Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · Jun 2009
Case Reports[Spinal granuloma in a patient receiving a spinal infusion of morphine and clonidine].
Patients treated with long-term spinal infusion of high doses of morphine develop a granuloma at the location of the catheter tip. Diagnosis is based on a steady increase in intrathecal morphine dosage after a relatively prolonged period of stability, on the gradual development of neurologic signs and symptoms suggesting radicular or spinal cord compression, and on magnetic resonance images. We describe a man with central neuropathic pain after removal of a tumor. The presence of all 3 of the aforementioned diagnostic criteria led to suspicion of a spinal granuloma.
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Rev Esp Anestesiol Reanim · Jun 2009
Randomized Controlled Trial Multicenter Study Comparative Study[Efficacy of sugammadex in the reversal of neuromuscular blockade induced by rocuronium in long-duration surgery: under inhaled vs. intravenous anesthesia].
Sugammadex reverses neuromuscular blockade induced by aminosteroid agents by encapsulating these agents. The objective of this study was to compare the efficacy and safety of sugammadex to reverse a rocuronium-induced neuromuscular blockade in long-duration surgery in association with inhaled or intravenous anesthesia. ⋯ Sugammadex effectively and safely reverses a rocuronium-induced neuromuscular blockade in less than 2 minutes in long-duration surgery performed under both inhaled and intravenous anesthesia. The interaction of neuromuscular blocking agents with sevoflurane appears not to affect the reversal time of sugammadex in such operations.
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Rev Esp Anestesiol Reanim · Jun 2009
Case Reports[Combined posterior lumbar plexus and sacral block for emergency surgery to treat hip fracture].
Ultrasound-guided peripheral nerve blocks are being used more widely in modern anesthesiology, yet spinal anesthesia remains the most commonly used technique for lower limb surgery in general and for hip fracture in particular. A combined lumbar plexus and sacral block may provide an alternative to other local and regional anesthetic techniques in special situations such as the treatment of patients with serious concomitant disease who are on treatment that affects platelet aggregation. ⋯ Patient histories included serious heart and lung conditions, double antiplatelet therapy, risk factors for difficult airway, and intracranial hypertension. The aforementioned nerve block provided appropriate conditions for surgery, hemodynamic stability, and postoperative analgesia without complications.
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Interventional neuroradiology procedures have become increasingly complex, requiring planning and coordination. Key roles are played by the anesthesiologist and the radiologist, as well as by technicians and nurses. ⋯ Rapid awakening must also be assured so that the patient's neurologic status can be assessed in situ. The anesthesiologist should treat any neurologic complications that develop and that might lead to emergency situations during the procedures.
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Rev Esp Anestesiol Reanim · Jun 2009
Controlled Clinical Trial[Fascia iliaca compartment block for analgesia following total hip replacement surgery].
The objective of this pilot study was to evaluate the effectiveness of the fascia iliaca compartment block to control pain following total hip replacement by assessing pain intensity 24 hours after surgery and recording the use of opiates for rescue analgesia. ⋯ A single-injection fascia iliaca compartment block was effective in controlling initial postoperative pain in a postanesthetic recovery unit. It was effective on the ward in the first few hours after surgery but not for the entire 24-hour period because of the limited duration of the block.