Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · Feb 2013
Case Reports[Anaesthetic management of caesarean section in pregnancy with diabetes and hypertrophic myocardiopathy with restrictive diastolic dysfunction].
Haemodynamic changes that occur during pregnancy are maximal between 28 and 34 weeks. In the pregnant woman with several associated diseases, such as hypertensive myocardiopathy and pre-gestational diabetes, these changes can lead to a difficult control of pulmonary hypertension and acute pulmonary oedema. We report the case of a pregnant woman with long term type 1 diabetes mellitus who suffered pre-eclampsia in a previous pregnancy, and since then developed hypertensive cardiomyopathy. ⋯ A transthoracic echocardiogram showed a non-dilated hypertrophic left ventricle with good systolic function, restrictive diastolic dysfunction and moderate pulmonary arterial hypertension. When her general condition improved, we performed a caesarean section under regional anaesthesia to prevent the complications of pulmonary and systemic hypertension. We present the anaesthetic management and resolution of complications after oxytocin administration.
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Rev Esp Anestesiol Reanim · Feb 2013
[Orotracheal intubation difficulty with lighted stylet: correlation of body mass index and neck circumference].
To evaluate the difficulty of intubation with a lighted stylet by correlating the body mass index (BMI) with the neck or cervical circumference (CC), and to establish the values of BMI and CC that could help identify a possible difficult intubation with this device. ⋯ A lineal correlation exists between a BMI above 33 kg/m² and/or a CC greater than 40 cm and a difficult intubation using lighted stylet. Another method other than transillumination is recommended for orotracheal intubation in a patient with both characteristics.
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Rev Esp Anestesiol Reanim · Feb 2013
Historical Article[Contributions of the Spanish Navy to the introduction of anaesthesia in Spain. Medical science in the last third of the XIX century].
The last decades of the xix century were years of resurgence and progress in the field of Naval Health, which was in the vanguard of European health structures at that time. In this era, the navy physicians produced some documents known as "Memorias Clínicas" (Clinical Reports), previously established as obligatory in their rules and regulations. ⋯ The introduction of these discoveries was surrounded by immense controversy, with its defenders and critics. The exclusiveness of the documents presented here is an original testimony to the medical-surgical knowledge of the era and places Naval Health in the vanguard of European health structures at that time.