Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · Feb 2013
Review[Do anesthetic techniques influence postoperative outcomes? Part II].
The knowledge of the influence of anesthetic techniques in postoperative outcomes has opened a large field of research in recent years. In this second part, we review some of the major controversies arising from the literature on the impact of anesthetic techniques on postoperative outcomes in 6 areas: postoperative cognitive dysfunction, chronic postoperative pain, cancer recurrence, postoperative nausea/vomiting, surgical outcomes, and resources utilization. The development of protective and preventive anesthetic strategies against short and long-term postoperative complications will probably occupy an important role in our daily anesthetic practice. ⋯ The classic pattern of perioperative fluid therapy may increase postoperative complications. On the other hand, the maintenance of normoglycemia and normothermia was associated with a decreased postoperative morbidity. The high volume of surgical procedures means that the adequacy of human, organizational and technological resources have a major impact on overall costs.
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Rev Esp Anestesiol Reanim · Feb 2013
Multicenter Study[Blood transfusion during heart surgery. A retrospective nested case-control study].
To assess the correlation between intraoperative packed red blood cells transfusion and adverse outcome in a Spanish cohort of cardiac surgery patients. ⋯ In this cohort of patients, intraoperative transfusion might independently predict higher risk of early acute kidney damage, prolonged postoperative mechanical ventilation, and a need for haemodynamic support, and reduced short term survival (adjusted OR for mortality: 1.30; 95% CI: 1.19-1.42), and longer hospital stays (4 days longer).
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Rev Esp Anestesiol Reanim · Feb 2013
[Orotracheal intubation difficulty with lighted stylet: correlation of body mass index and neck circumference].
To evaluate the difficulty of intubation with a lighted stylet by correlating the body mass index (BMI) with the neck or cervical circumference (CC), and to establish the values of BMI and CC that could help identify a possible difficult intubation with this device. ⋯ A lineal correlation exists between a BMI above 33 kg/m² and/or a CC greater than 40 cm and a difficult intubation using lighted stylet. Another method other than transillumination is recommended for orotracheal intubation in a patient with both characteristics.
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Rev Esp Anestesiol Reanim · Feb 2013
Case Reports[Effect of sub-anaesthetic doses of ketamine in the postoperative period in a patient with uncontrolled depression].
Recent studies indicate that the intravenous infusion of ketamine hydrochloride (an N-methyl-D-aspartate receptor antagonist) leads to a rapid reduction in depressive symptoms. A 42 year-old woman with breast cancer and major depression resistant to medical treatment received a 90 minute intravenous infusion of 0.3 mg/kg ketamine for 5 consecutive days. A significant reduction from 22 to 13 (-41%) was observed in the symptoms assessed using the Hamilton scale, with the effect maintained for 14 days. The possible therapeutic mechanism is discussed.
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Rev Esp Anestesiol Reanim · Feb 2013
Management of pregnancy-related emergencies: what do Polish anesthesiologists know?
Emergencies can occur at any time during pregnancy. In addition to obstetricians and midwives, anesthesiologists should also be familiar with pregnancy-related emergencies. The aim of this study was to assess the basic and advanced knowledge regarding the management of pregnancy-related emergencies of anesthesiologists. ⋯ Older specialists in anesthesiology did not know how to properly manage pregnancy-related emergencies at the basic level; however, anesthesiologists were familiar with advanced management. No relationship between recalling and using such knowledge in difficult situations was observed. The teaching process of acute obstetric emergencies must be improved through implementation of compulsory nationwide courses and verification of knowledge every few years.