Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · Mar 1992
[Utility of the brachial plexus block combined with continuous intradural anesthesia for axillo-femoral bypass surgery].
Extra-anatomic axillofemoral bypass is a surgical procedure that is indicated in cases of occlusive aortoiliac pathology in which the transabdominal way is not feasible or in patients of high risk. We present a preliminary study in which we have prospectively evaluated 14 patients who were received an axillofemoral bypass during 1990. After preoperative evaluation two groups were identified: Group ALR (5 patients) with combined anesthetic blockade of supraclavicular brachial plexus and continuous subarachnoid blockade. ⋯ One patient subjected to general anesthesia died. Combined blockade induces a satisfactory analgesia in all surgical interventions without exceeding in any case the maximal doses of anesthetic drugs. Additionally, this technique affords the advantages of regional anesthesia and can be used as an alternative anesthetic procedure in patients of high risk who undergo axillofemoral bypass.
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Rev Esp Anestesiol Reanim · Mar 1992
Letter Comparative Study[Identification of the epidural space: what to choose?].
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Rev Esp Anestesiol Reanim · Jan 1992
Comparative Study Clinical Trial Controlled Clinical Trial[Evaluation of 2 techniques for ventilation support during single-lung ventilation].
In a group of 22 patients undergoing thoracotomy we compared two techniques of ventilatory assistance to the nondependent lung during single lung ventilation. We simultaneously administered a 0.5% FiO2 to the dependent lung. We used a CPAP system with continuous O2 flow limited by an underwater valve at a pressure of +5 cmH2O. ⋯ In 11 out of the 22 patients we firstly applied the lobar CPAP and thereafter the CPAP to the whole lung in order to compare the efficacy of both techniques in the same patient. The PaO2 during single lung ventilation was 86.9 +/- 22.7 mmHg and it increased to 111.1 +/- 37.9 mmHg after lobar CPAP (p less than 0.01) ant to 163.3 +/- 64 mmHg after total lung CPAP ventilation (p less than 0.001). Our results confirm the usefulness of both techniques and they indicate that CPAP to the whole nondependent lung is the most effective.
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The lesions produced by the expansive wave are characteristic of severe injury produced by explosion. This type of injury is being classified as primary lesion. ⋯ In the discussion section we analyze the physical mechanisms leading to this primary lesion and we indicate the organs most commonly affected. We rise general considerations dealing with the management of these patients and we remark the advantages of a coordinated medical attendance policy.