Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · Jun 1998
[Environmental and biological control in a population exposed to isoflurane in the operating room].
To measure the level of occupational exposure to isoflurane in the operating room, and to determine the relation between isoflurane concentration in atmospheric and exhaled air. ⋯ The concentrations of isoflurane in atmospheric and exhaled air found in our study exceed the maximum levels for halogenated gases recommended by the National Institute for Occupational Safety and Health, although they do not exceed the levels stipulated by Swiss authorities. In order to adequately assess operating room antipollution measures, atmospheric and biologic monitoring of isoflurane and other inhaled anesthetic gas concentrations is necessary.
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Rev Esp Anestesiol Reanim · Jun 1998
Randomized Controlled Trial Multicenter Study Clinical Trial[Explicit and implicit memory during inhalation and intravenous anesthesia].
Patients rarely report memory or knowledge of surgery after general anesthesia. During apparently adequate surgical anesthesia, however, information processing of high level functions, such as language comprehension and learning, can continue unconsciously. Our objective is to assess whether different anesthetic techniques (two inhalational and two intravenous) guarantee the absence of both types of memory. ⋯ Explicit memory was absent with all four anesthetic techniques used in our study. Implicit memory was more difficult to inhibit, however, with isoflurane/N2O.
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Cisatracurium is one of ten isomers that form the racemic mix of atracurium (51W89 or 1 R-cis, 1'R-cis atracurium). It is three times more potent than atracurium itself and hemodynamically stable thanks to its scarce release of histamine. Cisatracurium is hydrolyzed mainly by the pathway of Hofmann (77%) and to a lesser degree it is metabolized by organ-dependent modes (mainly by the kidney (16%)). ⋯ Cisatracurium has proven useful in intensive care because of its hemodynamic stability, which is comparable to that of steroid derivatives but with faster recovery from blockade once administration is discontinued. Its metabolism predominantly through Hofmann's pathway, with less laudanosine formation than is produced by atracurium, is also appreciated. Cisatracurium is described as the nondepolarizing muscle relaxant of choice for medium-to-long-term surgery on hemodynamically unstable patients or those with kidney or liver disease, and for neuromuscular blockade in intensive care.
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Rev Esp Anestesiol Reanim · Jun 1998
Randomized Controlled Trial Clinical Trial[Arm adduction does not increase block extension in anesthesia of the brachial plexus by the axillary approach].
Arm abduction of 90 degrees during injection of local anesthetic followed by adduction of the arm has been recommended traditionally to favor proximal distribution of local anesthetic and extension of the blockade in the brachial plexus by the axillary route. A recent study demonstrated that there are no clinical or radiological differences between axillary blockades performed with abduction or adduction. ⋯ Axillary rotation of the arm is not a determining factor in sensory blockade in brachial plexus anesthesia by the axillary route.
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Rev Esp Anestesiol Reanim · May 1998
[Analysis of the current status of neuroanesthesia in Spain using a national survey].
Advances in complementary diagnostic explorations, surgical support technology and the complexity of neurophysiological monitoring require anesthesiologists to acquire specific knowledge for dealing with neurosurgery. We aimed to study the implantation of new anesthetic-surgical techniques in the field of neurosurgery, and the state of neuroanesthesia as a subspecialty in Spain. ⋯ Although most centers continue performing "classical" neurosurgery with standard monitoring, a substantial proportion of hospitals (38%) show evidence of advancing in anesthetic techniques for neurosurgery in Spain. Anesthesia for neurosurgery as a subspecialty is available in 62% of the responding hospitals.