Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · Feb 2017
Practice GuidelineRecommendations on the use of deep neuromuscular blockade by anaesthesiologists and surgeons. AQUILES (Anestesia QUIrúrgica para Lograr Eficiencia y Seguridad) Consensus.
Neuromuscular blockade enables airway management, ventilation and surgical procedures. However there is no national consensus on its routine clinical use. The objective was to establish the degree of agreement among anaesthesiologists and general surgeons on the clinical use of neuromuscular blockade in order to make recommendations to improve its use during surgical procedures. ⋯ Collaboration among anaesthesiologists and surgeons has enabled some general recommendations to be established on deep neuromuscular blockade use during abdominal surgery.
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Rev Esp Anestesiol Reanim · Feb 2017
Randomized Controlled Trial Comparative StudyEffectiveness and safety of continuous ultrasound-guided femoral nerve block versus epidural analgesia after total knee arthroplasty.
Total knee arthroplasty is associated with severe postoperative pain. The aim of this study was to compare continuous ultrasound-guided femoral nerve block with continuous epidural analgesia, both with low concentrations of local anaesthetic after total knee arthroplasty. ⋯ Continuous ultrasound-guided femoral nerve block provides analgesia and morphine consumption similar to epidural analgesia, with the same level of satisfaction, but with a lower rate of side effects after total knee arthroplasty.
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Rev Esp Anestesiol Reanim · Feb 2017
Use of King Vision® videolaryngoscope in an unanticipated difficult airway in an adult patient with giant vallecular cyst, a case report.
Laryngeal cysts are largely asymptomatic and typically described in the context of incidental discovery on routine laryngoscopy. These cysts, in adults are even rarer and can have catastrophic consequences in an anaesthetized patient if airway management is inappropriate. We describe a case of difficult endotracheal intubation and the treatment of an adult patient with an asymptomatic, giant vallecular cyst that was discovered during rapid-sequence induction of general anesthesia in urgent surgery. ⋯ It is important to avoid complications associated with repeated attempts at intubation, airway loss, or cyst rupture causing difficulty visualizing vocal cords and aspiration. The use of King Vision® videolaryngoscope is a good alternative in these cases. Close attention to logistics and the immediate availability of an otolaryngologist is vital.
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Rev Esp Anestesiol Reanim · Feb 2017
A predictive test for difficult intubation in laryngeal microsurgery. Validation study.
In 2003 a simple test to detect difficult intubation (DI) in patients underwent laryngeal microsurgery was described. The present study was conducted to validate the test. ⋯ The index was validated at a cut-off of ≥5, being a useful and reliable test to predict DI in patients with laryngeal diseases and it is a useful tool for anaesthesiologists with conventional training.