Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · Oct 2019
Comparative Study Observational StudyComparison between different epidural analgesia modalities for labor.
In recent years new modalities of epidural analgesia maintenance (EA) have been introduced. ⋯ It is possible to say that PIEB+PCEA is associated with higher frequency of non-instrumented deliveries. The possibility of instrumented deliveries increases with CI versus PIEB+PCEA. There is less motor block with PIEB+PCEA than with CI+PCEA. There are no differences in time of dilatation, expulsion, or patient satisfaction.
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Rev Esp Anestesiol Reanim · Oct 2019
Case ReportsThe erector spinae plane block (ESPB) in the management of chronic thoracic pain. Correlation of pain/analgesia areas and long term effect of the treatment in three cases.
The erector spinae plane block (ESPB) is a technique that is used both as perioperative analgesia and in the management of chronic pain. This has been described recently and is being a resource increasingly used for its easy implementation and low rate of complications. However, the correlation between pain and analgesia, as well as its long-term effect on chronic pain, should be studied. ⋯ The block was performed in all cases by depositing 20ml of 0.2% Ropivacaine in the fascial plane of the erector spinae muscle. The pain was measured using a numerical scale prior to the block, at 30minutes and a month. The areas were marked on the skin with different colours for comparison.
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Rev Esp Anestesiol Reanim · Oct 2019
Observational StudyAnatomical description of anaesthetic spread after deep erector spinae block at L-4.
Thoracic erector spinae plane (ESP) block is now used for postoperative analgesia. However, although reports of lumbar ESP have been published, the anesthetic spread and mechanism of action of this technique remains unclear. We describe the lumbar ESP block technique and evaluate the spread of 20ml of solution administered at the level of the transverse process of L4 in a cadaver model. ⋯ Lumbar ESP at L4 always acts on the posterior branches of the spinal nerves, but seldom spreads to the paravertebral space to block the spinal nerve.
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Haemorrhagic shock is one of the main causes of mortality in severe polytrauma patients. To increase the survival rates, a combined strategy of treatment known as Damage Control has been developed. The aims of this article are to analyse the actual concept of Damage Control Resuscitation and its three treatment levels, describe the best transfusion strategy, and approach the acute coagulopathy of the traumatic patient as an entity. The potential changes of this therapeutic strategy over the coming years are also described.