Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · Mar 2003
[Platelet count and hematic punction with epidural block in obstetrics].
The reference value for and the significance of mild thrombocytopenia associated with pregnancy remain undetermined, and therefore the timing, validity and meaning of coagulation tests before a regional block may vary. ⋯ A complete clinical history must be obtained during the anesthetist's interview with the patient in the last month of pregnancy, and detailed information on the risk of regional blocks during labor must be offered. When blood tests at the time of the interview are normal and the clinical history indicates low risk, repeating tests immediately before the block is unjustified, provided the clinical situation does not change.
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Rapid-sequence induction (RSI) techniques are designed to reduce the risk of aspiration in cases where risk is high. ISR is often for surgery, particularly under emergency conditions, but is also found in procedures requiring emergency tracheal intubation inside and outside the hospital. ISR techniques have proven safe for reducing the risk of aspiration and providing good conditions for intubation in such situations. ⋯ Precisely because of this last factor and the good results obtained with short-acting opiates, great interest has developed in recent years in RSI that does not use neuromuscular blocking agents. However, conclusive data are unavailable. Studies are often difficult to compare because of small differences in the combination of drugs, the dosing of one or more of them, the route of administration, or because the criteria used to define ideal intubation conditions are different.
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Rev Esp Anestesiol Reanim · Feb 2003
[Evaluation of a formula for optimal positioning of a central venous catheter through the right internal jugular vein].
To evaluate the efficiency of a formula for predicting the optimal length of catheter inserted through the right internal jugular vein. ⋯ The aforementioned formula predicted appropriate placement of the catheter tip in 94.54% of the patients.
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Rev Esp Anestesiol Reanim · Feb 2003
Case Reports[Anesthesia and fibrobronchoscopy for the study of chronic stridor in a boy with Robinow syndrome].
Robinow's syndrome involves fetal facial features, short stature, brachymelia, hypoplastic genitals and a normal karyotype. A 10-year-old boy with Robinow's syndrome was scheduled for study of chronic stridor by fiberoptic bronchoscopy. Airway exploration with the patient awake revealed hipertelorism, retromicrognathia, poor dental alignment, macroglossia and class IV Mallampati. ⋯ However, when continuous positive airway pressure (CPAP) was set al 10 cm H2O, pulse oxymetry did increase; likewise, expired and inspired sevoflurane concentrations became equal, and expired CO2 increased. Fiberoptic bronchoscopy revealed an area of intrathoracic tracheomalacia, which collapsed partially during spontaneous expiration and collapsed less when CPAP was started. We discuss the relation between the facial dysmorphia characteristic of this syndrome and the possibility of finding a difficult airway, as well as the diagnosis and treatment of intrathoracic tracheomalacia during anesthesia.