Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · Feb 2003
Randomized Controlled Trial Comparative Study Clinical Trial[Epidural anesthesia with ropivacaine vs. bupivacaine in continuous perfusion for the treatment of labor pains].
To compare the analgesic efficacy and extent of motor block when 0.125% ropivacaine or 0.125% bupivacaine were given in continuous perfusion through an epidural catheter during labor. ⋯ Both drugs were equally effective for controlling the pain accompanying labor, such that ropivacaine offered no advantage over bupivacaine in that regard. Ropivacaine's reduced motor block effect at the doses administered may offer an advantage in some situations, such as when a walking epidural is provided.
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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
[Early extubation with caudal morphine after pediatric heart surgery].
To analyze the viability of immediate extubation of children after corrective surgery for congenital heart defects with extracorporeal membrane oxygenation using an anesthetic technique involving caudal morphine, and to study the effect on length of stay in the pediatric intensive care unit (PICU) or elsewhere in the hospital. ⋯ Of patients undergoing simple corrective heart surgery with extracorporeal membrane oxygenation immediate extubation did not increase postoperative morbimortality and shortened the hospital stay. A single dose of caudal morphine provided optimum conditions for extubation and good control of postoperative pain. Strict measures must be taken, however, to avoid postpuncture bleeding.
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Rev Esp Anestesiol Reanim · Jan 2003
[Headache caused by cerebral angiopathy during labor with epidural analgesia].
A 29-year-old woman presented projectile vomiting followed by frontal headache, immediately upon receiving epidural analgesia for labor. The clinical picture persisted until expulsion. Although no leaking of spinal fluid into the needle or epidural catheter had been observed, post-dural puncture headache was diagnosed. ⋯ Those findings and imaging studies (computed tomography of the brain, transcranial Doppler and magnetic resonance angiography) established a final diagnosis of postpartum cerebral angiopathy. Although epidural analgesia is increasingly requested by women entering labor, it is not a risk-free procedure. We describe a relatively unknown clinical entity, postpartum cerebral angiopathy, that developed during epidural analgesia for labor and that was initially believed to be a complication of the analgesic technique.