Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · Mar 2015
Case ReportsPostoperative analgesia with transversus abdominis plane catheter infusions of levobupivacaine after major gynecological and obstetrical surgery. A case series.
Transversus abdominis plane block has become an important method of postoperative pain management for patients undergoing abdominal surgery but the modest duration is a major limitation. We report the successful use of a novel TAP catheter technique for continuous infusion of levobupivacaine in six gynecologic and obstetric patients. Bilateral TAP catheters were inserted at the end of surgery by ultrasound imaging using a Contiplex® C needle (B. ⋯ Successful analgesia was achieved in all six cases utilizing continuous infusion of levobupivacaine, minimizing the volume required. TAP infusions produce significant opioid sparing and better patient mobility. This technique may be a reliable alternative to neuraxial analgesia in major gynecological and obstetrical surgery.
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Rev Esp Anestesiol Reanim · Feb 2015
Randomized Controlled Trial Comparative Study[Epidural anaesthesia: Simulated intravascular test dose with S(+) ketamine, lidocaine and adrenaline. A prospective, randomized, double blind and placebo controlled study].
The use of a test dose in epidural anaesthesia is a safety recommendation. However specificity and sensitivity of the drugs used with this indication have been not conclusive. The main objective of this study was to compare the effectiveness and the adverse effects of a simulated intravascular test dose of adrenaline, lidocaine and S(+)-ketamine. ⋯ Both lidocaine an adrenaline at the scheduled doses showed low sensitivity and specificity as a simulated iv epidural test dose. S(+)-ketamine could be a feasible marker after accidental iv injection during epidural anaesthesia or analgesia.
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Rev Esp Anestesiol Reanim · Feb 2015
Randomized Controlled Trial Comparative Study[Effect of priming solution and ultrafiltration on post-operative bleeding and blood transfusion in cardiac surgery. Randomized controlled trial].
Assess the effectiveness of priming the extracorporeal circulation system with albumin-mannitol combined with ultrafiltration during extracorporeal circulation to reduce post-operative bleeding and transfusion requirements in heart surgery, as well as its impact on the fluid balance, coagulation and hematocrit parameters, re-operation for bleeding, ICU, and hospital length of stay. ⋯ The priming of extracorporeal reservoir with mannitol, albumin, and Ringer's lactate, combined with ultrafiltration, significantly improves intra- and post-operative fluid balance, resulting in a reduction in blood transfusions, with no significant decrease in post-operative bleeding, re-operation bleeding rate, and length of stay in the ICU.
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Rev Esp Anestesiol Reanim · Feb 2015
Review Case Reports[Peroneal nerve injury: anesthesia is not always to blame].
We introduce a case report of a woman that was operated of foot surgery under locoregional anesthesia with an echo-guided peripheral sciatic-popliteal nerve block. As post operatory complication a peroneal nerve injury was noticed. ⋯ In our case the finding was a high degree axonotmesis secondary to extrinsic compressure due to pneumatic tourniquet placed in the ankle used during surgery. There was no relationship with the anesthetic technique.