Bloqueo del plano del serrato/Serratus plane block

Bloqueo del plano del Serrato: una novedosa técnica guiada con US para bloquear nervios de la pared torácica


Serratus plane block: a novel ultrasound-guided thoracic wall nerve block.
Blanco R, Parras T, McDonnell JG, Prats-Galino A.
Anaesthesia. 2013 Nov;68(11):1107-13. doi: 10.1111/anae.12344. Epub 2013 Aug 7.
Abstract
We present a novel ultrasound-guided regional anaesthetic technique that may achieve complete paraesthesia of the hemithorax. This technique may be a viable alternative to current regional anaesthetic techniques such as thoracic paravertebral and central neuraxial blockade, which can be technically more challenging and have a higher potential side-effect profile. We performed the serratus block at two different levels in the midaxillary line on four female volunteers. We recorded the degree of paraesthesia obtained and performed fat-suppression magnetic resonance imaging and three-dimensional reconstructions of the spread of local anaesthetic in the serratus plane. All volunteers reported an effective block that provided long-lasting paraesthesia (750-840 min). There were no side-effects noted in this initial descriptive study. While these are preliminary findings, and must be confirmed in a clinical trial, they highlight the potential for the serratus plane block to provide analgesia following surgery on the thoracic wall. We suggest that this novel approach appears to be safe, effective, and easy to perform, and is associated with a low risk of side-effects.

http://onlinelibrary.wiley.com/doi/10.1111/anae.12344/pdf



Bloqueo del plano anterior del serrato para fracturas costales múltiples


Serratus anterior plane block for multiple rib fractures.
Kunhabdulla NP, Agarwal A1, Gaur A, Gautam SK, Gupta R, Agarwal A.
Pain Physician. 2014 Jul-Aug;17(4):E553-5.

http://www.painphysicianjournal.com/2014/july/2014;17;E553-E555.pdf


Otros usos potenciales del bloqueo del plano anterior del serrato


Other potential uses of serratus anterior plane block.

Eid M.

Anaesthesia. 2014 Aug;69(8):933-4. doi: 10.1111/anae.12778.
http://onlinelibrary.wiley.com/doi/10.1111/anae.12778/pdf






Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org

Efectos de la raquia en cesárea electiva sobre los índices de pulsatividad en las arterias uterinas y del cordón umbilical en mujeres normotensas y con hipertensión crónica. Estudio prospectivo, longitudinal

Efectos de la raquia en cesárea electiva sobre los índices de pulsatividad en las arterias uterinas y del cordón umbilical en mujeres normotensas y con hipertensión crónica. Estudio prospectivo, longitudinal



The effects of spinal anaesthesia for elective caesarean section on uterine and umbilical arterial pulsatility indexes in normotensive and chronic hypertensive pregnant women: a prospective, longitudinal study.
Guedes-Martins L, Graça H, Saraiva JP, Guedes L, Gaio R, Cerdeira AS, Macedo F, Almeida H.
BMC Pregnancy Childbirth. 2014 Aug 28;14(1):291. [Epub ahead of print]
Abstract
BACKGROUND: Despite the known effects of neuraxial blockade on major vessel function and the rapid decrease in uterine vascular impedance, it is unclear how the blockade affects the utero-placental circulation in the near-term. We hypothesize that among women with chronic hypertension, a loss of sympathetic tonus consequent to spinal block may cause significant changes in the utero-placental haemodynamics than the changes typical in normal pregnant women. Therefore, the main study objective was to analyse the effect of spinal anaesthesia for caesarean section on uterine and umbilical arterial impedance in pregnant women at term diagnosed with stage-1 chronic hypertension. METHODS: A prospective, longitudinal study was performed in singleton pregnant women (203 low-risk and 33 with hypertension) scheduled to undergo elective caesarean section. The mean arterial blood pressure and pulsatility indexes for the uterine and umbilical arteries were recorded before and after spinal anaesthesia was performed using 8-9 mg hyperbaric bupivacaine (5 mg/mL) and 2-2.5 mug sufentanil (5 mug/mL). Multiple linear regression models with errors capable of correlation or with unequal variances were fitted using the generalized least squares. RESULTS: In normotensive women, the mean arterial blood pressure decreased after administering spinal anaesthesia (p < 0.05). The pulsatility index of the uterine and umbilical arteries did not change after spinal anaesthesia. In the hypertensive women, the mean arterial blood pressure (p < 0.05) and uterine artery pulsatility index (p < 0.05) decreased. In both groups, the umbilical artery pulsatility index did not change after spinalanaesthesia. CONCLUSIONS: In stage-1 chronic hypertensive pregnant women at term, spinal anaesthesia for caesarean section reduces uterine artery impedance but not umbilical artery impedance.

http://www.biomedcentral.com/content/pdf/1471-2393-14-291.pdf




Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org

New gadget lets police detect when you're texting while driving

http://www.dailydot.com/technology/texting-while-driving-gun/?tw=dd

New gadget lets police detect when you're texting while driving: http://t.co/Goqa9RIl0k pic.twitter.com/FKAL5qF4Me
— The Daily Dot (@dailydot) septiembre 18, 2014

A review of the ways in which healthcare professionals can be helped to involve their patients in the healthcare decision making process

A review of the ways in which healthcare professionals can be helped to involve their patients in the healthcare decision making process



A review of the ways in which healthcare professionals can be helped to involve their patients in the healthcare decision making process Updated


Légaré F, Stacey D, Turcotte S, Cossi M, Kryworuchko J, Graham ID, Lyddiatt A, Politi MC, Thomson R, Elwyn G, Donner-Banzhoff N
Published Online:
15 September 2014


When there are several treatments possible, healthcare professionals can involve patients in the process of making decisions about their care so that the patients can choose care that meets their needs and reflects what is important to them. We call this 'shared decision making'. Although the results are better when patients are involved, healthcare professionals often do not involve their patients in these decisions. We wanted to know more about what can be done to encourage healthcare professionals to share decision making with their patients. In our review we identified 39 studies that tested what activities work in helping healthcare professionals involve their patients more in the decision-making process. We learned that any such activity was better than none, and that activities for healthcare professionals and patients together worked somewhat better than activities just for patients or just for healthcare professionals. However, given the small number of studies and the differences across the studies, it was difficult to know which activities worked best. This review suggested ways to better evaluate how much healthcare professionals involve patients in healthcare decisions so that we can understand this process better in the future.

- See more at: http://summaries.cochrane.org/CD006732/EPOC_a-review-of-the-ways-in-which-healthcare-professionals-can-be-helped-to-involve-their-patients-in-the-healthcare-decision-making-process#sthash.cA1YtawR.dpuf

Bibliotecas. Alerta

Biblioteca
Notificaciones diarias ⋅ 2 de septiembre de 2014
NOTICIAS


El Universal

Remodelan biblioteca de centro penitenciario del DF
El Universal
El Subsecretario de Sistema Penitenciario del DF, Hazael Ruíz Ortega, informó que esto fue posible gracias a la colaboración de la Academia ...
Remodelan Biblioteca de la Comunidad para Mujeres del sistema penitenciario del DF - El Occidental
Cobertura total de la noticia



El Gobierno traspasa a la Generalitat el edificio de la nueva biblioteca de Girona
20minutos.es
El Gobierno central ha traspasado el edificio de la nueva biblioteca de Girona a la Generalitat, que a partir de ahora puede gestionar el equipamiento ...



Una biblioteca 100% sustentable
La Voz del Interior
Considerada la primera biblioteca 100 por ciento ecológica del país azteca, la casa de libros se construyó con el diseño solar pasivo, lo que le ...



Sede virtual de la UNAM en Biblioteca de Torreón
Milenio.com
Ruth Idalia Ysais Antuna, informó que la casa de estudios superiores proveyó a la biblioteca con un módulo de servicios digitales compuesto de diez ...



Club de lectura inicia nuevo ciclo en la biblioteca del Juan de Salazar
ÚltimaHora.com
Se extenderá hasta el 29 de octubre en la Biblioteca Cervantes del referido centro. Las horas se dedican a la lectura y análisis de autores ...


Presentarán libro en biblioteca del Metro
Milenio.com
Presentarán libro en biblioteca del Metro. El ITCA anunció la apertura de dos cursos para bibliotecarios que se estará impartiendo del 9 al 12 de ...




Salamanca24horas

La biblioteca de Libreros abre sus puertas hasta las doce de la noche para la preparación de ...
Salamanca24horas
Con la llegada del mes de septiembre, muchos estudiantes regresan a Salamanca para preparar las asignaturas que no han aprobado en ...




Salamanca24horas

La biblioteca retoma el 15 de septiembre el horario de invierno
Salamanca24horas
La Biblioteca David Hernández de Guijuelo iniciará la nueva temporada el próximo lunes, 15 de septiembre, con el regreso a su horario de invierno.



La Biblioteca Popular y Pública Apronovid recuerda que tiene vigencia su Banco de Voz
LU 22 Radio Tandil
El objetivo es que toda persona ciega o con problemas visuales, pueda contar con el servicio de lectura en una especie de recreación dentro de los ...


BLOGS

Concurso-Oposición: Ayudante/a de Biblioteca para el Ayto. de S/C de Tenerife

Ofertas de trabajo, becas, empleo y cursos en Canarias - Enbuscade ⋅ Xiomara Méndez
En el BOP del viernes, 29 de agosto de 2014, el Excmo. Ayuntamiento de Santa Cruz de Tenerife publicaba la convocatoria y las bases que han de ...



Recorrido de la Biblioteca Móvil en el mes de septiembre

Periodico SIC ⋅ admin
La Biblioteca móvil anuncia el nuevo cronograma de actividades de que se realizará en el mes de septiembre, en las cuales participan niños y ...



Las bibliotecas escolares se suben al carro de las TIC

NEST ⋅ begona.romero
“La biblioteca escolar es parte integrante del proceso educativo” según refleja un documento elaborado por la UNESCO que, además, señala que ...



La biblioteca pública integral (V): derechos de remuneración, mala fe y malas soluciones

verba volant, scripta manent ⋅ Bernat Ruiz Domènech
La digitalización de la biblioteca pública abocará a los autores a tener que elegir: o bien cobrar el porcentaje ya previsto en el PVP por cada título ...


WEB

Homenaje a Graciela Huinao en la Biblioteca Nacional
Biblioteca Nacional
El viernes 5 de septiembre se conmemora el Día Internacional de la Mujer Indígena en recuerdo de Bartolina Sisa, mujer indígena aymara asesinada ...



Noticia
Biblioteca Nacional de España
La Biblioteca Nacional de España (BNE) ha recibido la donación del archivo personal del compositor y director José Luis de Delás (Barcelona, 1928), ...



Comienza campaña de libros para crear biblioteca en Renca
Universidad del Desarrollo
Una vez recopiladas todas las donaciones, el personal de biblioteca de la UDD se encargará de la clasificación de las obras para entregarlas con un ...



Acceso a materiales formativos de la Biblioteca en RIUMA
Facebook
Si estás interesado en usar las diversas herramientas de búsqueda de información disponibles en la BUMA, además de inscribirte en los cursos ...



Ingresar a
Biblioteca "Dr. Jorge Villalobos Padilla, SJ" - Instituto Tecnológico y de Estudios Superiores de Occidente
BibliotecaWeb ITESOAviso de privacidad. Biblioteca Dr. Jorge Villalobos Padilla, S.J.ITESO, UNIVERSIDAD JESUITA DE GUADALAJARA logo iteso.



Escenas de baño
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[Escenas de baño] entre 1910 y 1920 Ver serie completa en la Biblioteca Digital Hispánica:http://bdh.bne.es/bnesearch/detalle/bdh0000052920.



Biblioteca comunitaria a disposición del público
Yelp
Fotos de Centro Cultural Resurgimiento Biblioteca comunitaria a disposición del público Buenos Aires.

Fuego en quirófano/OR fire

Operativo de seguridad contra incendios en quirófano


Operating room fire safety.
Hart SR, Yajnik A, Ashford J, Springer R, Harvey S.
Ochsner J. 2011 Spring;11(1):37-42.
Abstract
Operating room fires are a rare but preventable danger in modern healthcare operating rooms. Optimal outcomes depend on all operating room personnel being familiar with their roles in fire prevention and fire management. Despite the recommendations of major safety institutes, this familiarity is not the current practice in many healthcare facilities. Members of the anesthesiology and the surgery departments are commonly not actively involved in fire safety programs, fire drills, and fire simulations that could lead to potential delays in prevention and management of intraoperative fires.
KEYWORDS: Fire; intraoperative; program; safety; team
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3096161/pdf/i1524-5012-11-1-37.pdf



Pensando en tres: cambios en las prácticas quirúrgicas de seguridad del paciente en la sala de operaciones moderna.


Thinking in three's: changing surgical patient safety practices in the complex modern operating room.
Gibbs VC.

World J Gastroenterol. 2012 Dec 14;18(46):6712-9. doi: 10.3748/wjg.v18.i46.6712.

Abstract

The three surgical patient safety events, wrong site surgery, retained surgical items (RSI) and surgical fires are rare occurrences and thus their effects on the complex modern operating room (OR) are difficult to study. The likelihood of occurrence and the magnitude of risk for each of these surgical safety events are undefined. Many providers may never have a personal experience with one of these events and training and education on these topics are sparse. These circumstances lead to faulty thinking that a provider won't ever have an event or if one does occur the provider will intuitively know what to do. Surgeons are not preoccupied with failure and tend to usually consider good outcomes, which leads them to ignore or diminish the importance of implementing and following simple safety practices. These circumstances contribute to the persistent low level occurrence of these three events and to the difficulty in generating sufficient interest to resource solutions. Individual facilities rarely have the time or talent to understand these events and develop lasting solutions. More often than not, even the most well meaning internal review results in a new line to a policy and some rigorous enforcement mandate. This approach routinely fails and is another reason why these problems are so persistent. Vigilance actions alone have been unsuccessful so hospitals now have to take a systematic approach to implementing safer processes and providing the resources for surgeons and other stakeholders to optimize the OR environment. This article discusses standardized processes of care for mitigation of injury or outright prevention of wrong site surgery, RSI and surgical fires in an action-oriented framework illustrating the strategic elements important in each event and focusing on the responsibilities for each of the three major OR agents-anesthesiologists, surgeons and nurses. A Surgical Patient Safety Checklist is discussed that incorporates the necessary elements to bring these team members together and influence the emergence of a safer OR.

KEYWORDS: Complex adaptive systems; Retained foreign bodies; Retained foreign objects; Retained surgical items; Safety checklist; Surgical fires; Surgical patient safety; Wrong site surgery

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3520159/pdf/WJG-18-6712.pdf

Factores que involucran fuego en la cirugía dental. Revisión de la literatura


Factors involved in dental surgery fires: a review of the literature.
VanCleave AM, Jones JE, McGlothlin JD, Saxen MA, Sanders BJ, Walker LA.

Anesth Prog. 2014 Spring;61(1):21-5. doi: 10.2344/0003-3006-61.1.21.

Abstract

Surgical fires are well-characterized, readily preventable, potentially devastating operating room catastrophes that continue to occur from 20 to 100 times per year or, by one estimate, up to 600 times per year in US operating rooms, sometimes with fatal results. The most significant risk factors for surgical fires involve (a) the use of an ignition source, such as laser or electrocautery equipment, in or around an oxygen-enriched environment in the head, neck, and upper torso area and (b) the concurrent delivery of supplemental oxygen, especially via nasal cannula. Nonetheless, while these 2 conditions occur very commonly in dental surgery, especially in pediatric dental surgery where sedation and anesthesia are regularly indicated, there is a general absence of documented dental surgical fires in the literature. Barring the possibility of underreporting for fear of litigation, this may suggest that there is another mechanism or mechanisms present in dental or pediatric dental surgery that mitigates this worst-case risk of surgical fires. Some possible explanations for this include: greater fire safety awareness by dental practitioners, incidental ventilation of oxygen-enriched environments in patient oral cavities due to breathing, or suction used by dental practitioners during procedures. This review of the literature provides a background to suggest that the practice of using intraoral suction in conjunction with the use of supplemental oxygen during dental procedures may alter the conditions needed for the initiation of intraoral fires. To date, there appear to be no published studies describing the ability of intraoral suctioning devices to alter the ambient oxygen concentration in an intraoral environment. In vivo models that would allow examination of intraoral suction on the ambient oxygen concentration in a simulated intraoral environment may then provide a valuable foundation for evaluating the safety of current clinical dental surgical practices, particularly in regard to the treatment of children.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3975610/pdf/i0003-3006-61-1-21.pdf




Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org

Nueva Historia Mínima de México Ilustrada

Mexican History Nueva Historia Mínima de México Ilustrada Pablo Escalante y colaboradores El Colegio de México, 2008 http://www.colmex.mx/pdf/historiaminima.pdf Atentamente Anestesiología y Medicina del Dolor www.anestesia-dolor.org