Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · Aug 2002
[Use of mivacurium chloride during transsternal thymectomy in myasthenic patient].
Myasthenia gravis is an autoimmune disease characterized by the presence of circulating IgG antibodies, which interact with acetylcholine receptors and interfere with neuromuscular transmission. ⋯ The anesthetic effect of mivacurium was twice as great in myasthenic patients, in whom it behaved like an intermediate-level non-depolarizing muscle relaxant. Mivacurium can reduce prolonged mechanical ventilation in patients who are myasthenic or pharmacologically immunosuppressed and at risk of sepsis arising in the respiratory tract.
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Rev Esp Anestesiol Reanim · Aug 2002
Case Reports[Anesthesia for cesarean section in a patient with von Hippel-Lindau disease].
We report the case of a pregnant 38-year-old woman at full-term who had a history of von Hippel-Lindau disease with neurological symptoms. She had previously undergone surgical removal of cerebellar hemangioblastomas. A cesarean delivery performed under general anesthesia was uneventful and the outcomes were excellent for both mother and fetus. ⋯ As such involvement could not be ruled out, we preferred to avoid the risks related to regional anesthesia. One of the main features of von Hippel-Lindau disease is the presence of central nervous system hemangioblastomas, which are highly vascularized, slow growing tumors that may become enlarged during pregnancy. We describe the implications of the disease for anesthesia.
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Rev Esp Anestesiol Reanim · Jun 2002
Review[Preoperative fasting regimens and premedication to reduce the risk of pulmonary aspiration].
Our greater understanding of gastric physiology and the epidemiology of Mendelson's syndrome has allowed the traditional guidelines for preoperative fasting (nothing by mouth after midnight or 6 hours before surgery) to be changed, based on the results of many scientific studies. The stomach is not emptied of liquids and solids in the same way, and therefore preoperative fasting should not be the same for both. ⋯ Factors such as premedication, anxiety, age, certain associated diseases or injuries may or may not influence gastric emptying and/or acidity at the time of anesthesia. We review the literature, including the guidelines on fasting of the American Society of Anesthesiologists for application with healthy patients of all ages in elective procedures, excluding, among others, women in childbirth and patients undergoing emergency surgery.
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Rev Esp Anestesiol Reanim · Jun 2002
Randomized Controlled Trial Comparative Study Clinical Trial[Duration and quality of postoperative analgesia after brachial plexus block for shoulder surgery: ropivacaine 0.5% versus ropivacaine 0.5% plus clonidine].
Some authors have found that nerve blocks with local anesthetics may last longer if clonidine is added. The present study analyzed the duration and quality of analgesia provided by an interscalene brachial plexus block for shoulder surgery using 0.5% ropivacaine or 0.5% ropivacaine with added clonidine. ⋯ Adding 40 micrograms of clonidine to 200 mg of 0.5% ropivacaine does not prolong the sensory-motor block or improve the quality of analgesia in the early postoperative period.