Revista española de anestesiología y reanimación
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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.