Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · Jan 2011
[Postoperative pain management for patients who are long-term users of opioid].
Pain is one of the most common reasons for seeking medical care and the frequency of prescription of opioid analgesics by both primary care physicians and specialists has increased. It is therefore unsurprising that many patients with chronic pain who must undergo scheduled or emergency surgery will be on long-term medication, including opioids. ⋯ Adjuvants may be particularly useful; the most thoroughly studied adjuvants are nonsteroidal anti-inflammatory drugs and ketamine. Regional anesthesia offers a particularly attractive approach when long-term users of opioids must undergo surgery.
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Rev Esp Anestesiol Reanim · Jan 2011
Randomized Controlled Trial Multicenter Study Comparative Study[Efficacy of low-dose oxytocin during elective cesarean section].
In cesarean section, the optimal dose of oxytocin to reduce the risk of hemorrhage with the least risk of adverse effects has yet to be defined. We studied the effects of using 2 different doses of oxytocin in women undergoing elective cesarean section under spinal anesthesia. The women had had no prior labor. ⋯ The incidence of obstetric bleeding is not higher when a lower dose of oxytocin is used; the rate of postoperative adverse events also does not increase.
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Rev Esp Anestesiol Reanim · Jan 2011
Randomized Controlled Trial Comparative Study[Prophylaxis for hypotension during cesarean section under spinal anesthesia: a randomized trial comparing hydroxyethyl starch 130/0.4 to ephedrine].
Spinal anesthesia is the technique of choice for scheduled or emergency cesarean section, but the prevalence of hypotension is high in this setting. Our aim was to compare the efficacy of a colloid (6% hydroxyethyl starch [HES] 130/0.4) to ephedrine for preventing hypotension. ⋯ HES 130/0.4 is as useful for hypotension prophylaxis as 5-mg or 10-mg intravenous doses of ephedrine. HES 130/0.4 might be a substitute for sympathomimetic agents if adverse effects are predicted or contraindications to the use of such drugs are present.