Revista española de anestesiología y reanimación
-
Rev Esp Anestesiol Reanim · Feb 1998
Case Reports[Early pressure in pneumocephalus: an perioperative complication in neuroanesthesia].
We report two cases of early-onset pressure pneumocephalus, one occurring during supratentorial brain surgery (craniopharyngioma) which was diagnosed at the end of the anesthetic period upon appearance of comatose status leading to the suspicion of surgical complication in the form of a hematoma. The second case of pneumocephalus was detected after posterior fossa surgery performed with the patient in the sitting position. We review the significance of our anesthetic management on the prevention of tension pneumocephalus, and discuss diagnostic and therapeutic measures available for use in the Postoperative Intensive Care Recovery Unit.
-
Rev Esp Anestesiol Reanim · Feb 1998
Randomized Controlled Trial Comparative Study Clinical Trial[Comparison of lidocaine and urapidil for prevention of hemodynamic response to tracheal intubation in patients in general good health].
To compare the efficacy of endovenous administration of 0.5 mg/kg-1 of urapidil to 1 mg/kg-1 of lidocaine for attenuating hemodynamic response to laryngoscopy and tracheal intubation. ⋯ In healthy ASA I and II patients with normal blood pressure, a dose of 1 mg/kg-1 of lidocaine provided better protection against the hemodynamic response to laryngoscopy and tracheal intubation than does 0.5 mg/kg-1 of urapidil.
-
Rev Esp Anestesiol Reanim · Jan 1998
[Changes in therapeutic attitude based on transesophageal echocardiography in cardiac surgery].
Transesophageal echocardiography is a monitoring system that is changing the practice of cardiovascular anesthesia and surgery by providing real time images of cardiovascular anatomy and pathophysiology. Our hospital's anesthesiology and postoperative intensive care departments, in particular the cardiac anesthesia team, initiated a joint project in June 1993 with the echocardiography laboratory team to incorporate this surgical monitoring system. Here we report the wealth of information we obtained and describe the possibility of modifying a therapeutic approach based on the images visualized, even when conventional monitoring gives contradictory information. Two illustrative case reports are included.
-
Rev Esp Anestesiol Reanim · Dec 1997
Clinical Trial[Synchronized independent pulmonary ventilation in the treatment of adult respiratory distress syndrome].
Synchronized independent lung ventilation (SILV) is an effective mode of mechanical ventilation for treating both unilateral and bilateral pulmonary lesions. Oxygenation improves with an increase in the ventilation/perfusion ratio and also diminishes the risk of barotrauma. We describe our broad experience with this technique. Our main objective was to confirm whether SILV is able to improve the alveolar-arterial oxygen difference [P(A-a)O2] of patients with severe adult respiratory distress syndrome (ARDS) in whom conventional mechanical ventilation has not brought about improvement after being used for over 48 hours. ⋯ SILV is useful for providing ventilatory support when ARDS fails to improve with conventional mechanical ventilation. Clear improvement in respiratory function was observed, with significant decrease in PA-aO2 and no change in distensibility. SILV is a safe technique with few complications and can be managed by the intensive care unit nursing staff.