than when a Quincke-point needle is used. The number of failed anesthetic procedures is similar with both needles. Whitacre-point 27-gauge needles are preferable to Quincke-point 27-gauge needles.
-
Rev Esp Anestesiol Reanim · Apr 2003
Case Reports[Continuous popliteal block with ropivacaine via a stimulant catheter for postoperative analgesia after foot surgery].
Three patients underwent foot surgery to correct hallux valgus and other toe deformities. Postoperative analgesia was provided by a sciatic nerve block in the popliteal fossa through a 21-gauge 64 mm needle and a 50 cm catheter connected to a nerve stimulator. ⋯ Hallux valgus surgery causes intense postoperative pain that can be prevented by a peripheral nerve block. A continuous popliteal block through a catheter equipped with a nerve stimulator is an easy technique that provides very good pain management after this type of surgery, with few undesirable side effects.