Revista española de anestesiología y reanimación
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Anaphylactic reaction during anesthesia is a constant source of concern for anesthesiologists, given that the rates of death and serious complications are high and predicting which patients will be susceptible is impossible. All substances used in the perioperative period carry a certain risk of releasing histamine and triggering an allergic reaction, though muscle relaxants are the drugs usually implicated. ⋯ The diagnostic procedure to follow upon observing an allergic reaction is to first identify the responsible mechanism and later the responsible agent, as well as drugs that can be used safely. Prophylaxis is based mainly on recognizing predisposed patients before surgery and following recommendations and pharmacological protocols based on better understanding of the pathophysiological mechanisms that cause anaphylactic reaction and on experience in managing them.
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We review the results of 312 cases of sciatic nerve blockade in the poplitea fossa for surgery of the dorsal foot. An atraumatic, insulated needle connected to a neurostimulator was used to make a single puncture using a posterior approach. The anesthetic was 1% mepivacaine (4-5 mg/kg-1). ⋯ Time of analgesia was 6 h 15 min (range 3-16 h). No complications or sequelae were recorded. We conclude that the technique is highly effective and comfortable for patients, as it requires only one puncture and gives good postoperative analgesia with no major side effects.