Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · Jun 2010
Case Reports[Cerebral oximetry monitoring during bypass surgery: can the approach be changed?].
We describe the detection of postoperative neurologic complications by means of monitoring cerebral oximetry during cardiac surgery. A 54-year-old man underwent emergency surgery for aortic dissection, type A. Cerebral oximetry was monitored by near-infrared spectroscopy. ⋯ Improvement came only when the recently inserted arterial cannula was switched to the ascending aortic prosthetic graft. After surgery, the patient was diagnosed with anoxic brain injury. We believe that the detected fall in cerebral oxygen saturation during axillary artery cannulization probably coincided with the occurrence of anoxic brain injury.
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Rev Esp Anestesiol Reanim · Jun 2010
Randomized Controlled Trial[Tracheal intubation quality under remifentanil-propofol with sevoflurane compared with remifentanil-propofol with rocuronium: a randomized double-blind clinical trial].
To determine whether intubation conditions under remifentanil-propofol plus sevoflurane rather than a nondepolarizing neuromuscular blocker are similar to those obtained when a neuromuscular blocker is used. ⋯ Adequate doses of remifentanil, propofol, and sevoflurane provide intubation conditions that are similar to those achieved by using a nondepolarizing neuromuscular blocker, without exposing patients to additional risk. Avoiding use of a neuromuscular blocker would circumvent the development of complications associated with use of these agents or their antagonists and costs would be lower.
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Rev Esp Anestesiol Reanim · Jun 2010
Review[Near-infrared spectroscopy in the postanesthesia recovery care unit: noninvasive monitoring of peripheral perfusion].
Clinical signs of recovery, such as blood pressure or heart rate, do not accurately reflect the perfusion of organs and tissues in patients in critical condition. Of the various means for monitoring perfusion, regional monitors are the most sensitive. ⋯ In patients with sepsis or multiple injuries, tissue oxygen saturation can be useful as an early indicator of shock, as a marker of recovery or need for transfusion, or as a prognostic factor. In spite of widespread interest in NIRS, however, there are gaps to fill in our understanding of clinical signs and physiology in relation to this technique before peripheral tissue monitoring can become routine in postanesthesia recovery care units.