Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · Apr 2005
Review[Magnesium in anesthesia and postoperative recovery care].
Magnesium is involved in many physiological processes and in the pathophysiology of many diseases that affect surgical patients. The incidence of hypomagnesemia in the perioperative setting is high and is sometimes underestimated, with important prognostic implications. ⋯ It has become essential for the anesthesiologist to understand the pharmacological, clinical, and physiological properties of magnesium. The present review aims to give a simple but complete overview of the physiological importance of the magnesium ion, the perioperative changes that occur, and its therapeutic applications in numerous clinical contexts.
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Endotracheal intubation and mechanical ventilation have traditionally been employed in patients with acute respiratory insufficiency. However, this form of management can have serious adverse effects, mainly infections and barotrauma. ⋯ It is also commonly applied in patients with asthma, pneumonia, and acute cardiogenic pulmonary edema. Correct indication and training in use of NIV equipment is necessary to ensure success and facilitate patient tolerance.
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Rev Esp Anestesiol Reanim · Dec 2004
Review[Effectiveness of epidural administration of saline solutions to prevent or treat postdural puncture headache].
Epidural anesthesia is the most versatile and widely used of the techniques for regional anesthesia. The most common complication of epidural or spinal anesthesia is postdural puncture headache. The loss of cerebrospinal fluid through the hole can be an important causative factor of this cephalalgia. ⋯ The studies had small samples and most did not include a control group. The doses and methods of epidural administration of saline solutions were highly variable and the results were often contradictory. We conclude that using this technique to prevent and/or treat postdural puncture headache is difficult to justify.
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Rev Esp Anestesiol Reanim · Nov 2004
Review Multicenter Study Clinical Trial Controlled Clinical Trial[Incidence of pain upon injection of a new formula of propofol in a fat emulsion of medium- and long-chain triglycerides].
To study the incidence of pain upon injection of 1% propofol (Propofol-Lipuro 1%, B. Braun, Melsungen, Germany) in a 10% fat emulsion containing equal proportions (50:50) of medium- and long-chain triglycerides. ⋯ The incidence of pain upon injection of propofol-lipuro is low in comparison with incidence rates reported in the literature for the traditional formula, but administration of the fat emulsion formula through a vein on the dorsal side of the hand or through a venous catheter smaller than 18 G should be avoided. Double-blind randomized controlled trials should be conducted to clarify the advantages that propofol-lipuro seems to offer.
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Rev Esp Anestesiol Reanim · Oct 2004
Review[Anesthesia and postoperative care of 11 patients undergoing peritonectomy and hypothermic intraperitoneal chemotherapy].
Peritoneal carcinomatosis is the final stage of certain malignant tumors located both inside and outside the abdomen. Mortality is high with conventional treatments and the best mean survival rates reported have reached up to 6 months. One technique tried in recent years involves resection of macroscopic parietal and visceral peritoneal lesions (peritonectomy) combined with intra- and postoperative perfusion of the abdominal cavity with hyperthermic chemotherapy to treat residual microscopic lesions. ⋯ The main complications are related to the long duration of surgery, bleeding secondary to the many surgical resections, and hyperthermia caused by the chemical agents. The therapeutic process, therefore, is not risk-free and involves high rates of morbidity and mortality. We describe the anesthetic and postoperative management of the first 11 cases in which this procedure was carried out at our hospital, analyzing the main complications arising.