Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · Dec 2011
Randomized Controlled Trial Comparative Study[Rocuronium vs vecuronium for neuromuscular block during transsternal thymectomy in the patient with myasthenia gravis].
Myasthenia gravis is an autoimmune disease marked by high titers of immunoglobulin G antibodies, which accelerate destruction of cholinergic receptors and interfere with neuromuscular transmission. This study aimed to determine whether neuromuscular function under a rocuronium block is different from function under a vecuronium block patients with myasthenia gravis and to describe extubation conditions in the operating room or the intensive care unit. ⋯ The rocuronium block had a better profile than the vecuronium block in this study. With this blocking agent we were able to circumvent respiratory depression, with its immediate consequences, and thus meet the main clinical criterion when anesthetizing patients with myasthenia gravis.
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Rev Esp Anestesiol Reanim · Dec 2011
Multicenter Study[Neuromuscular block management during general anesthesia in a cohort of 1545 patients: a multicenter study].
Neuromuscular blockers (NMBs) have traditionally been thought to increase the risk of respiratory complications, although drawing conclusions in this respect would require complex studies in large patient samples. The aim of this study was to analyze data from the ARISCAT study to obtain an overall picture of how NMBs are being used and blocks are reversed in Catalonia, Spain. ⋯ Nondepolarizing NMBs are used in combination with general anesthesia often in Catalonia; their use is associated with duration and type of surgery. A reversal drug is administered relatively more often in Catalonia than in other geographic areas.
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Rev Esp Anestesiol Reanim · Dec 2011
Multicenter Study[Peripheral nerve stimulation in the treatment of various types of headache].
Headache has a great impact on patients' quality of life and in industrialized countries there is economic impact as well. One of the pathophysiologic theories to explain headache is activation of afferent C2-C3 nerve fibers. Afferent peripheral nerve stimulation by occipital nerve provocation at C2-C3 seems to alleviate headache by acting on the trigeminocervical complex, which would largely explain the effectiveness of this modality. The aim of this study was to describe peripheral nerve stimulation as an alternative therapy in patients who do not respond to other headache treatments. ⋯ Of 31 patients, 87% had positive results, with a significant decrease in pain from baseline (P < .001); 85.2% reported sustained improvement of > 50%, and 96.3% reported a decrease of > 2 points on the pain scale. All patients expressed satisfaction during the period of follow-up. Fifty-six percent had no headaches after a year and 47% had stopped taking medication. The most frequent complication was electrode migration.