Revista española de anestesiología y reanimación
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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[Two cases of congenital airway obstruction managed with ex utero intrapartum treatment procedures: anesthetic implications].
An ex utero intrapartum treatment (EXIT) procedure provides sufficient time to gain control of the potentially obstructed fetal upper airway while uterine placental circulation is maintained during cesarean section. We report 2 cases in which fetal congenital upper airway obstruction was managed without complications during EXIT procedures. We also discuss general considerations concerning the obstetric patient and the performance of intramuscular fetal anesthesia. ⋯ In the other, a tracheostomy was created. After the umbilical cord was clamped, the concentration of sevoflurane anesthetic gas was reduced and oxytocin and methylergometrine were administered to induce adequate uterine contractions within a few minutes. Both neonates survived the EXIT procedure with no complications.
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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.