Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · Apr 1995
Randomized Controlled Trial Comparative Study Clinical Trial[Comparative study of single-dose intradural anesthesia and continuous intradural anesthesia with or without fentanyl].
To compare the hemodynamic effects, level of anesthetic blockade and advantages of single-dose versus continuous intrathecal anesthesia with hyperbaric bupivacaine with and without fentanyl. ⋯ A single dose intrathecal anesthesia, produces less hemodynamic changes than a continuous intrathecal block. Nevertheless, continuous intrathecal block, allows the maintenance of the block as long as required. The association of fentanyl enhances the hemodynamic changes with no other beneficial effects.
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Rev Esp Anestesiol Reanim · Apr 1995
Review[Analgesia of postoperative pain in ambulatory surgery].
Although the role of outpatient surgery has become increasingly important in the campaign to reduce waiting lists and health care costs, careful control and treatment of postoperative pain too often receives slight attention. Pain control after surgery must produce high quality analgesia without lengthening the hospital stay or increasing the risk of complications. ⋯ Anesthesiologists must therefore take preventive measures as well as apply techniques during and after surgery that diminish the intensity of pain and the incidence of nausea or vomiting. Drugs that act in the short term and have few side effects, regional anesthesia (depending on type of operation), non-opioid analgesics and balanced analgesia seem to give good quality control of pain after outpatient surgery.
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Rev Esp Anestesiol Reanim · Apr 1995
Historical Article[Obstetric anesthesia-analgesia in Spain. A review of its historic evolution during the second half of the past century].
To examine the historical development of obstetric anesthesia in Spain during the second half of the nineteenth century. Research was based on in-depth analysis of accounts of anesthesia during the period covered, mainly from original sources, using established methods for studying the history of medicine. ⋯ We emphasize that controversy limited to a large extent the use of anesthesia in obstetrics. The controversy seems to have been fed by physicians' uneasiness with anesthesia as well as by certain prejudices of a religious or moral nature that are deeply rooted in Spanish society.
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The process of quality control and auditing of anesthesiology allows us to evaluate care given by a service and solve problems that are detected. Quality control is a basic element of care giving and is only secondarily an area of academic research; it is therefore a meaningless effort if the information does not serve to improve departmental procedures. Quality assurance procedures assume certain infrastructural requirements and an initial period of implementation and adjustment. The main objectives of quality control are the reduction of morbidity and mortality due to anesthesia, assurance of the availability and proper management of resources and, finally, the well-being and safety of the patient.
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Rev Esp Anestesiol Reanim · Mar 1995
Case Reports[Postoperative lesions of the peripheral nerves. 8 years' analysis].
Damage to a plexus or peripheral nerve is a rare and avoidable complication of surgical anesthesia. We reviewed 2,750 case histories of patients who underwent surgery between 1985 and 1992, finding 6 cases of nerve lesions presenting postoperatively. ⋯ Our data are important given the difficulty of studying the incidence of such cases due to patient dispersion and the loss of records of possible occurrences. The mechanisms by which lesions are produced are sometimes difficult to pinpoint but all are generally preventable.