Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · May 2015
Review Meta AnalysisEfficiency of tranexamic acid in perioperative blood loss in hip arthroplasty: a systematic literature review and meta-analysis.
Tranexamic acid (TXA) is an antifibrinolytic drug used to reduce bleeding in mortality risk situations such as trauma. Our objective was to conduct a systematic literature review to evaluate the effectiveness and safety of TXA in reducing bleeding in hip arthroplasty. ⋯ TXA can be routinely used to reduce intra- and post-operative blood loss in primary hip arthroplasty.
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Anesthesiology societies have issued various guidelines on preoperative fasting since 1990, not only to decrease the incidence of lung aspiration and anesthetic morbidity, but also to increase patient comfort prior to anesthesia. Some of these societies have been updating their guidelines, as such that, since 2010, we now have 2 evidence-based preoperative fasting guidelines available. In this article, an attempt is made to review these updated guidelines, as well as the current instructions for more controversial patients such as infants, the obese, and a particular type of ophthalmic surgery.
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In septic shock, high adrenergic stress is associated with cardiovascular and systemic adverse effects, which can negatively affect the results. Beta-adrenergic receptor block has been shown to be effective in controlling the disproportionate increase in heart rate, maintaining a favorable hemodynamic profile and apparently improving the efficiency of the cardiovascular system in order to maintain tissue perfusion. ⋯ Selective beta-1 blockers appear to provide better results than non-selective blockers, even suggesting a positive impact on mortality. Future clinical trials are still needed to confirm these findings and define the scope of their benefits.
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Rev Esp Anestesiol Reanim · Feb 2015
Review Case Reports[Peroneal nerve injury: anesthesia is not always to blame].
We introduce a case report of a woman that was operated of foot surgery under locoregional anesthesia with an echo-guided peripheral sciatic-popliteal nerve block. As post operatory complication a peroneal nerve injury was noticed. ⋯ In our case the finding was a high degree axonotmesis secondary to extrinsic compressure due to pneumatic tourniquet placed in the ankle used during surgery. There was no relationship with the anesthetic technique.
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Rev Esp Anestesiol Reanim · Oct 2014
Review Case Reports[Anaesthetic implications in a pregnant patient with an extreme thrombocytopenia due to a May-Hegglin anomaly: general o regional anaesthesia?].
The May-Hegglin anomaly is an inherited disorder, so uncommon that the incidence is still unknown. It is characterized by macro-thrombocytopenia with normal platelet function and cytoplasmic inclusion bodies in granulocytes. The case is reported of a 28-year-old primiparous patient who had an urgent caesarean section due to failed induction of labour. ⋯ The platelet count prior to surgery was 20,900/mm(3) with normal platelet function. General anaesthesia was performed. No excessive bleeding occurred and a platelet transfusion was not needed.