Revista española de anestesiología y reanimación
-
Rev Esp Anestesiol Reanim · Dec 2000
Review[Morphology of peripheral nerves, their sheaths, and their vascularization].
This review aims to update our understanding of peripheral nerves, including the nature and function of their sheaths and, finally, their vascularization. The peripheral nervous system is made up of nerves whose function is to gather stimuli from the periphery as well as to transport the motor, secretory or vegetative responses that are triggered to the periphery. The connective tissue surrounding peripheral nerves all along their extension is made up of endoneurial, perineurial and epineurial. ⋯ Regarding the blood-nerve barrier and the existence of capillary permeability: endoneural capillaries have junctions that are stronger than those of the endothelial cells of vessels in the epineurium and perineurium. Two distinct lymph channels networks are present in the peripheral nerve stems and are separated by the perineural barrier. The nervi-nervorum are special nerves of a sympathetic and sensory nature that arise from the nerve itself and the perivascular plexuses.
-
Rev Esp Anestesiol Reanim · Dec 2000
Randomized Controlled Trial Comparative Study Clinical Trial[Analysis of implicit memory during propofol anesthesia].
Consensus has not been achieved on the presence of unconscious memory of messages in general anesthesia for methodological reasons. Our objective was to apply a model of anesthesia that allows for clinical control of the level of hypnosis in order to evaluate the presence and characteristics of implicit memory in deep sedation with propofol. ⋯ Implicit memory is preserved under hypnosis with propofol and is more likely to be present among those who are younger or experience greater anxiety. Concrete words with object references are more easily remembered than abstract words referring to perception. The semantic load of messages is relevant.
-
Rev Esp Anestesiol Reanim · Dec 2000
Case Reports[Embolism at the iliac bifurcation secondary to an atrial myxoma].
A 73-year-old woman presented a clinical picture of bilateral acute ischemia of the lower limbs. After embolectomy, transthoracic echocardiography revealed left atrial tumor. The picture was complicated by the onset of compartment syndrome in the lower extremities requiring decompressive fasciotomy. ⋯ Transthoracic echocardiography is the main diagnostic technique available, proving more useful than transesophageal echocardiography for small tumors. Such techniques can also be used during surgery, particularly in cases where preoperative assessment has left doubts about tumor location. We also argue in favor of early use of transesophageal echocardiography when peripheral arterial embolism is the diagnosis, in order to locate a cardiac focus as the cause of the clinical picture.