Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · Jan 2007
Randomized Controlled Trial Comparative Study[Hyperbaric bupivacaine: a randomized double-blind trial of different doses with or without fentanyl for cesarean section under spinal anesthesia].
To compare the effects of spinal anesthesia with different doses of hyperbaric bupivacaine with or without fentanyl in patients undergoing cesarean section. ⋯ Acceptable operative conditions with a low incidence of hypotension are provided with an 11 mg dose of hyperbaric bupivacaine.
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Rev Esp Anestesiol Reanim · Jan 2007
Review Case Reports[Infectious spondylodiskitis and epidural abscess after spinal puncture for pilonidal sinus excision].
Vertebral infections after spinal puncture are rare and often inadequately documented. Their incidence does not exceed that of spontaneous epidural abscesses and we should therefore be cautious about assuming a causal relation between puncture and an abscess. ⋯ This complication should be considered whenever a patient develops back pain and fever, even if there are no neurological deficits and even after a simple spinal puncture. Given that early diagnosis and treatment have proven effective in improving the survival rate and reducing the rate of neurological sequelae, magnetic resonance images should be ordered urgently so that early treatment can be established.
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Rev Esp Anestesiol Reanim · Jan 2007
Review[Multimodal approaches to postoperative pain management and convalescence].
Coping with pain is a complex, multifactorial phenomenon that requires an interdisciplinary approach. Multimodal analgesia involves the association of several analgesics administered by different routes to achieve more effective relief than analgesics administered individually. This approach reduces side effects and increases patient satisfaction. ⋯ The choice of local anesthetic, the route of administration, and the duration of treatment will depend on the type of patient and operation. The combination of an anti-inflammatory drug with an analgesic that works on the central nervous system is recommended, whether the route is oral or parenteral, provided there are no contraindications. Integrating these techniques into a rehabilitation program will facilitate postoperative convalescence.
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Rev Esp Anestesiol Reanim · Jan 2007
Case Reports[Analgesia for childbirth in a patient with factor V Leiden mutation].
Factor V Leiden mutation is the most common congenital thrombophilic disorder, affecting between 5% and 8% of the Caucasian population. Pregnancy creates a state of hypercoagulability and all factors that increase the risk of thrombosis should be considered, as they may be cumulative. In recent years, the diagnosis of new allelic variants of thrombophilic states have increased the incidence of pregnant women receiving anticoagulant therapy, with the anesthetic considerations that implies. ⋯ She was taking low molecular weight heparin therapy. An epidural catheter was inserted to provide analgesia for labor, with all safety precautions to prevent an epidural hematoma. Epidural anesthesia is the technique of choice for obstetric labor in patients with hypercoagulability because of its effects of favoring blood flow and inhibiting clot formation.
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Rev Esp Anestesiol Reanim · Jan 2007
[Outpatient external dacryocystorhinostomy under regional anesthesia and sedation].
To assess the rate of early complications of outpatient external dacryocystorhinostomy (DCR) and patient satisfaction with the anesthetic technique. ⋯ External DCR can be performed on an outpatient basis within a reasonable safety margin and with a low early postoperative complication rate. Patient satisfaction with anesthesia was high. Provision of preoperative information about the meaning of sedation, postoperative analgesia, and surgical bleeding are aspects to improve in this practice setting.