Revista española de anestesiología y reanimación
-
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.
-
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.
-
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.
-
Rev Esp Anestesiol Reanim · Jan 2012
Review[Resuscitation damage control in the patient with severe trauma].
Severe trauma is the principle cause of death among young people in developed countries, with the main causes being due to road traffic accidents and accidents at work. The principle cause of death in severe trauma is the massive uncontrolled loss of blood. ⋯ Patients with severe trauma are complex patients; they have a high mortality, they consume a significant amount of sources and can require rapid, intensive and multidisciplinary treatment encompassed within the concept of resuscitation damage control. In this article we attempt to present a current view of the pathophysiology of severe trauma and resuscitation damage control that may be applied to these types of patients.