Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · Nov 2005
Randomized Controlled Trial Comparative Study[Brachial plexus block with levobupivacaine at the humeral canal: comparison of a small volume at high concentration with a large volume at low concentration].
To assess differences in the brachial plexus block in 2 groups who received the same dose of levobupivacaine: 1 group received a small volume of solution at high concentration and the other group received a large volume in solution at low concentration. ⋯ The success rate was lower in the group receiving the smaller volume at a higher concentration. It is advisable to administer local anesthetics in larger volumes at lower concentrations to improve block quality. Latency and duration were similar in both groups.
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Rev Esp Anestesiol Reanim · Aug 2005
Randomized Controlled Trial Comparative Study Clinical Trial[Hemodynamic effects of levosimendan following cardiac surgery].
The hemodynamic effect of levosimendan was compared to that of dobutamine in a trial enrolling 30 adults undergoing scheduled cardiac surgery with cardiopulmonary bypass. Fifteen patients were randomly assigned to receive levosimendan in a single dose of 18 microg x kg(-1) followed in 15 to 20 minutes by start of infusion at a rate of 0.2 microg x kg(-1) min(-1) for 24 hours (levosimendan group). Another 15 randomized patients received dobutamine infused at a rate of 7.5 microg x kg(-1) min(-1). ⋯ We found that mean arterial pressure and both systemic and pulmonary vascular resistance decreased significantly in the levosimendan group (P < 0.05), but not in the dobutamine group. On the other hand, both heart rate and cardiac index increased in the levosimendan group only (P < 0.05). We conclude that levosimendan improves hemodynamic stability in patients who have undergone cardiac surgery and that it is a good alternative for treating postoperative low cardiac output syndrome.
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Rev Esp Anestesiol Reanim · Apr 2005
Randomized Controlled Trial Clinical Trial[Stress, hemodynamic and immunological responses to inhaled and intravenous anesthetic techniques for video-assisted laparoscopic cholecystectomy].
Given the immunomodulatory effects of anesthesia and surgery, 2 anesthetic regimens in clinical use were compared to evaluate hemodynamic, stress, and immunologic response in patients undergoing laparoscopic cholecystectomy. ⋯ Although both techniques afford hemodynamic stability, lower cortisol levels were observed with the application of TIVA with propofol-remifentanil. That would be the technique of choice for patients with compromised immune response.
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Rev Esp Anestesiol Reanim · Feb 2005
Randomized Controlled Trial Comparative Study Clinical Trial[Randomized controlled trial comparing a low dose to a conventional dose of hyperbaric bupivacaine for scheduled cesarean section].
Spinal anesthesia is the technique most often applied in cases of scheduled cesarean section. Many authors have tried decreasing the local anesthetic dose by adding opioids to achieve adequate analgesia with greater hemodynamic stability, although the ideal dose remains to be established. Our aim was to analyze hemodynamic stability and quality of analgesia with 2 different regimens for administering spinal hyperbaric bupivacaine. ⋯ Spinal anesthesia with low doses of bupivacaine and fentanyl provides acceptable intraoperative conditions for a high percentage of patients undergoing cesarean section, with a similar incidence of hypotension. The low dose generates a less intense intraoperative motor blockade with similar spread of the sensory block. The low dose was not efficacious for 10% of the patients who received it.
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Rev Esp Anestesiol Reanim · Jan 2005
Randomized Controlled Trial Comparative Study Clinical Trial[Popliteal fossa sciatic nerve block for ambulatory hallux valgus surgery: comparison of lateral and posterior approaches].
The aim of this study was to assess the efficacy, effectiveness, technical difficulty, and clinical usefulness of the popliteal sciatic peripheral nerve block for unilateral hallus valgux surgery and to compare the posterior and lateral approaches. We also aimed to investigate patient comfort during the procedure. ⋯ Both the posterior and lateral approaches provide easy access to the sciatic nerve for performing a block. The rate of success is high and postoperative analgesia is good, with no noteworthy complications. However, the lateral approach is more comfortable for the patient.