Estimad@ colega:
Es un placer saludarle, sobre todo en estas fechas en que le decimos adiós a un año y un año más se acerca a nuestras vidas y a nuestros corazones. Generalmente lo iniciamos con buenos deseos y magníficos proyectos para cada uno de nosotros y las de nuestros familiares. A nombre de Anestesiología y Medicina del Dolor, quiero desearte que tengas un año de mucha felicidad y amor pero ante todo que tengas mucha salud para que de esta forma puedas realizar todos tus proyectos importantes para este 2013.
En estos tres años de vida del Proyecto Alfa se han enviado casi cuatro millones y medio de correos electrónicos conteniendo 1 a 5 artículos completos, de los cuales la cuarta parte de ellos han sido abiertos por médicos de los 5 continentes. Hoy esta información está llegando a más de 125 países; sitios como México, Perú, España, Venezuela, Colombia, Argentina, Ecuador, Chile, Estados Unidos de Norteamérica y Bolivia y nos complace informarte que países tan remotos como Kuwait, Congo, Quatar, y Mongolia están abriendo esta información al servicio de su profesión.
Nuestro portal http://www.anestesia-dolor.org/ está siendo visitado por cientos de profesionistas diariamente. El 35% de las personas que visitan el portal, lo han hecho en más de una ocasión y las secciones más consultadas son las revistas científicas, el listado de eventos científicos-profesionales, y la sección de libros de acceso gratuito.
Para este 2013 nuevos proyectos estarán llegando hasta el interior de su casa y/ su hospital en forma totalmente gratuita y con la única finalidad de actualización vigente en el campo de la anestesiología y de otras ciencias relacionadas.
¡Gracias por ser parte de este proyecto educativo y felices fiestas!
http://youtu.be/GpootJZksQ0
Avances recientes en analgesia epidural
Recent advances in epidural analgesia.
Bauer M, George JE 3rd, Seif J, Farag E.
Department of Outcomes Research, Cleveland Clinic, Cleveland, OH 44195, USA.
Anesthesiol Res Pract. 2012;2012:309219. doi: 10.1155/2012/309219. Epub 2011 Nov 24.Abstract
Neuraxial anesthesia is a term that denotes all forms of central blocks, involving the spinal, epidural, and caudal spaces. Epidural anesthesia is a versatile technique widely used in anesthetic practice. Its potential to decrease postoperative morbidity and mortality has been demonstrated by numerous studies. To maximize its perioperative benefits while minimizing potential adverse outcomes, the knowledge of factors affecting successful block placement is essential. This paper will provide an overview of the pertinent anatomical, pharmacological, immunological, and technical aspects of epidural anesthesia in both adult and pediatric populations and will discuss the recent advances, the related rare but potentially devastating complications, and the current recommendations for the use of anticoagulants in the setting of neuraxial block placement.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3232404/pdf/ARP2012-309219.pdf
Comparación de bupivacaína-dexmedetomidina vs bupivacaína-fentanilo epidurales sobre su efecto en el velocímetro Doppler de las arterias uterinas y umbilical durante el parto
Comparative evaluation of epidural bupivacaine - dexmedetomidine and bupivacaine -fentanyl on Doppler velocimetry of uterine and umbilical arteries during labor.
Selim MF, Elnabtity AM, Hasan AM.
Faculty of Medicine, Zagazig University, Cairo, Egypt.
J Prenat Med. 2012 Jul;6(3):47-54.
Abstract
OBJECTIVE: uteroplacental blood flow is affected by myometrial contractions and hypotension. Epidural analgesia is frequently complicated by hypotension. The aim of the study was to compare the effect of bupivacaine-dexmedetomidine (BD) or bupivacaine - fentanyl (BF) on uterine artery pulsatitly index (UtA-PI) and umbilical artery pulsatitly index (UA-PI) during uterine contractions and relaxations.
METHODS: this was a prospective controlled observational study performed in 130 healthy full term parturients divided into 3 groups [23 cases as control, 44 cases as (BD) epidural group and 43 cases as (BF) epidural group]. Over the study duration of 120 minutes; UtA-PI and UA-PI were measured at baseline, 30, 60, 120 minutes during uterine contractions and relaxations. Maternal hemodynamic, visual analogue scale (VAS), sedation score, side effects of epidural analgesia including nausea, vomiting, pruritis and respiratory depression were assessed. RESULTS: VAS significantly decreased after epidural compared with control group. BD group showed significant improvement in onset and duration of analgesia and sedation scores with lower incidence of nausea and pruritis compared with BF group. The BF and BD groups were associated with significant maternal hypotension and bradycadia that increase the UtA-PI during uterine contractions and relaxations compared with control group. UA-PI was increased with uterine contractions compared with during uterine relaxations in the three studied groups yet the effect of epidural and uterine contractions does significantly affect newborns apgar scores or umbilical cord pH. CONCLUSION: Bupivacaine-dexmedetomidine epidural analgesia showed better maternal satisfaction for labor pains control compared with bupivacaine - fentanyl without deleterious effect on utroplacental circulation and newborns outcome.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3503522/pdf/47-54_prenatal_3_2012.pdf
Aplicación de la anatomía epidural
Applied epidural anatomy
Jonathan Richardson MD MRCP FRCA FIPP
Gerbrand J Groen MD PhD
Continuing Education in Anaesthesia, Critical Care & Pain | Volume 5 Number 3 2005
Key points
Clinicians performing epidural procedures should have a good knowledge of the relevant anatomy. Radiological screening is helpful for difficult epidural entry. Maximal neck flexion can almost double the depth of the cervical epidural space. Spinal endoscopy adds another dimension to epidural catheterization. At present, its main application is in relation to the management and diagnosis of chronic radicular pain.
http://ceaccp.oxfordjournals.org/content/5/3/98.full.pdf
Atentamente
Dr. Enrique Hernández-Cortez
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
Es un placer saludarle, sobre todo en estas fechas en que le decimos adiós a un año y un año más se acerca a nuestras vidas y a nuestros corazones. Generalmente lo iniciamos con buenos deseos y magníficos proyectos para cada uno de nosotros y las de nuestros familiares. A nombre de Anestesiología y Medicina del Dolor, quiero desearte que tengas un año de mucha felicidad y amor pero ante todo que tengas mucha salud para que de esta forma puedas realizar todos tus proyectos importantes para este 2013.
En estos tres años de vida del Proyecto Alfa se han enviado casi cuatro millones y medio de correos electrónicos conteniendo 1 a 5 artículos completos, de los cuales la cuarta parte de ellos han sido abiertos por médicos de los 5 continentes. Hoy esta información está llegando a más de 125 países; sitios como México, Perú, España, Venezuela, Colombia, Argentina, Ecuador, Chile, Estados Unidos de Norteamérica y Bolivia y nos complace informarte que países tan remotos como Kuwait, Congo, Quatar, y Mongolia están abriendo esta información al servicio de su profesión.
Nuestro portal http://www.anestesia-dolor.org/ está siendo visitado por cientos de profesionistas diariamente. El 35% de las personas que visitan el portal, lo han hecho en más de una ocasión y las secciones más consultadas son las revistas científicas, el listado de eventos científicos-profesionales, y la sección de libros de acceso gratuito.
Para este 2013 nuevos proyectos estarán llegando hasta el interior de su casa y/ su hospital en forma totalmente gratuita y con la única finalidad de actualización vigente en el campo de la anestesiología y de otras ciencias relacionadas.
¡Gracias por ser parte de este proyecto educativo y felices fiestas!
http://youtu.be/GpootJZksQ0
Avances recientes en analgesia epidural
Recent advances in epidural analgesia.
Bauer M, George JE 3rd, Seif J, Farag E.
Department of Outcomes Research, Cleveland Clinic, Cleveland, OH 44195, USA.
Anesthesiol Res Pract. 2012;2012:309219. doi: 10.1155/2012/309219. Epub 2011 Nov 24.Abstract
Neuraxial anesthesia is a term that denotes all forms of central blocks, involving the spinal, epidural, and caudal spaces. Epidural anesthesia is a versatile technique widely used in anesthetic practice. Its potential to decrease postoperative morbidity and mortality has been demonstrated by numerous studies. To maximize its perioperative benefits while minimizing potential adverse outcomes, the knowledge of factors affecting successful block placement is essential. This paper will provide an overview of the pertinent anatomical, pharmacological, immunological, and technical aspects of epidural anesthesia in both adult and pediatric populations and will discuss the recent advances, the related rare but potentially devastating complications, and the current recommendations for the use of anticoagulants in the setting of neuraxial block placement.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3232404/pdf/ARP2012-309219.pdf
Comparación de bupivacaína-dexmedetomidina vs bupivacaína-fentanilo epidurales sobre su efecto en el velocímetro Doppler de las arterias uterinas y umbilical durante el parto
Comparative evaluation of epidural bupivacaine - dexmedetomidine and bupivacaine -fentanyl on Doppler velocimetry of uterine and umbilical arteries during labor.
Selim MF, Elnabtity AM, Hasan AM.
Faculty of Medicine, Zagazig University, Cairo, Egypt.
J Prenat Med. 2012 Jul;6(3):47-54.
Abstract
OBJECTIVE: uteroplacental blood flow is affected by myometrial contractions and hypotension. Epidural analgesia is frequently complicated by hypotension. The aim of the study was to compare the effect of bupivacaine-dexmedetomidine (BD) or bupivacaine - fentanyl (BF) on uterine artery pulsatitly index (UtA-PI) and umbilical artery pulsatitly index (UA-PI) during uterine contractions and relaxations.
METHODS: this was a prospective controlled observational study performed in 130 healthy full term parturients divided into 3 groups [23 cases as control, 44 cases as (BD) epidural group and 43 cases as (BF) epidural group]. Over the study duration of 120 minutes; UtA-PI and UA-PI were measured at baseline, 30, 60, 120 minutes during uterine contractions and relaxations. Maternal hemodynamic, visual analogue scale (VAS), sedation score, side effects of epidural analgesia including nausea, vomiting, pruritis and respiratory depression were assessed. RESULTS: VAS significantly decreased after epidural compared with control group. BD group showed significant improvement in onset and duration of analgesia and sedation scores with lower incidence of nausea and pruritis compared with BF group. The BF and BD groups were associated with significant maternal hypotension and bradycadia that increase the UtA-PI during uterine contractions and relaxations compared with control group. UA-PI was increased with uterine contractions compared with during uterine relaxations in the three studied groups yet the effect of epidural and uterine contractions does significantly affect newborns apgar scores or umbilical cord pH. CONCLUSION: Bupivacaine-dexmedetomidine epidural analgesia showed better maternal satisfaction for labor pains control compared with bupivacaine - fentanyl without deleterious effect on utroplacental circulation and newborns outcome.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3503522/pdf/47-54_prenatal_3_2012.pdf
Aplicación de la anatomía epidural
Applied epidural anatomy
Jonathan Richardson MD MRCP FRCA FIPP
Gerbrand J Groen MD PhD
Continuing Education in Anaesthesia, Critical Care & Pain | Volume 5 Number 3 2005
Key points
Clinicians performing epidural procedures should have a good knowledge of the relevant anatomy. Radiological screening is helpful for difficult epidural entry. Maximal neck flexion can almost double the depth of the cervical epidural space. Spinal endoscopy adds another dimension to epidural catheterization. At present, its main application is in relation to the management and diagnosis of chronic radicular pain.
http://ceaccp.oxfordjournals.org/content/5/3/98.full.pdf
Atentamente
Dr. Enrique Hernández-Cortez
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
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