Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · Jun 1997
Case Reports[General convulsive crisis related to pneumocephalus after inadvertant dural puncture in an obstetric patient].
We report a case of iatrogenic pneumocephalus in an obstetric patient after accidental dural puncture during repeated attempts to locate the epidural space by the technique of loss-of-resistance to air. Analgesia was provided throughout labor. Two days after puncture, typical spinal headache developed and was treated with bed rest, oral analgesics and hydration. ⋯ A computerized tomography (CT) scan revealed pneumocephalus, to which the convulsions were attributed. No further convulsions occurred in spite of the fact that anticonvulsives were not prescribed. A CT scan one month later was normal.
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Rev Esp Anestesiol Reanim · Jun 1997
Case Reports[Subcutaneous, pneumomediastinal, pneumopericardial emphysema and pneumothorax following retrosigmoid resection].
Pulmonary alveolar rupture can occur spontaneously or as a result of mechanical ventilation or other causes, and may give rise to bullae or emphysema without producing extrapulmonary air. Most but not all cases occur in patients with underlying lung disease. ⋯ Soon after the patient awoke from anesthesia, subcutaneous, pneumomediastinal and pneumopericardiac emphysema developed, along with bilateral pneumothorax. We discuss the possible causes of extra-alveolar air was well as ways to detect and treat it.
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Although postoperative behavioral anomalies were first reported more than one hundred years ago, only in the past ten years has the profile for postoperative cognitive dysfunction (POCD) been defined. POCD is reversible and it has been suggested that the disorder has implications for increased mortality and morbidity if it is not diagnosed and treated early. At present the clinical presentation of POCD is thought to be variable and fluctuating, ranging from slight disorientation to coma. ⋯ Once symptoms have developed,whether in the recovery unit or later, it is important to eliminate organic factors and begin treating the cause. The most important drugs for treatment are neuroleptics and benzodiazepines. We review the definition, epidemiology, etiology, pathophysiology and treatment of POCD and include a list of diseases and drugs associated with its development, as well as a description of psychological tests used for diagnosis.
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Rev Esp Anestesiol Reanim · May 1997
Case Reports[Late ischemia and carpal tunnel syndrome secondary to catheterization of the radial artery].
Invasive measurement of blood pressure has many advantages. Although arterial canalization is a low-risk technique of great benefit to the patient, complications must be looked for. ⋯ Two weeks after the procedure the patient showed signs of hand ischemia and acute carpal tunnel syndrome, which evolved favorably after treatment with heparin sodium and prostaglandin E1. We emphasize the importance of an earlier wrist fracture as the predisposing factor for both conditions and the need to examine collateral circulation in the hand and look for carpal tunnel syndrome before canalization.