Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · Feb 2014
Comparative StudyCerebral oxygenation in patients undergoing shoulder surgery in beach chair position: comparing general to regional anesthesia and the impact on neurobehavioral outcome.
Ischemic brain damage has been reported in healthy patients after beach chair position for surgery due to cerebral hypoperfusion. Near-infrared spectroscopy has been described as a non-invasive, continuous method to monitor cerebral oxygen saturation. However, its impact on neurobehavioral outcome comparing different anesthesia regimens has been poorly described. ⋯ The incidence of regional cerebral oxygen desaturations seems to influence the neurobehavioral outcome. Regional anesthesia offers more stable cardiovascular conditions for shoulder surgery in beach chair position influencing neurobehavioral test results at 24h.
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Rev Esp Anestesiol Reanim · Feb 2014
Randomized Controlled Trial Comparative StudyIncidence of intraneural needle insertion in ultrasound-guided femoral nerve block: a comparison between the out-of-plane versus the in-plane approaches.
The optimal method of ultrasound-guided femoral nerve block (in-plane vs. out-of-plane) has not been established. We tested the hypothesis that the incidence of needle-nerve contact may be higher with out-of-plane than with in-plane needle insertion. ⋯ Under the conditions of our study, needle-nerve contact during femoral nerve block occurs frequently with the out-of-plane approach. An in-plane approach results in an equally effective femoral block and less incidence of needle-nerve contact.
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Rev Esp Anestesiol Reanim · Feb 2014
Review[Intravenous regional anesthesia with long-acting local anesthetics. An update].
Intravenous regional anesthesia is a widely used technique for brief surgical interventions, primarily on the upper limbs and less frequently, on the lower limbs. It began being used at the beginning of the 20th century, when Bier injected procaine as a local anesthetic. ⋯ Additionally, drugs like opioids, muscle relaxants, paracetamol, neostigmine, magnesium, ketamine, clonidine, and ketorolac, have all been investigated as adjuncts to intravenous regional anesthesia, and were found to be fairly useful in terms of an increased onset of operative anesthesia and longer lasting perioperative analgesia. The present article provides an overview of current knowledge with emphasis on long-acting local anesthetic drugs.
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Rev Esp Anestesiol Reanim · Jan 2014
Observational Study[Quality of the anesthesiologist written record during the transfer of postoperative patients: Influence of implementing a structured communication tool].
The lack of communication is a major cause of health care errors, especially during patient transfer between practitioners and/or healthcare units, when standardization of communication is a recommended practice. In our study we wanted to assess whether the application of the structured communication SBAR tool could influence the quality of the information written on the progress sheet by the anesthesiologist involved in the transfer of the patient after surgery. ⋯ There was an improvement in the quality of written records made in 2012 during the implementation of the SBAR, without the actual application of this instrument appearing to influence it. The anesthesiologists that were involved in new forms of patient safety were also those who made written records of highest quality.
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Rev Esp Anestesiol Reanim · Jan 2014
Comparative Study[Ultrasound-guided axillary block: anatomical variations of terminal branches of the brachial plexus in relation to the brachial artery].
To describe the distribution of the terminal branches of the brachial plexus at the axillary level and define distribution patterns after ultrasound evaluation. ⋯ Our results allow defining four different anatomical patterns, two based in the position of the musculocutaneous nerve and two based on the disposition of the ulnar nerve with respect to the humeral vein. These patterns were not related to laterality, gender or body weight.