Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · May 2012
Review[Perioperative tumour dissemination. 2. Effects of anaesthesia and analgesia].
There has been growing concern over the last few years on the effect that the anaesthetic drugs used during oncological surgery could have on long-term tumour progression. In laboratory studies, it has been observed how some substances used during the anaesthetic procedure influence tumour immunosurveillance, cell proliferation or tumour angiogenesis processes. ⋯ However, based on retrospective studies, it appears that those anaesthetic techniques combined with the use of regional anaesthesia and analgesia may be beneficial compared to those that are maintained on the use of opioids. Further research should help to clarify the long-term clinical relevance of the anaesthetic process during oncological surgery.
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Rev Esp Anestesiol Reanim · Mar 2012
Review[Indications and use of prothrombin complex in cardiac surgery].
On of the most common, and serious, complications in cardiac surgery is postoperative bleeding. According to the majority of studies, between 10% and 92% of patients subjected to elective surgery require transfusions of blood products and blood derivatives. ⋯ There have been some important changes in the treatment of changes in haemostasis and post-surgical bleeding in the last few years, particularly with the introduction into clinical practice of working procedures backed up by clinical guidelines, as well as the appearance of new drugs. The aim of this work is to describe the main characteristics and update the use of prothrombin complexes that are currently available in Spain, with special emphasis on their use in cardiac surgery.
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Rev Esp Anestesiol Reanim · Jan 2012
Review[Review: effect of preventive analgesia on postoperative pain].
Preventive analgesia (administration of a technique or analgesic drug with the aim of reducing postoperative pain, hyperalgesia and allodynia) has shown to be effective in experimental studies. However, the results in patients have been controversial. A review has been made of the clinical trials published during the last 5 years to test the efficacy of preventive analgesia on postoperative pain. ⋯ Preventive analgesia was effective in 15 of the 27 studies, with pre-incisional epidural drug administration being the most effective (local anaesthetics with or without opioids, clonidine). The possible effectiveness of preventive analgesia in humans is still controversial, partly due to the wide heterogeneity in the inclusion criteria, types of patients, or the analgesia measurement parameters analysed by the studies. More studies are required with common criteria and objectives.
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Rev Esp Anestesiol Reanim · Jan 2012
Review Meta Analysis[Levosimendan reduces mortality in cardiac surgery: a systematic review and meta-analysis].
To evaluate whether Levosimendan has any impact on peri-operative mortality in cardiac surgery. ⋯ The meta-analysis showed that the use of Levosimendan was associated with a reduction in mortality in patients subjected to cardiac surgery, although there is still no definitively clear evidence. Additional randomised and multicentre clinical studies, with a much larger number of patients are required, in which hospital mortality and mortality at 6 months are analysed as the primary outcomes.