Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · May 2007
Review Case Reports[Neuraxial analgesia during labor in a patient with Arnold-Chiari type I malformation and syringomyelia].
Chiari type I malformation is a caudal displacement of the cerebellum with tonsillar herniation through the foramen magnum, frequently associated with syringomyelia, a syndrome characterized by cyst-like cavities in the spinal cord; each of the conditions leads to characteristic neurologic abnormalities. Pregnant patients with these types of malformation are considered to have an increased risk of brainstem compression and/or progression of the disease during labor. ⋯ The patient revealed during labor that she had syringomyelia associated with Chiari type I malformation, after having made no mention of it in previous history taking. Finally, we review the pathology observed in these patients.
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Rev Esp Anestesiol Reanim · May 2007
Review[Analgesia and sedation of mechanically ventilated critical patients].
Provision of adequate analgesia and sedation is an essential element in the overall management of critically ill patients who require mechanical ventilation. Familiarity with the regimens used for the different sedatives and analgesic drugs and awareness of their pharmacodynamics and pharmacokinetics in the context of each patient are essential for provision of the most appropriate treatment. In this article, we review assessment methods, the most recent therapeutic recommendations, and a range of analgesic and sedative drugs.