Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · Dec 2006
Randomized Controlled Trial Comparative Study[Occupational exposure to nitrous oxide and sevoflurane during pediatric anesthesia: evaluation of an anesthetic gas extractor].
To determine the level of occupational exposure to anesthetic gases in the absence of an extractor during pediatric anesthesia and to assess the efficacy of a purpose-built extraction system. ⋯ Gas extraction decreased the level of exposure by up to 94%, achieving levels that were below the recommended limits and greatly reducing occupational risk.
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Rev Esp Anestesiol Reanim · Dec 2006
Randomized Controlled Trial Comparative Study[Comparison of 2 techniques for inhaled anesthetic induction with sevoflurane in coronary artery revascularization].
Our objective was to evaluate efficacy, side effects, and hemodynamic alterations during anesthetic induction with sevoflurane in patients undergoing coronary artery bypass surgery, comparing the techniques of administration with tidal volume breathing and with vital capacity breaths. ⋯ Mean arterial pressure decreased in both groups, with no significant differences. The results indicate that hemodynamic stability seems to be similar with both techniques for providing inhaled anesthetic induction with sevoflurane.
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Rev Esp Anestesiol Reanim · Dec 2006
Case Reports[Perioperative treatment of a pregnant woman with recent cerebral infarction secondary to noncompaction cardiomyopathy].
Recent-onset noncompaction of the myocardium is a rare but serious entity with uncertain prognosis. Cerebral infarction is among the forms of presentation, and pregnancy and hypercoagulability increase risk. We report the case of a pregnant woman brought to the emergency department with ischemic cerebral infarction. ⋯ Myocardial injury and progression to cerebrovascular accident must be prevented in such cases; the patient must be stabilized and antiplatelet and/or anticoagulant therapy initiated before surgery. Hemodynamic stability must be maintained throughout the perioperative period and neonatal depression avoided after delivery. Various approaches are available to be adapted to the patient's situation.
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Intranasal drug administration is an easy, well-tolerated, noninvasive transmucosal route that avoids first-pass metabolism in the liver. The nasal mucosa provides an extensive, highly vascularized surface of pseudostratified ciliated epithelium. It secretes mucus that is subjected to mucociliary movement that can affect the time of contact between the drug and the surface. ⋯ We review the literature on intranasal administration of fentanyl, meperidine, diamorphine, and butorphanol to treat acute pain. The adverse systemic effects are similar to those described for intravenous administration, the most common being drowsiness, nausea, and vomiting. Local effects reported are a burning sensation with meperidine and a bad taste.