Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · Jun 2002
Randomized Controlled Trial Comparative Study Clinical Trial[Duration and quality of postoperative analgesia after brachial plexus block for shoulder surgery: ropivacaine 0.5% versus ropivacaine 0.5% plus clonidine].
Some authors have found that nerve blocks with local anesthetics may last longer if clonidine is added. The present study analyzed the duration and quality of analgesia provided by an interscalene brachial plexus block for shoulder surgery using 0.5% ropivacaine or 0.5% ropivacaine with added clonidine. ⋯ Adding 40 micrograms of clonidine to 200 mg of 0.5% ropivacaine does not prolong the sensory-motor block or improve the quality of analgesia in the early postoperative period.
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A 55-year-old man with liver cancer underwent partial hepatectomy under combined lumbar epidural and general anesthesia. Asystole during postoperative recovery was followed by ventricular fibrillation. After unsuccessful cardiopulmonary resuscitation efforts, brain death was diagnosed. In the absence of anemia, acidosis, electrolytic alterations or hypothermia, and after ruling out hemoperitoneum, acute myocardial infarction and stroke, we conclude that the clinical picture described was the result of autonomic imbalance due to spreading of the sympathetic block.
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An epidural abscess is a rare lesion whose consequences can cause high morbi-mortality, particularly in obstetrics, where it occurs in young, healthy patients. With increased use of regional anesthesia, the incidence of epidural abscess will increase. We therefore review the risk factors, most common etiology and clinical signs, which may be non-specific but are nevertheless suggestive. ⋯ It may be difficult to distinguish epidural abscess from other causes of medullar compression, but prompt diagnosis is essential so that emergency surgical repair can proceed and neurological recovery will be as early and complete as possible. Appropriate antibiotic therapy should be aggressive. Basic aseptic measures are critical for preventing infection through epidural needles, as the presence of infection at the moment of puncture facilitates greater susceptibility to epidural abscess.
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Rev Esp Anestesiol Reanim · May 2002
Randomized Controlled Trial Comparative Study Clinical Trial[Effect of low-dose intravenous ketamine in postoperative analgesia for hysterectomy and adnexectomy].
To evaluate the efficacy of low dose ketamine (0.15 mg/Kg i.v.) as a pre-emptive pain relief after general anesthesia. ⋯ A low dose of ketamine has no preemptive analgesic effect.