Revista española de anestesiología y reanimación
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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.
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Many recent studies have underlined the importance of quantitative neuromuscular monitoring and the high incidence of residual block in clinical practice in spite of the use of nondepolarizing neuromuscular blockers of intermediate duration. Neuromuscular monitoring facilitates the tailoring of the muscular paralysis and appropriate patient recovery at the end of surgery. Monitoring also controls or prevents residual block and serves to guide the use of reversing agents. ⋯ In addition to drawing on their own experience, the authors have reviewed the literature available through evidence-based indexes and other databases up to December 2008. Most references found were case series and reviews. Quantitative monitoring is an evidence-based practice that should be applied in all situations in which a neuromuscular block is established.
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Rev Esp Anestesiol Reanim · Feb 2010
Review[Sugammadex, a novel drug for neuromuscular blockade reversal].
Significant progress in the management of aminosteroid nondepolarizing neuromuscular blockers will follow the introduction of sugammadex (Org 25969). Safety and rapid recovery of muscle force will improve and the adverse effects of acetylcholinesterase inhibitors will be avoided. ⋯ Sugammadex was recently approved by the European Medicines Evaluation Agency and became available in Spain in 2009, leading to a series of changes related to patient safety and surgical conditions. We review the literature on sugammadex published to date.
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Rev Esp Anestesiol Reanim · Jan 2010
Review[Applications of noninvasive mechanical ventilation in anesthesiology and postanesthesia recovery care].
Noninvasive ventilation (NIV) can be useful to anesthesiologists working in critical care units, postanesthesia recovery units, operating theaters, or other settings. NIV can help in situations of acute respiratory failure or serve as a preventive measure in patients undergoing interventions under local-regional anesthesia or diagnostic or therapeutic procedures requiring sedation. Successful NIV depends on adequately trained health personnel and the proper choice of material (interfaces, respirators, etc.) for each setting where this modality is used.