Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · Feb 2000
Randomized Controlled Trial Clinical Trial[Use of the anesthetic cream EMLA in arterial punction].
Arterial puncture is a painful procedure requiring prior local anesthesia. Various products are available for pain relief, among them EMLA anesthetic cream. ⋯ Mepivacaine infiltration is the more effective method for minimizing pain from puncture of the radial artery. EMLA anesthetic cream is not effective against pain caused by this procedure.
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Rev Esp Anestesiol Reanim · Feb 2000
Randomized Controlled Trial Comparative Study Clinical Trial[The administration of 20 ppm of inhaled nitric oxide produces a faster response than the inhalation of 5 ppm in adult respiratory distress syndrome].
To compare the effects of 5 and 20 ppm of nitric oxide, evaluating time until response for each dose, in patients with adult respiratory distress syndrome (ARDS). ⋯ Inhaled nitric oxide significantly improves oxygenation and decreases pulmonary vascular resistance without altering systemic vascular resistance during treatment of ARDS. The final outcomes were similar for both doses, but the 20 ppm dose produced a significantly faster response as well as a significant decrease in Qs/Qt.
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Rev Esp Anestesiol Reanim · Feb 2000
Review[Postoperative nausea and vomiting. Controversies, evidence and new drugs].
In spite of the availability of drugs to control postoperative nausea and vomiting, emesis remains an unresolved problem for the anesthesiologist. The etiology of postoperative nausea and vomiting is multifactorial: some causes are well-defined whereas others continue to be the object of debate. Statistical methods applying logistical regression have proven valuable for assessing the risk of emesis in individual patients. ⋯ The therapeutic options available for postoperative nausea and vomiting are moderately effective and are distinguishable by their side effects and prices. Clinical trials with a new group of drugs (neurokinin receptor antagonists) are currently underway. With their wider spectrum of action and absence of side effects, these drugs may represent a qualitative advance in the treatment of postoperative nausea and vomiting.
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Rev Esp Anestesiol Reanim · Feb 2000
Review[Immune response in the surgical patient: effect of anesthesia and blood transfusion].
Anesthesiology has progressed spectacularly over the last two decades, largely parallel to developments in basic and clinically applied sciences such as immunology. The anesthesiologist's involvement now extends to all matters involved in perioperative care. Surgery, anesthetic procedures themselves, and other associated techniques such as blood transfusion all alter the patient's immune response and all fall within the range of procedures monitored by the anesthesiologist. ⋯ Replacement of lost red blood cells is another factor leading to immunological changes. New anesthetic techniques, the optimization of methods already in use, and the development of modern, less immunodepressant drugs and of alternatives to homologous blood transfusion are all solutions that have been proposed. This is an exciting field of study in which today, perhaps more than ever, the anesthesiologist has a critical role to play.