Revisiones bibliográficas. Documentación científica en Ortopedia y Traumatología, medicina deportiva, artroscopia, artroplastia y de todas las patologías del sistema Músculo-Esquelético
sábado, 1 de noviembre de 2014
viernes, 31 de octubre de 2014
Clonidina caudal en niños/Caudal clonidine in children
Comparación de analgesia caudal con ropivacaína vs. ropivacaína con clonidina en niños. Estudio randomizado controlado
Comparison of caudal analgesia between ropivacaine and ropivacaine with clonidine in children: A randomized controlled trial.
Laha A, Ghosh S, Das H.
Saudi J Anaesth. 2012 Jul;6(3):197-200. doi: 10.4103/1658-354X.101199.
Abstract
BACKGROUND: Addition of clonidine to ropivacaine (0.2%) can potentially enhance analgesia without producing prolonged motor blockade. The aim of the present study was to compare the post-operative pain relieving quality of ropivacaine 0.2% and clonidine mixture to that of plain ropivacaine 0.2% following caudal administration in children. METHODS: In a prospective, double-blinded, randomized controlled trial, 30 ASA 1 pediatric patients undergoing infraumbilical surgery were randomly allocated to receive a caudal injection of either plain ropivacaine 0.2% (1 ml/kg) (group A) or a mixture of ropivacaine 0.2% (1 ml/kg) with clonidine 2 μg/kg (group B). Objective pain score and need for supplemental analgesics were compared during the 1(st) 24 hours postoperatively. Residual post-operative sedation and motor blockade were also assessed. RESULTS: Significantly prolonged duration of post-operative analgesia was observed in group B (P<0.0001). Heart rate and blood pressure were not different in 2 groups. Neither motor blockade nor post-operative sedation varied significantly between the groups. CONCLUSION: The combination of clonidine (2 μg/kg) and ropivacaine 0.2% was associated with an improved quality of post-operative analgesia compared to plain 0.2% ropivacaine. The improved analgesic quality of the clonidine-ropivacaine mixture was achieved without causing any significant degree of post-operative sedation or prolongation of motor blockade.
KEYWORDS:
Caudal; clonidine; infra-umbilical surgery; paediatrics; ropivacaine
http://www.saudija.org/downloadpdf.asp?issn=1658-354X;year=2012;volume=6;issue=3;spage=197;epage=200;aulast=Laha;type=2
Eficacia de clonidina como adyuvante de ropivacaína en analgesia caudal en niños con cirugía subumbilical
Efficacy of clonidine as an adjuvant to ropivacaine for caudal analgesia in children undergoing subumbilical surgery.
Manickam A, Vakamudi M, Parameswari A, Chetan C.
J Anaesthesiol Clin Pharmacol. 2012 Apr;28(2):185-9. doi: 10.4103/0970-9185.94839.
Abstract
CONTEXT: The use of clonidine as an adjuvant to ropivacaine in different concentrations through the caudal space has been shown to improve the analgesic efficacy of local anesthetics. AIMS: The purpose of our study was to compare the efficacy of ropivacaine 0.1% with clonidine 1 mcg/kg to that of plain 0.1% and 0.2% ropivacaine for caudal analgesia in children. SETTINGS AND DESIGN: Prospective, double blind, randomized controlled trial. MATERIALS AND METHODS: Sixty children in the age group of 1-6 years undergoing subumbilical surgeries were included in the study. Group A received 1 ml/kg of 0.1% ropivacaine, group B received 1 ml/kg of 0.1% ropivacaine with clonidine 1 mcg/kg, and group C received 1 ml/kg of 0.2% ropivacaine. RESULTS: The mean duration of analgesia was 243.7 ± 99.29 min in group A, 590.25 ± 83.93 min in group B, and 388.25 ± 82.35 min in group C. The duration of analgesia was significantly prolonged in group B compared to groups A and C with the P value of 0.001. At 8 h, all the 20 children in group A had received the first rescue analgesic compared to 18 children in group C and 3 children in group B. The duration of motor blockade after extubation was 30.6 ± 7.8 min and was noted only in group C. Only 1 child in group B received two rescue medications compared to 15 (75%) children in group A and 8 (40%) children in group C. None of the groups were treated for bradycardia or hypotension and no significant sedation was noted. CONCLUSIONS: Clonidine 1 mcg/kg with ropivacaine 0.1% prolongs the duration and quality of analgesia compared to plain ropivacaine 0.1% and 0.2% without any significant sedation.
KEYWORDS: Caudal analgesia; clonidine; ropivacaine
http://www.joacp.org/downloadpdf.asp?issn=0970-9185;year=2012;volume=28;issue=2;spage=185;epage=189;aulast=Manickam;type=2
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
Comparison of caudal analgesia between ropivacaine and ropivacaine with clonidine in children: A randomized controlled trial.
Laha A, Ghosh S, Das H.
Saudi J Anaesth. 2012 Jul;6(3):197-200. doi: 10.4103/1658-354X.101199.
Abstract
BACKGROUND: Addition of clonidine to ropivacaine (0.2%) can potentially enhance analgesia without producing prolonged motor blockade. The aim of the present study was to compare the post-operative pain relieving quality of ropivacaine 0.2% and clonidine mixture to that of plain ropivacaine 0.2% following caudal administration in children. METHODS: In a prospective, double-blinded, randomized controlled trial, 30 ASA 1 pediatric patients undergoing infraumbilical surgery were randomly allocated to receive a caudal injection of either plain ropivacaine 0.2% (1 ml/kg) (group A) or a mixture of ropivacaine 0.2% (1 ml/kg) with clonidine 2 μg/kg (group B). Objective pain score and need for supplemental analgesics were compared during the 1(st) 24 hours postoperatively. Residual post-operative sedation and motor blockade were also assessed. RESULTS: Significantly prolonged duration of post-operative analgesia was observed in group B (P<0.0001). Heart rate and blood pressure were not different in 2 groups. Neither motor blockade nor post-operative sedation varied significantly between the groups. CONCLUSION: The combination of clonidine (2 μg/kg) and ropivacaine 0.2% was associated with an improved quality of post-operative analgesia compared to plain 0.2% ropivacaine. The improved analgesic quality of the clonidine-ropivacaine mixture was achieved without causing any significant degree of post-operative sedation or prolongation of motor blockade.
KEYWORDS:
Caudal; clonidine; infra-umbilical surgery; paediatrics; ropivacaine
http://www.saudija.org/downloadpdf.asp?issn=1658-354X;year=2012;volume=6;issue=3;spage=197;epage=200;aulast=Laha;type=2
Eficacia de clonidina como adyuvante de ropivacaína en analgesia caudal en niños con cirugía subumbilical
Efficacy of clonidine as an adjuvant to ropivacaine for caudal analgesia in children undergoing subumbilical surgery.
Manickam A, Vakamudi M, Parameswari A, Chetan C.
J Anaesthesiol Clin Pharmacol. 2012 Apr;28(2):185-9. doi: 10.4103/0970-9185.94839.
Abstract
CONTEXT: The use of clonidine as an adjuvant to ropivacaine in different concentrations through the caudal space has been shown to improve the analgesic efficacy of local anesthetics. AIMS: The purpose of our study was to compare the efficacy of ropivacaine 0.1% with clonidine 1 mcg/kg to that of plain 0.1% and 0.2% ropivacaine for caudal analgesia in children. SETTINGS AND DESIGN: Prospective, double blind, randomized controlled trial. MATERIALS AND METHODS: Sixty children in the age group of 1-6 years undergoing subumbilical surgeries were included in the study. Group A received 1 ml/kg of 0.1% ropivacaine, group B received 1 ml/kg of 0.1% ropivacaine with clonidine 1 mcg/kg, and group C received 1 ml/kg of 0.2% ropivacaine. RESULTS: The mean duration of analgesia was 243.7 ± 99.29 min in group A, 590.25 ± 83.93 min in group B, and 388.25 ± 82.35 min in group C. The duration of analgesia was significantly prolonged in group B compared to groups A and C with the P value of 0.001. At 8 h, all the 20 children in group A had received the first rescue analgesic compared to 18 children in group C and 3 children in group B. The duration of motor blockade after extubation was 30.6 ± 7.8 min and was noted only in group C. Only 1 child in group B received two rescue medications compared to 15 (75%) children in group A and 8 (40%) children in group C. None of the groups were treated for bradycardia or hypotension and no significant sedation was noted. CONCLUSIONS: Clonidine 1 mcg/kg with ropivacaine 0.1% prolongs the duration and quality of analgesia compared to plain ropivacaine 0.1% and 0.2% without any significant sedation.
KEYWORDS: Caudal analgesia; clonidine; ropivacaine
http://www.joacp.org/downloadpdf.asp?issn=0970-9185;year=2012;volume=28;issue=2;spage=185;epage=189;aulast=Manickam;type=2
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
El té y los cítricos pueden prevenir el cáncer de ovario
http://www.madrimasd.org/informacionidi/noticias/noticia.asp?id=61933&origen=notiweb&dia_suplemento=miercoles
El té y los cítricos pueden prevenir el cáncer de ovario
Un taza de té y zumo de naranja puede ser una buena opción para prevenir el cáncer de ovario. Lo asegura un estudio de la Universidad de East Anglia (Gran Bretaña). La investigación revela que las mujeres que consumen alimentos que contienen flavonoles y flavanonas (ambas subclases de flavonoides de la dieta) disminuyen significativamente el riesgo de desarrollar cáncer de ovario epitelial, la quinta causa de muerte por cáncer entre las mujeres.
Los investigadores han analizado los hábitos alimenticios de 171.940 mujeres de edades comprendidas entre los 25 y 55 años durante más de tres décadas. Así han visto que aquellas que consumieron alimentos y bebidas con alto contenido de flavonoles (presente en el té, vino tinto, manzanas y uvas) y flavanonas (se encuentra en cítricos y zumos) eran menos propensas a desarrollar la enfermedad. Según señala Aedin Cassidy, directora del estudio que se publica en American Journal of Clinical Nutrition, este es el primer estudio a gran escala que analiza en si la ingesta habitual de diferentes flavonoides puede reducir el riesgo de cáncer de ovario epitelial. Y parece ser que sí: «hemos encontrado que las mujeres que consumen alimentos ricos en estos dos grupos de sustancias -flavonoles y flavanonas- tenían un riesgo significativamente menor de desarrollar cáncer de ovario epitelial. CAMBIOS EN LA DIETA La investigadora destaca que es importante que las principales fuentes de estos compuestos sean el té y los cítricos, que se incorporan fácilmente a la dieta. Esto sugiere, afirma, que simples cambios en la ingesta de alimentos podrían tener un impacto en la reducción del riesgo de cáncer de ovario. Por ejemplo, "beber dos tazas de té negro cada día se asociaba con una reducción del 31% en el riesgo de cáncer". La investigación es la primera en examinar la relación entre las seis principales subclases de flavonoides presentes en la dieta normal con el riesgo de cáncer de ovario, y la primera en investigar el impacto de los polímeros y antocianinas. Autor: S. Gutiérrez |
la importancia de la rehabilitación
http://www.madrimasd.org/informacionidi/noticias/noticia.asp?id=61930&origen=notiweb&dia_suplemento=miercoles
la importancia de la rehabilitación
Una de cada 6 personas va a sufrir un ictus. Solo en España el accidente cerebrovascular afecta a unas 120.000 personas cada año y deja con alguna discapacidad a alrededor del 40% (48.000), según datos de la Federación Española de Ictus (FEI). Julio es uno de esos 120.000 españoles al que el ictus le ha visitado. Aunque, como él mismo dice tuvo mucha suerte. "Tuve un ictus cerebeloso en 2011 y afortunadamente no me dejó secuelas cognitivas". Es decir, su capacidad de memoria, aprendizaje y hablar no se vio alterada. "Pero sí tuve secuelas físicas: equilibrio y coordinación. Y también ha perdido motricidad fina, fuerza y tono muscular". Es decir, nos cuenta, "la motricidad fina es el día a día y no te das cuenta hasta que no la pierdes: lavarse los dientes, atarse las zapatillas o escribir".
PREVENIR La probabilidad de tener un ictus aumenta en las personas que presentan ciertos factores de riesgo controlables como la hipertensión, el colesterol, el tabaquismo, el sedentarismo o la obesidad, entre otros. "El paciente puede actuar para modificarlos, disminuir e, incluso, evitar el accidente cerebrovascular", asegura Carmen Aleix, presidenta de la FEI, con motivo del Día Mundial de esta patología, que se celebra el 29 de octubre. Este año, bajo el lema La prevención del ictus es tu responsabilidad, la FEI quiere concienciar a los ciudadanos de la importancia de controlar los factores de riesgo. Pero además, hace hincapié en que el ictus «es cosa de todos, porque en la prevención y en la atención sociosanitaria todos contamos y todos somos corresponsables: pacientes, administración y profesionales». MUJERES Y MAYORES Según datos del Grupo de Estudio de Enfermedades Cerebrovasculares de la Sociedad Española de Neurología, el 30% de las personas que lo sufre fallece, es decir 36.000 cada año, y en el 40% provoca una discapacidad grave. Aunque también se produce en población joven, suele afectar más a personas mayores, al aumentarse el riesgo con la edad. La mejora de la atención a pacientes con ictus en España es uno de los objetivos estratégicos del Ministerio de Sanidad, Servicios Sociales e Igualdad desde que en 2008 se aprobara la Estrategia en Ictus del Sistema Nacional de Salud (SNS). Según la evaluación de esta estrategia, en general todas las comunidades autónomas han desarrollado de forma parcial la estructura necesaria para disponer de una red asistencial de Unidades o Equipos de Ictus de referencia accesibles en menos de 60 minutos, así como la implantación del código Ictus, de vías clínicas, protocolos o procesos asistenciales. "Por el momento son 12 las comunidades autónomas las que tienen totalmente implantado el código ictus en sus zonas básicas de salud, lo que significa prácticamente un 80% de zonas básicas cubiertas", apunta la presidenta de FEI, quien recalca la necesidad de tratar a los pacientes que sobreviven a un ictus. "Hasta el 45% presenta hemiparesia como secuela, hasta un 15% afasia (trastorno del habla), el 20% no podrá caminar, el 30% sufre depresión o deterioro cognitivo y entre el 20% y 55% precisaran de ayuda parcial o total", añade. FRENO AL ICTUS "Pero la rehabilitación no acaba cuando te dan alta", advierte Julio. "Ese es el momento más difícil porque dejas la rehabilitación controlada y tienes que hacerla tu". Julio se enganchó a la bicicleta, después de casi ahogarse en la piscina o de intentar correr arrastrando la pierna. ·Y eso que la bici necesita mucho equilibrio". Desde su ictus Julio se ha embarcado en proyecto de comunicación, Freno al Ictus, que nace con la única aspiración de sensibilizar al mayor número de personas sobre una enfermedad que es la primera causa de discapacidad en nuestro país. Gracias al deporte Julio ha ido recuperando su vida normal y por ello está muy presente en todos los proyectos y retos. El deporte, apunta, "ha sido y es una palanca fundamental en el proceso de recuperación y en la forma que tengo ahora de entender la vida". Autor: R. I. |
E-Books. Alerta
E-Books
Notificaciones semanales ⋅ 29 de octubre de 2014
NOTICIAS
Genbeta
Skoobe llega a España ofreciéndonos miles de eBooks en tarifa plana
Genbeta
Después de haberse consolidado en Alemania durante sus dos años y medio de existencia, Skoobe llega a España para ofrecernos la posibilidad de ...
Skoobe llega a España para ofrecernos una tarifa de plana eBooks - Todo eReaders
Cobertura total de la noticia
Te Interesa
La Biblioteca Central de Cantabria inicia el préstamo de libros electrónicos
El Periódico
Los libros se pueden leer desde e-Readers, ordenadores, tabletas y teléfonos móviles. Para estos dos últimos dispositivos se han generado app ...
Amazon alcanza acuerdo con Bonnier sobre la disputa por los E-Book
Vanguardia.com.mx
El acuerdo regula a largo plazo la venta de libros y E-Books de sus editoriales alemanas, informó Bonnier a última hora del martes. Amazon confirmó ...
Todo eReaders
El aeropuerto de San Antonio ofrece eBooks gratuitos a todos sus viajeros
Todo eReaders
Si hace unos cuantos meses conocimos la posibilidad de los viajeros del metro de poder conseguireBooks de forma gratuita para leer en los ...
¿Cómo descargar E-books de forma gratuita?
Terra España
Google Books: Entre los servicios del gigante de Internet se encuentra este, que permite a los usuarios consultar textos de cualquier materia o autor.
Todo eReaders
Tan sólo el 11% de los franceses lee eBooks
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Si ayer conocíamos un interesante estudio sobre la situación del mundo de la lectura digital en el Reino Unido, hoy hemos conocido un nuevo ...
Lectura terrorífica, ahora en E-books
El Nuevo Siglo (Colombia)
ADEMÁS DE disfrazarse y planear la fiesta más miedosa de toda la cuadra, en Halloween también se vale leer y qué mejor que obras que inspiraron ...
Todo eReaders
Las lecturas online podrían estar infectadas de malware
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No hace mucho os anunciamos que alguien se estaba dedicando a infectar los ebooks de Amazon con malware, algo que invadía nuestra seguridad ...
Cinco Días
Los libros electrónicos incentivan la lectura y no perjudican las ventas de libros impresos
Cinco Días
Es evidente que el menor precio de los ebooks tiene un papel importante, de hecho es la razón que esgrimen para este incremento de compras que, ...
WEB
eldiario.es on Twitter: "Ebooks en Europa: un mercado tradicional con falta de catálogo y precios ...
twitter.com
... Unblock Pending Cancel. eldiario.es @eldiarioes 9h9 hours ago. Ebooks en Europa: un mercado tradicional con falta de catálogo y precios altos ...
Biblioteconomía. Alerta
Biblioteconomía
Notificaciones semanales ⋅ 29 de octubre de 2014
NOTICIAS
Microponencias 2014 este jueves en la Facultad de Biblioteconomía y Documentación
Hoy Digital
Microponencias 2014 es un acto abierto al público en el que escritores y profesores del Centro de Estudios Literarios Antonio Román Díez, ...
InfonorteDigital
El profesor Francisco Javier García Gómez, ponente del XVI Encuentro de Bibliotecarios ...
InfonorteDigital
Tiene publicados varios artículos en revistas especializadas en Biblioteconomía. Ha participado en jornadas, congresos, etc. del ramo de bibliotecas ...
WEB
Prácticas Biblioteconomía en Torrejón de Ardoz
Empleo - Universia
Oferta de trabajo de esPRÁCTICAS como Prácticas Biblioteconomía en Torrejón de Ardoz. Inscríbete a esta oferta de empleo. Y busca otras ...
Clonidina caudal en pediatría/Caudal clonidine in pediatrics
La adición de clonidina a la anestesia caudal en niños aumenta la duración de la analgesia postoperatoria
Addition of clonidine in caudal anesthesia in children increases duration of post-operative analgesia.
Lak M, Araghizadeh H, Shayeghi S, Khatibi B.
Trauma Mon. 2012 Jan;16(4):170-4. doi: 10.5812/kowsar.22517464.3393. Epub 2012 Jan 15.
Abstract
BACKGROUND: Pain in infancy is a developmental process. Due to the underdeveloped pain pathways in the spinal cord, the threshold of stimulation and sensation of pain is low at birth and has potential impacts on increasing the central effects of pain. Primary trauma during infancy can cause long term changes in structure and function of pain pathways that continue until adulthood. Lack of pain management in children can result in morbidity and mortality. OBJECTIVES: In this study we examined the duration of post-operative analgesia in children when clonidine is added to bupivacaine in caudal anesthesia. MATERIALS AND METHODS: In this clinical trial, 40 children aged 1-8 years who were candidates for elective inguinal hernia repair were studied. Induction and maintenance of anesthesia were achieved using sodium thiopenthal, halothane and nitrous oxide. Children were randomly divided into 2 groups in a double-blind fashion, and were given caudal anesthesia with 0.125% bupivacaine (1ml/kg) alone or b bupivacaine plus 2 μg/kg clonidine. Blood pressure and heart rate were recorded peri-operatively. Analgesia was evaluated using objective pain scale (OPS) and sedation was assessed using Ramsay sedation scale (RSS). Acetaminophen was administered rectally for cases with OPS score greater than five. RESULTS: Duration of analgesia was found to be significantly longer in the group given bupivacaine plus clonidine (mean 417.50 min vs. 162.00 min). Peri-operative hypotension or bradycardia, post-operative respiratory depression, nausea or vomiting were not recorded in any patient. CONCLUSIONS: We concluded that addition of clonidine to bupivacaine prolongs the duration of post-operative analgesia without any respiratory or hemodynamic side-effects.
KEYWORDS:Analgesia; Anesthesia; Bupivacaine; Caudal; Clonidine
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3989567/pdf/traumamon-16-170.pdf
Analgesia postoperatoria en niños utilizando clonidina o fentanilo con ropivacaína caudal
Postoperative analgesia in children when using clonidine or fentanyl with ropivacaine given caudally.
Shukla U, Prabhakar T, Malhotra K.
J Anaesth Clin Pharcol 2011;27:205.
Abstract
BACKGROUND:The aim of the study was to compare the efficacy of clonidine and fentanyl as an additive to ropivacaine given via single shot caudal epidural in pediatric patients for postoperative pain relief. MATERIALS AND METHODS:In the present double blind study, 90 children of ASA-I-II aged 3-8 years scheduled for infraumblical surgical procedures were randomly allocated to two groups to receive either ropivacaine 0.25% 1 ml/kg + clonidine 2 μg/kg (group I) or ropivacaine 0.25% 1 μl/kg + fentanyl 1 μg/kg (group II). Caudal block was performed after the induction of general anesthesia. Postoperatively patients were observed for analgesia, sedation, hemodynamics, and side effects/complications. RESULTS: Both the groups were similar with respect to patient and various block characteristics. The analgesic properties and hemodynamics were also comparable in both groups (P > 0.05). Side effects such as respiratory depression, vomiting bradycardia were significantly less in group I than group II (P < 0.05) ensuing more patient comfort. CONCLUSIONS: The analgesic properties of clonidine and fentanyl as additives to ropivacaine in single shot caudal epidural in children are comparable but clonidine offers a more favorable side effect profile. The use of clonidine as additive to ropivacaine in caudal epidural is superior choice to fentanyl because of lack of unwanted side effects and increased patient comfort.
KEYWORDS: Caudal epidural; clonidine; fentanyl; pediatric; postoperative analgesia; ropivacaine
http://www.joacp.org/downloadpdf.asp?issn=0970-9185;year=2011;volume=27;issue=2;spage=205;epage=210;aulast=Shukla;type=2
Clonidina caudal para reducción abierta de cadera en pacientes pediátricos
Dra. María de Lourdes González-Flores, Dr. Efraín Peralta-Zamora, Dra. Guadalupe Zaragoza-Lemus,*Dr. Salomón Sergio Flores-Hernández
Rev Mex Anestesiol Vol. 30. No. 4 Octubre-Diciembre 2007 pp 201-207
http://www.medigraphic.com/pdfs/rma/cma-2007/cma074e.pdf
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
Addition of clonidine in caudal anesthesia in children increases duration of post-operative analgesia.
Lak M, Araghizadeh H, Shayeghi S, Khatibi B.
Trauma Mon. 2012 Jan;16(4):170-4. doi: 10.5812/kowsar.22517464.3393. Epub 2012 Jan 15.
Abstract
BACKGROUND: Pain in infancy is a developmental process. Due to the underdeveloped pain pathways in the spinal cord, the threshold of stimulation and sensation of pain is low at birth and has potential impacts on increasing the central effects of pain. Primary trauma during infancy can cause long term changes in structure and function of pain pathways that continue until adulthood. Lack of pain management in children can result in morbidity and mortality. OBJECTIVES: In this study we examined the duration of post-operative analgesia in children when clonidine is added to bupivacaine in caudal anesthesia. MATERIALS AND METHODS: In this clinical trial, 40 children aged 1-8 years who were candidates for elective inguinal hernia repair were studied. Induction and maintenance of anesthesia were achieved using sodium thiopenthal, halothane and nitrous oxide. Children were randomly divided into 2 groups in a double-blind fashion, and were given caudal anesthesia with 0.125% bupivacaine (1ml/kg) alone or b bupivacaine plus 2 μg/kg clonidine. Blood pressure and heart rate were recorded peri-operatively. Analgesia was evaluated using objective pain scale (OPS) and sedation was assessed using Ramsay sedation scale (RSS). Acetaminophen was administered rectally for cases with OPS score greater than five. RESULTS: Duration of analgesia was found to be significantly longer in the group given bupivacaine plus clonidine (mean 417.50 min vs. 162.00 min). Peri-operative hypotension or bradycardia, post-operative respiratory depression, nausea or vomiting were not recorded in any patient. CONCLUSIONS: We concluded that addition of clonidine to bupivacaine prolongs the duration of post-operative analgesia without any respiratory or hemodynamic side-effects.
KEYWORDS:Analgesia; Anesthesia; Bupivacaine; Caudal; Clonidine
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3989567/pdf/traumamon-16-170.pdf
Analgesia postoperatoria en niños utilizando clonidina o fentanilo con ropivacaína caudal
Postoperative analgesia in children when using clonidine or fentanyl with ropivacaine given caudally.
Shukla U, Prabhakar T, Malhotra K.
J Anaesth Clin Pharcol 2011;27:205.
Abstract
BACKGROUND:The aim of the study was to compare the efficacy of clonidine and fentanyl as an additive to ropivacaine given via single shot caudal epidural in pediatric patients for postoperative pain relief. MATERIALS AND METHODS:In the present double blind study, 90 children of ASA-I-II aged 3-8 years scheduled for infraumblical surgical procedures were randomly allocated to two groups to receive either ropivacaine 0.25% 1 ml/kg + clonidine 2 μg/kg (group I) or ropivacaine 0.25% 1 μl/kg + fentanyl 1 μg/kg (group II). Caudal block was performed after the induction of general anesthesia. Postoperatively patients were observed for analgesia, sedation, hemodynamics, and side effects/complications. RESULTS: Both the groups were similar with respect to patient and various block characteristics. The analgesic properties and hemodynamics were also comparable in both groups (P > 0.05). Side effects such as respiratory depression, vomiting bradycardia were significantly less in group I than group II (P < 0.05) ensuing more patient comfort. CONCLUSIONS: The analgesic properties of clonidine and fentanyl as additives to ropivacaine in single shot caudal epidural in children are comparable but clonidine offers a more favorable side effect profile. The use of clonidine as additive to ropivacaine in caudal epidural is superior choice to fentanyl because of lack of unwanted side effects and increased patient comfort.
KEYWORDS: Caudal epidural; clonidine; fentanyl; pediatric; postoperative analgesia; ropivacaine
http://www.joacp.org/downloadpdf.asp?issn=0970-9185;year=2011;volume=27;issue=2;spage=205;epage=210;aulast=Shukla;type=2
Clonidina caudal para reducción abierta de cadera en pacientes pediátricos
Dra. María de Lourdes González-Flores, Dr. Efraín Peralta-Zamora, Dra. Guadalupe Zaragoza-Lemus,*Dr. Salomón Sergio Flores-Hernández
Rev Mex Anestesiol Vol. 30. No. 4 Octubre-Diciembre 2007 pp 201-207
http://www.medigraphic.com/pdfs/rma/cma-2007/cma074e.pdf
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
¿Facilita la dexmedetomidina como adyuvante neuroaxial una mejor anestesia y analgesia? Revisión sistemática y meta-análisis
¿Facilita la dexmedetomidina como adyuvante neuroaxial una mejor anestesia y analgesia? Revisión sistemática y meta-análisis.
Does dexmedetomidine as a neuraxial adjuvant facilitate better anesthesia and analgesia? A systematic review and meta-analysis.
Wu HH, Wang HT, Jin JJ, Cui GB, Zhou KC, Chen Y, Chen GZ, Dong YL, Wang W.
PLoS One. 2014 Mar 26;9(3):e93114. doi: 10.1371/journal.pone.0093114. eCollection 2014.
Abstract
BACKGROUND: Neuraxial application of dexmedetomidine (DEX) as adjuvant analgesic has been invetigated in some randomized controlled trials (RCTs) but not been approved because of the inconsistency of efficacy and safety in these RCTs. We performed this meta-analysis to access the efficacy and safety of neuraxial DEX as local anaesthetic (LA) adjuvant. ...... CONCLUSION: Neuraxial DEX is a favorable LA adjuvant with better and longer analgesia. The greatest concern is bradycardia. Further large sample trials with strict design and focusing on long-term outcomes are needed.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3966844/pdf/pone.0093114.pdf
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
Does dexmedetomidine as a neuraxial adjuvant facilitate better anesthesia and analgesia? A systematic review and meta-analysis.
Wu HH, Wang HT, Jin JJ, Cui GB, Zhou KC, Chen Y, Chen GZ, Dong YL, Wang W.
PLoS One. 2014 Mar 26;9(3):e93114. doi: 10.1371/journal.pone.0093114. eCollection 2014.
Abstract
BACKGROUND: Neuraxial application of dexmedetomidine (DEX) as adjuvant analgesic has been invetigated in some randomized controlled trials (RCTs) but not been approved because of the inconsistency of efficacy and safety in these RCTs. We performed this meta-analysis to access the efficacy and safety of neuraxial DEX as local anaesthetic (LA) adjuvant. ...... CONCLUSION: Neuraxial DEX is a favorable LA adjuvant with better and longer analgesia. The greatest concern is bradycardia. Further large sample trials with strict design and focusing on long-term outcomes are needed.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3966844/pdf/pone.0093114.pdf
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
Dermatitis Atópica y Lactancia Materna
Estimado Pediatra te invito al Seminario de Pediatría, Cirugía Pediátrica y Lactancia Materna. El día 5 de Noviembre 2014 las 21hrs (Centro, México DF, Guadalajara y Lima Perú) a la Conferencia: “Dermatitis Atópica y Lactancia Materna” por el “Dr. Mario Magaña Garcia”, Dermatólogo Pediatra de México DF. La sesión inicia puntualmente las 21 hrs.
Para entrar a la Sala de Conferencia:
1.- hacer click en la siguiente liga, o cópiala y escríbela en tu buscador http://connectpro60196372.adobeconnect.com/lactancia_dermatitis/
2.- “Entra como Invitado” Escribes tu nombre y apellido en el espacio en blanco
3.- Hacer click en el espacio que dice “Entrar en la Sala”
5.- A disfrutar la conferencia
Para entrar a la Sala de Conferencia:
1.- hacer click en la siguiente liga, o cópiala y escríbela en tu buscador http://connectpro60196372.adobeconnect.com/lactancia_dermatitis/
2.- “Entra como Invitado” Escribes tu nombre y apellido en el espacio en blanco
3.- Hacer click en el espacio que dice “Entrar en la Sala”
5.- A disfrutar la conferencia
6.- Recomendamos que dejes tu Nombre Completo, Correo electrónico y que participes.
Henrys
Dr. Enrique Mendoza López
Webmaster: CONAPEME
Coordinador Nacional: Seminario Ciberpeds-Conapeme
Av La clinica 2520-310
Colonia Sertoma ,Mty N.L. México
CP 64710
Tel-Fax 52 81 83482940 y 52 81 81146053
Celular 8183094806
www.conapeme.org
www.pediatramendoza.com
enrique@pediatramendoza.com
emendozal@yahoo.com.mx
Henrys
Dr. Enrique Mendoza López
Webmaster: CONAPEME
Coordinador Nacional: Seminario Ciberpeds-Conapeme
Av La clinica 2520-310
Colonia Sertoma ,Mty N.L. México
CP 64710
Tel-Fax 52 81 83482940 y 52 81 81146053
Celular 8183094806
www.conapeme.org
www.pediatramendoza.com
enrique@pediatramendoza.com
emendozal@yahoo.com.mx
martes, 28 de octubre de 2014
Finlandia ama los libros y lo expresa en acciones públicas como sus bibliotecas
'Richard D'Bury' richardebury@gmail.com [richardebury]
oct24 a las 8:31 A.M.
Un buen artículo de prensa salió el 4 de octubre en Babelia, una de las secciones del diario El País. Es sobre cómo Finlandia ama los libros y lo expresa en acciones públicas como sus bibliotecas.
Un dato de la causa. Cada finlandés lee un promedio de 47 libros al año y no importa si es papel o digital, la cosa es que son libros y los leen.
El artículo es extenso, para leer en casa. Yo me acordé de él ahora y se los comparto.
http://goo.gl/4iJMso
Saludos,
Patricio Pastor Howard
Bibliotecólogo
oct24 a las 8:31 A.M.
Un buen artículo de prensa salió el 4 de octubre en Babelia, una de las secciones del diario El País. Es sobre cómo Finlandia ama los libros y lo expresa en acciones públicas como sus bibliotecas.
Un dato de la causa. Cada finlandés lee un promedio de 47 libros al año y no importa si es papel o digital, la cosa es que son libros y los leen.
El artículo es extenso, para leer en casa. Yo me acordé de él ahora y se los comparto.
http://goo.gl/4iJMso
Saludos,
Patricio Pastor Howard
Bibliotecólogo
Nicotina y analgesia/Nicotine and analgesia
Receptores nicotínicos neuronales como dianas analgésicas. Es un camino sinuoso
Neuronal nicotinic receptors as analgesic targets: it's a winding road.
Umana IC1, Daniele CA, McGehee DS.
Biochem Pharmacol. 2013 Oct 15;86(8):1208-14. doi: 10.1016/j.bcp.2013.08.001. Epub 2013 Aug 12.
Abstract
Along with their well known role in nicotine addiction and autonomic physiology, neuronal nicotinic receptors (nAChRs) also have profound analgesic effects in animal models and humans. This is not a new idea, even in the early 1500s, soon after tobacco was introduced to the new world, its proponents listed pain relief among the beneficial properties of smoking. In recent years, analgesics that target specific nAChR subtypes have shown highly efficacious antinociceptive properties in acute and chronic pain models. To date, the side effects of these drugs have precluded their advancement to the clinic. This review summarizes the recent efforts to identify novel analgesics that target nAChRs, and outlines some of the key neural substrates that contribute to these physiological effects. There remain many unanswered mechanistic questions in this field, and there are still compelling reasons to explore neuronal nAChRs as targets for the relief of pain.
KEYWORDS:Analgesia; Nicotinic; Nociception; Pain
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4127197/pdf/nihms515177.pdf
Parche transdémico de nicotina como modalidad analgésica adyuvante de la analgesia torácica epidural en dolor postoracotomía
Transdermal nicotine patch as adjunctive analgesic modality to thoracic epidural analgesia for post-thoracotomy pain.
Nagy HI, ElKadi HW.
Egypt J Cardiothorac Anesth [serial online] 2014 [cited 2014 Oct 20];8:75-82.
Abstract
Objective. The aim of the study was to evaluate the applicability of transdermal nicotine patch (TNP) as an analgesic modality adjunctive to thoracic epidural analgesia (TEA) for patients undergoing thoracotomy. Patients and methods. The current study included 100 adult nonsmoker male patients assigned to undergo thoracotomy and resection for lung cancer. Patients were randomly allocated into two equal groups: group N received TNP (5 mg/16 h) applied to glabrous skin immediately before induction of anesthesia and group C included patients who received placebo patch. All patients received bupivacaine (0.125%) TEA initiated at the time of induction of anesthesia until 48 h postoperative (PO). All patients received a β-lactam antibiotic as prophylactic and PO antibiotic. Rescue analgesia was provided as increments of dose of epidural bupivacaine until 48 h PO, and thereafter as intravenous meperidine 50 mg. PO pain was assessed using 10-point visual analog scale (VAS) and rescue analgesia was given if VAS was greater than 4. Intraoperative variability of heart rate and blood pressure measures, the frequency of requests for PO rescue analgesia, and the frequency of postoperative nausea and vomiting (PONV) were recorded. Results. Epidural analgesia induced significant decrease in systolic arterial blood pressure and mean arterial blood pressure estimated at the end of surgery in both groups. Nicotine induced significantly higher heart rate compared with baseline measures in group N. Mean systolic arterial blood pressure and mean arterial blood pressure measures estimated at the end of surgery were significantly higher in group N compared with group C. Pain VAS scores were significantly lower in group N compared with group C throughout the first 48 h after admission to ICU, but thereafter pain VAS scores were significantly higher as against that determined at 48 h after ICU admission, in both groups. Pain VAS scores were significantly lower in group N compared with group C after removal of epidural catheter until 80 h after the end of surgery. The number of requests of rescue analgesia was significantly higher in group C compared with group N. TNP significantly reduced the number of requests of rescue analgesia after removal of epidural catheter in comparison with placebo. The frequency of PONV was significantly higher in group N compared with group C. Conclusion. TNP could be considered as appropriate adjuvant analgesic to TEA for patients who had thoracotomy during early PO period and could be used as the sole analgesic after cessation of TEA. Prophylactic antiemetics were advocated to guard against the high possibility of development of PONV.
Keywords: Post-thoracotomy pain, thoracic epidural analgesia, transdermal nicotine patch
http://www.ejca.eg.net/downloadpdf.asp?issn=1687-9090;year=2014;volume=8;issue=2;spage=75;epage=82;aulast=Nagy;type=2
http://www.ejca.eg.net/temp/EgyptJCardiothoracAnesth8275-3220565_085645.pdf
http://www.ejca.eg.net/text.asp?2014/8/2/75/143268
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
Neuronal nicotinic receptors as analgesic targets: it's a winding road.
Umana IC1, Daniele CA, McGehee DS.
Biochem Pharmacol. 2013 Oct 15;86(8):1208-14. doi: 10.1016/j.bcp.2013.08.001. Epub 2013 Aug 12.
Abstract
Along with their well known role in nicotine addiction and autonomic physiology, neuronal nicotinic receptors (nAChRs) also have profound analgesic effects in animal models and humans. This is not a new idea, even in the early 1500s, soon after tobacco was introduced to the new world, its proponents listed pain relief among the beneficial properties of smoking. In recent years, analgesics that target specific nAChR subtypes have shown highly efficacious antinociceptive properties in acute and chronic pain models. To date, the side effects of these drugs have precluded their advancement to the clinic. This review summarizes the recent efforts to identify novel analgesics that target nAChRs, and outlines some of the key neural substrates that contribute to these physiological effects. There remain many unanswered mechanistic questions in this field, and there are still compelling reasons to explore neuronal nAChRs as targets for the relief of pain.
KEYWORDS:Analgesia; Nicotinic; Nociception; Pain
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4127197/pdf/nihms515177.pdf
Parche transdémico de nicotina como modalidad analgésica adyuvante de la analgesia torácica epidural en dolor postoracotomía
Transdermal nicotine patch as adjunctive analgesic modality to thoracic epidural analgesia for post-thoracotomy pain.
Nagy HI, ElKadi HW.
Egypt J Cardiothorac Anesth [serial online] 2014 [cited 2014 Oct 20];8:75-82.
Abstract
Objective. The aim of the study was to evaluate the applicability of transdermal nicotine patch (TNP) as an analgesic modality adjunctive to thoracic epidural analgesia (TEA) for patients undergoing thoracotomy. Patients and methods. The current study included 100 adult nonsmoker male patients assigned to undergo thoracotomy and resection for lung cancer. Patients were randomly allocated into two equal groups: group N received TNP (5 mg/16 h) applied to glabrous skin immediately before induction of anesthesia and group C included patients who received placebo patch. All patients received bupivacaine (0.125%) TEA initiated at the time of induction of anesthesia until 48 h postoperative (PO). All patients received a β-lactam antibiotic as prophylactic and PO antibiotic. Rescue analgesia was provided as increments of dose of epidural bupivacaine until 48 h PO, and thereafter as intravenous meperidine 50 mg. PO pain was assessed using 10-point visual analog scale (VAS) and rescue analgesia was given if VAS was greater than 4. Intraoperative variability of heart rate and blood pressure measures, the frequency of requests for PO rescue analgesia, and the frequency of postoperative nausea and vomiting (PONV) were recorded. Results. Epidural analgesia induced significant decrease in systolic arterial blood pressure and mean arterial blood pressure estimated at the end of surgery in both groups. Nicotine induced significantly higher heart rate compared with baseline measures in group N. Mean systolic arterial blood pressure and mean arterial blood pressure measures estimated at the end of surgery were significantly higher in group N compared with group C. Pain VAS scores were significantly lower in group N compared with group C throughout the first 48 h after admission to ICU, but thereafter pain VAS scores were significantly higher as against that determined at 48 h after ICU admission, in both groups. Pain VAS scores were significantly lower in group N compared with group C after removal of epidural catheter until 80 h after the end of surgery. The number of requests of rescue analgesia was significantly higher in group C compared with group N. TNP significantly reduced the number of requests of rescue analgesia after removal of epidural catheter in comparison with placebo. The frequency of PONV was significantly higher in group N compared with group C. Conclusion. TNP could be considered as appropriate adjuvant analgesic to TEA for patients who had thoracotomy during early PO period and could be used as the sole analgesic after cessation of TEA. Prophylactic antiemetics were advocated to guard against the high possibility of development of PONV.
Keywords: Post-thoracotomy pain, thoracic epidural analgesia, transdermal nicotine patch
http://www.ejca.eg.net/downloadpdf.asp?issn=1687-9090;year=2014;volume=8;issue=2;spage=75;epage=82;aulast=Nagy;type=2
http://www.ejca.eg.net/temp/EgyptJCardiothoracAnesth8275-3220565_085645.pdf
http://www.ejca.eg.net/text.asp?2014/8/2/75/143268
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
Clonidina espinal en ortopedia/Spinal clonidine in orthopaedics
Evaluación de la combinación bupivacaína-clonidina para raquia unilateral en cirugía ortopédica por debajo de la rodilla
Evaluation of bupivacaine-clonidine combination for unilateral spinal anesthesia in lower limb below-knee orthopedic surgery.
Sapate M, Sahu P, Shah B, Suryawanshi C, Kulkarni A, Panditrao MM.
Saudi J Anaesth. 2014 Jul;8(3):384-7. doi: 10.4103/1658-354X.136626.
Abstract
BACKGROUND AND OBJECTIVES: The purposes of this study were to evaluate the onset, quality and duration of sensory and motor blockade between hyperbaric bupivacaine and clonidine combination with bupivacaine alone when administered intrathecally for unilateral spinal anesthesia in below-knee orthopedic surgery, efficacy of clonidine for post-operative analgesia and side-effects of clonidine, if any. METHODS:Sixty ASA I and ASA II patients scheduled for elective surgery with time duration up to 90 min were studied. Patients were randomised in two equal groups by the lottery method. Group A (control group) was given Inj. bupivacaine (hyperbaric) 0.5% - 12.5 mg (2.5 ml) + 0.5 ml of normal saline intrathecally. Group B (clonidine group) was given Inj. bupivacaine (hyperbaric) 0.5% - 12.5 mg (2.5 ml) + 50 mcg clonidine in 0.5 ml volume intrathecally. RESULTS: The mean peak sensory block was earlier in Group B (4.7±1.23 min) as compared with Group A (6.27±1.51 min). The mean peak motor block was earlier in Group B (6.17±1.20 min) as compared with Group A (8.63±1.71 min). The two-segment regression of sensory block was longer in Group B (106.23±9.17 min) as compared with Group A (104.43±17.75 min), which is clinically significant. Requirement of rescue analgesia was considerably prolonged in Group B (450.33±95.10 min) as compared with Group A (220±36.36 min), which was also clinically highly significant. CONCLUSION: Intrathecal clonidine potentiates bupivacaine induced spinal sensory block and, motor block and reduces the analgesic requirement in the early post-operative period in nilateral spinal anesthesia for lower limb below knee surgery.
KEYWORDS:Below-knee surgery; bupivacaine; clonidine; intrathecal
http://www.saudija.org/downloadpdf.asp?issn=1658-354X;year=2014;volume=8;issue=3;spage=384;epage=387;aulast=Sapate;type=2
Clonidina como adyuvante de bupivacaína hiperbárica en raquia para viejos sometidos a cirugía ortopédica de extremidades inferiores
Clonidine as an adjuvant to hyperbaric bupivacaine for spinal anesthesia in elderly patients undergoing lower limb orthopedic surgeries.
Agarwal D, Chopra M, Mohta M, Sethi AK.
Saudi J Anaesth. 2014 Apr;8(2):209-14. doi: 10.4103/1658-354X.130720.
Abstract
BACKGROUND: In elderly patients, use of adjuvant with small doses of local anesthetics is a preferred technique for spinal anesthesia for lower limb surgeries. This study tested the hypothesis that addition of small doses of clonidine augments the spinal block levels produced by hyperbaric bupivacaine in elderly without affecting the side-effects if any of clonidine in these patients. MATERIALS AND METHODS: This was a prospective, randomized, double-blind study. Above 60 years male patients were allocated to three equal groups. Group C received 9 mg hyperbaric bupivacaine without clonidine while Group C15 and Group C30 received 15 μg and 30 μg clonidine with hyperbaric bupivacaine respectively for spinal anesthesia. Effect of clonidine on sensory block levels was the primary study outcome measure. Motor blockade and hemodynamic parameters were also studied. RESULTS: A significantly higher median block levels were achieved in Group C15 (P < 0.001) and Group C30 (P = 0.015) than Group C. Highest median sensory block level, the mean times for sensory regression to T12 level and motor block regression were statistically significant between Groups C15 and C and between Groups C30 and C. On comparison of fall in systolic blood pressure trends, there was no significant difference in theclonidine groups as compared with the control group. CONCLUSIONS: In elderly patients, clonidine when used intrathecally in doses of 15 μg or 30 μg with bupivacaine, significantly potentiated the sensory block levels and duration of analgesia without affecting the trend of systolic blood pressure as compared to bupivacaine alone. Clonidine in doses of 30 μg however facilitated the ascent of sensory level block to unexpectedly higher dermatomes for a longer time.
KEYWORDS: Clonidine; elderly; spinal anesthesia
http://www.saudija.org/downloadpdf.asp?issn=1658-354X;year=2014;volume=8;issue=2;spage=209;epage=214;aulast=Agarwal;type=2
Comparación de dexmedetomidina, clonidina y fentanil intratecales como adyuvantes de bupivacaína espinal para cirugía de extremidad inferior
A comparison of intrathecal dexmedetomidine, clonidine, and fentanyl as adjuvants to hyperbaric bupivacainefor lower limb surgery: A double blind controlled study.
Mahendru V, Tewari A, Katyal S, Grewal A, Singh MR, Katyal R.
J Anaesthesiol Clin Pharmacol. 2013 Oct;29(4):496-502. doi: 10.4103/0970-9185.119151.
Abstract
BACKGROUND: Various adjuvants are being used with local anesthetics for prolongation of intraoperative and postoperative analgesia. Dexmedetomidine, the highly selective 2 adrenergic agonist is a new neuraxial adjuvant gaining popularity. SETTINGS AND DESIGN: The study was conducted in prospective, double blind manner. It included 120 American Society of Anesthesiology (ASA) class I and II patients undergoing lower limb surgery under spinal anesthesia after approval from hospital ethics committee with written and informed consent of patients. MATERIALS AND METHODS: The patients were randomly allocated into four groups (30 patients each). Group BS received 12.5 mg hyperbaricbupivacaine with normal saline, group BF received 12.5 mg bupivacaine with 25 g fentanyl, group BC received 12.5 mg of bupivacaine supplemented 30 g clonidine, and group BD received 12.5 mg bupivacaine plus 5 g dexmedetomidine. The onset time to reach peak sensory and motor level, the regression time of sensory and motor block, hemodynamic changes, and side effects were recorded. RESULTS: Patients in Group BD had significantly longer sensory and motor block times than patients in Groups BC, BF, and BS with Groups BC and BF having comparable duration of sensory and motor block. The mean time of two segment sensory block regression was 147 ± 21 min in Group BD, 117 ± 22 in Group BC, 119 ± 23 in Group BF, and 102 ± 17 in Group BS (P > 0.0001). The regression time of motor block to reach modified Bromage zero (0) was 275 ± 25, 199 ± 26, 196 ± 27, 161 ± 20 in Group BD, BC, BF, and BS, respectively (P > 0.0001). The onset times to reach T8 dermatome and modified Bromage 3 motor block were not significantly different between the groups. Dexmedetomidine group showed significantly less and delayed requirement of rescue analgesic. CONCLUSIONS: Intrathecal dexmedetomidine is associated with prolonged motor and sensory block, hemodynamic stability, and reduced demand of rescue analgesics in 24 h as compared to clonidine, fentanyl, or lone bupivacaine. KEYWORDS: adrenoreceptor agonist; bupivacaine; clonidine; dexmedetomidine; fentanyl; spinal anesthesia; α2
http://www.joacp.org/downloadpdf.asp?issn=0970-9185;year=2013;volume=29;issue=4;spage=496;epage=502;aulast=Mahendru;type=2
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
Evaluation of bupivacaine-clonidine combination for unilateral spinal anesthesia in lower limb below-knee orthopedic surgery.
Sapate M, Sahu P, Shah B, Suryawanshi C, Kulkarni A, Panditrao MM.
Saudi J Anaesth. 2014 Jul;8(3):384-7. doi: 10.4103/1658-354X.136626.
Abstract
BACKGROUND AND OBJECTIVES: The purposes of this study were to evaluate the onset, quality and duration of sensory and motor blockade between hyperbaric bupivacaine and clonidine combination with bupivacaine alone when administered intrathecally for unilateral spinal anesthesia in below-knee orthopedic surgery, efficacy of clonidine for post-operative analgesia and side-effects of clonidine, if any. METHODS:Sixty ASA I and ASA II patients scheduled for elective surgery with time duration up to 90 min were studied. Patients were randomised in two equal groups by the lottery method. Group A (control group) was given Inj. bupivacaine (hyperbaric) 0.5% - 12.5 mg (2.5 ml) + 0.5 ml of normal saline intrathecally. Group B (clonidine group) was given Inj. bupivacaine (hyperbaric) 0.5% - 12.5 mg (2.5 ml) + 50 mcg clonidine in 0.5 ml volume intrathecally. RESULTS: The mean peak sensory block was earlier in Group B (4.7±1.23 min) as compared with Group A (6.27±1.51 min). The mean peak motor block was earlier in Group B (6.17±1.20 min) as compared with Group A (8.63±1.71 min). The two-segment regression of sensory block was longer in Group B (106.23±9.17 min) as compared with Group A (104.43±17.75 min), which is clinically significant. Requirement of rescue analgesia was considerably prolonged in Group B (450.33±95.10 min) as compared with Group A (220±36.36 min), which was also clinically highly significant. CONCLUSION: Intrathecal clonidine potentiates bupivacaine induced spinal sensory block and, motor block and reduces the analgesic requirement in the early post-operative period in nilateral spinal anesthesia for lower limb below knee surgery.
KEYWORDS:Below-knee surgery; bupivacaine; clonidine; intrathecal
http://www.saudija.org/downloadpdf.asp?issn=1658-354X;year=2014;volume=8;issue=3;spage=384;epage=387;aulast=Sapate;type=2
Clonidina como adyuvante de bupivacaína hiperbárica en raquia para viejos sometidos a cirugía ortopédica de extremidades inferiores
Clonidine as an adjuvant to hyperbaric bupivacaine for spinal anesthesia in elderly patients undergoing lower limb orthopedic surgeries.
Agarwal D, Chopra M, Mohta M, Sethi AK.
Saudi J Anaesth. 2014 Apr;8(2):209-14. doi: 10.4103/1658-354X.130720.
Abstract
BACKGROUND: In elderly patients, use of adjuvant with small doses of local anesthetics is a preferred technique for spinal anesthesia for lower limb surgeries. This study tested the hypothesis that addition of small doses of clonidine augments the spinal block levels produced by hyperbaric bupivacaine in elderly without affecting the side-effects if any of clonidine in these patients. MATERIALS AND METHODS: This was a prospective, randomized, double-blind study. Above 60 years male patients were allocated to three equal groups. Group C received 9 mg hyperbaric bupivacaine without clonidine while Group C15 and Group C30 received 15 μg and 30 μg clonidine with hyperbaric bupivacaine respectively for spinal anesthesia. Effect of clonidine on sensory block levels was the primary study outcome measure. Motor blockade and hemodynamic parameters were also studied. RESULTS: A significantly higher median block levels were achieved in Group C15 (P < 0.001) and Group C30 (P = 0.015) than Group C. Highest median sensory block level, the mean times for sensory regression to T12 level and motor block regression were statistically significant between Groups C15 and C and between Groups C30 and C. On comparison of fall in systolic blood pressure trends, there was no significant difference in theclonidine groups as compared with the control group. CONCLUSIONS: In elderly patients, clonidine when used intrathecally in doses of 15 μg or 30 μg with bupivacaine, significantly potentiated the sensory block levels and duration of analgesia without affecting the trend of systolic blood pressure as compared to bupivacaine alone. Clonidine in doses of 30 μg however facilitated the ascent of sensory level block to unexpectedly higher dermatomes for a longer time.
KEYWORDS: Clonidine; elderly; spinal anesthesia
http://www.saudija.org/downloadpdf.asp?issn=1658-354X;year=2014;volume=8;issue=2;spage=209;epage=214;aulast=Agarwal;type=2
Comparación de dexmedetomidina, clonidina y fentanil intratecales como adyuvantes de bupivacaína espinal para cirugía de extremidad inferior
A comparison of intrathecal dexmedetomidine, clonidine, and fentanyl as adjuvants to hyperbaric bupivacainefor lower limb surgery: A double blind controlled study.
Mahendru V, Tewari A, Katyal S, Grewal A, Singh MR, Katyal R.
J Anaesthesiol Clin Pharmacol. 2013 Oct;29(4):496-502. doi: 10.4103/0970-9185.119151.
Abstract
BACKGROUND: Various adjuvants are being used with local anesthetics for prolongation of intraoperative and postoperative analgesia. Dexmedetomidine, the highly selective 2 adrenergic agonist is a new neuraxial adjuvant gaining popularity. SETTINGS AND DESIGN: The study was conducted in prospective, double blind manner. It included 120 American Society of Anesthesiology (ASA) class I and II patients undergoing lower limb surgery under spinal anesthesia after approval from hospital ethics committee with written and informed consent of patients. MATERIALS AND METHODS: The patients were randomly allocated into four groups (30 patients each). Group BS received 12.5 mg hyperbaricbupivacaine with normal saline, group BF received 12.5 mg bupivacaine with 25 g fentanyl, group BC received 12.5 mg of bupivacaine supplemented 30 g clonidine, and group BD received 12.5 mg bupivacaine plus 5 g dexmedetomidine. The onset time to reach peak sensory and motor level, the regression time of sensory and motor block, hemodynamic changes, and side effects were recorded. RESULTS: Patients in Group BD had significantly longer sensory and motor block times than patients in Groups BC, BF, and BS with Groups BC and BF having comparable duration of sensory and motor block. The mean time of two segment sensory block regression was 147 ± 21 min in Group BD, 117 ± 22 in Group BC, 119 ± 23 in Group BF, and 102 ± 17 in Group BS (P > 0.0001). The regression time of motor block to reach modified Bromage zero (0) was 275 ± 25, 199 ± 26, 196 ± 27, 161 ± 20 in Group BD, BC, BF, and BS, respectively (P > 0.0001). The onset times to reach T8 dermatome and modified Bromage 3 motor block were not significantly different between the groups. Dexmedetomidine group showed significantly less and delayed requirement of rescue analgesic. CONCLUSIONS: Intrathecal dexmedetomidine is associated with prolonged motor and sensory block, hemodynamic stability, and reduced demand of rescue analgesics in 24 h as compared to clonidine, fentanyl, or lone bupivacaine. KEYWORDS: adrenoreceptor agonist; bupivacaine; clonidine; dexmedetomidine; fentanyl; spinal anesthesia; α2
http://www.joacp.org/downloadpdf.asp?issn=0970-9185;year=2013;volume=29;issue=4;spage=496;epage=502;aulast=Mahendru;type=2
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
Clonidina espinal en obstetricia/Spinal clonidine in obstetrics
Aunque el uso de clonidina espinal en pacientes obstétricas aún es controversial, hay suficiente información para considerarlo como un adyuvante seguro para mejorar la analgesia del trabajo de parto, la anestesia espinal para la cesárea, y también para favorecer analgesia espinal postoperatoria después del parto quirúrgico. Usando dosis recomendadas, los efectos secundarios habituales de clonidina subaracnoidea son hipotensión moderada, arritmias fetales no perjudiciales, y sedación moderada en la madre.
Although spinal clonidine use in obstetrics patients still controversial, there is enough information to consider it as a safe adjuvant to enhance spinal labour analgesia and to improve spinal anaesthesia for caesarean section, and also to augment spinal postoperative anaesthesia after surgical delivery. Using recommended doses, the usual side effects of subarachnoid clonidine are moderate hypotension, non harm fetal arrhythmias, and moderate mother sedation.
Embora o uso de clonidina subaracnóidea em pacientes de obstetrícia, ainda é controverso, não há informação suficiente para considerá-lo como um adjuvante seguro para aumentar a analgesia de parto e melhorar a raquianestesia para cesariana, e também para aumentar a anestesia espinhal pós-operatório após o parto cirúrgico. Usando as doses recomendadas, os efeitos colaterais usuais de clonidina subaracnóidea são hipotensão moderada, bradicardia fetal não prejudicar, e sedação mãe moderado.
Clonidina subaracnoidea en Obstetricia
Clonidina intratecal como adyuvante en analgesia obstétrica, anestesia raquídea, y analgesia en cesárea.
Intrathecal Clonidine as Adjuvant for Labor Analgesia, Spinal Anesthesia, and Postoperative Analgesia in Caesarean Section
Victor M. Whizar-Lugo
J Anesth Crit Care Open Access 2014, 1(1): 00005
http://medcraveonline.com/JACCOA/JACCOA-01-00005.pdf
Clonidina espinal con bupivacaína hiperbárica administrada como mezcla y secuencial en cesárea. Estudio randomizado y controlado
Intrathecal clonidine with hyperbaric bupivacaine administered as a mixture and sequentially in caesarean section: A randomised controlled study.
Sachan P, Kumar N, Sharma J.
Indian J Anaesth. 2014 May;58(3):287-92. doi: 10.4103/0019-5049.135039.
http://www.ijaweb.org/article.asp?issn=0019-5049;year=2014;volume=58;issue=3;spage=287;epage=292;aulast=Sachan
http://www.ijaweb.org/downloadpdf.asp?issn=0019-5049;year=2014;volume=58;issue=3;spage=287;epage=292;aulast=Sachan;type=2
Comparación de la analgesia postoperatoria de la clonidina y fentanil intratecales adicionados a bupivacaína en pacientes de cesárea. Estudio prospectivo, randomizado y doble ciego
Comparison of postoperative analgesic effect of intrathecal clonidine and fentanyl added to bupivacaine in patients undergoing cesarean section: a prospective randomized double-blind study.
Khezri MB1, Rezaei M1, Delkhosh Reihany M1, Haji Seid Javadi E2.
Pain Res Treat. 2014;2014:513628. doi: 10.1155/2014/513628. Epub 2014 Feb 4.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3932201/pdf/PRT2014-513628.pdf
El efecto de agregar clonidina intratecal a bupivacaína hiperbárica sobre el dolor postoperatorio en cesárea. Estudio controlado randomizado
The effect of addition of intrathecal clonidine to hyperbaric bupivacaine on postoperative pain after lower segment caesarean section: A randomized control trial.
Singh R1, Gupta D, Jain A.
Saudi J Anaesth. 2013 Jul;7(3):283-90. doi: 10.4103/1658-354X.115360.
http://www.saudija.org/downloadpdf.asp?issn=1658-354X;year=2013;volume=7;issue=3;spage=283;epage=290;aulast=Singh;type=2
Raquia en cesárea electiva. Diferentes dosis de bupivacaína hiperbárica asociada con morfina y clonidina
Spinal anesthesia for elective ceasarean section: use of different doses of hyperbaric bupivacaine associated with morphine and clonidine.
Braga Ade F1, Frias JA, Braga FS, Pereira RI, Titotto SM.
Acta Cir Bras. 2013 Jan;28(1):26-32.
http://www.scielo.br/pdf/acb/v28n1/v28n1a05.pdf
Prevención de la hipotensión y prolongación de analgesia postoperataoria en cesárea urgente. Estudio randomizado con clonidina intratecal
Prevention of hypotension and prolongation of postoperative analgesia in emergency cesarean sections: A randomized study with intrathecal clonidine.
Bajwa SJ1, Bajwa SK, Kaur J, Singh A, Singh A, Parmar SS.
Int J Crit Illn Inj Sci. 2012 May;2(2):63-9. doi: 10.4103/2229-5151.97269.
http://www.ijciis.org/downloadpdf.asp?issn=2229-5151;year=2012;volume=2;issue=2;spage=63;epage=69;aulast=Bajwa;type=2
http://www.ijciis.org/temp/IntJCritIllnInjSci2263-470679_130427.pdf
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
Fabrican células madre con toxinas que matan las células cancerosas
http://www.madrimasd.org/informacionidi/noticias/noticia.asp?id=61922&origen=notiweb&dia_suplemento=martes
Fabrican células madre con toxinas que matan las células cancerosas
En concreto, el equipo dirigido por el neurocientífico Khalid Shah, quien recientemente demostró el valor de las células madre cargadas con virus de herpes para matar el cáncer, ha modificado mediante ingeniería genética una forma de células madre para que puedan producir y secretar toxinas para que eliminen las células tumorales. Los investigadores sugieren que las células madre de secretoras de estas toxinas se pueden utilizar para erradicar las células cancerosas que quedan en los cerebros de los animales, ratones, después de que se ha eliminado el tumor principal.
Tal y como explican en el último número de la revista Stem Cells, las células madre se ubican unas cápsulas biodegradables, gracia a lo que se resuelve el importante problema de la administración de las células, algo que ha supuesto el fracaso de los últimos ensayos clínicos centrados en entrega de toxinas dirigidas a eliminar el cáncer en tumores cerebrales. Los resultados positivos han hecho que Shah y su equipo estén actualmente gestionando la aprobación de las autoridades sanitarias de EE.UU. (FDA) para llevar éste y otros enfoques con células madre desarrollados por ellos a ensayos clínicos. RESISTENTES A TOXINAS "El uso de toxinas que eliminan el cáncer se ha utilizado con éxito en una variedad de cánceres de la sangre, pero hasta ahora no había funcionado bien en los tumores sólidos debido a que no son tan accesibles y las toxinas tienen una vida media corta", explica Shah. Shan señala que hace unos años se dieron cuenta que las células madre podrían utilizarse para administrar de forma continua estas toxinas terapéuticas en los tumores cerebrales, "pero primero teníamos que manipular genéticamente las células madre para que no fueron ellas mismas eliminadas por las toxinas", explica. Y ahora, confirma, "ya tenemos células madre resistentes a las toxinas que pueden liberar fármacos y matar así las células tumorales". Las citotoxinas son mortales para todas las células, pero desde finales de 1990 los investigadores han sido capaces de modificar las toxinas para que únicamente entren en aquellas células cancerosas con moléculas de superficie específicas; por eso, ahora ya posible obtener una toxina dirigida a estas células tumorales sin que ello plantee un riesgo para las células normales. Y una vez dentro de una célula, la toxina altera su capacidad para producir proteínas y, por ello, al cabo de un tiempo, la célula tumoral comienza a morir. CÓDIGO GENÉTICO Sin embargo las células madre diseñadas por el equipo de Shah escapan a este destino porque están hechas con una mutación que no permite que la toxina actué dentro de la célula. Además, las células madre resistentes a la toxina también tienen un código genético diferencial que les permite fabricar y secretar toxinas. Y así, cualquier célula cancerosa que encuentren estas toxinas, al no disponer de estos mecanismos de defensa natural, muere. En este caso concreto, los investigadores indujeron la resistencia a las toxinas en células madre neurales humanas y posteriormente, las manipularon genéticamente para que produjeran toxinas específicas. De momento los investigadores han probado estas células madre en un modelo de ratón con cáncer de cerebro, donde se habían extirpado los tumores, para posteriormente implantar las células madre en la cavidad de resección. "Después de múltiples análisis moleculares y de imagen para verificar si se había inhibido la síntesis de proteínas dentro de los tumores cerebrales, vimos las toxinas mataban las células cancerosas, lo que suponía un incremento en la supervivencia de los animales". Los expertos están pensando en combinar su idea con un número de diferentes células madre terapéuticas desarrolladas por su equipo para mejorar sus resultados en modelos de ratón de glioblastoma, el tumor cerebral más común en adultos humanos. Así esperan que las terapias puedan ser utilizadas en ensayos clínicos en los próximos cinco años. Autor: E. Ortega |
lunes, 27 de octubre de 2014
Más de clonidina IT./More on spinal clonidine
Clonidina espinal
Clonidina espinal adicionada a dosis pequeñas de bupivacaína prolonga la analgesia postoperatoria en cirugía transuretral
Intrathecal clonidine added to small-dose bupivacaine prolongs postoperative analgesia in patients undergoing transurethral surgery.
Gecaj-Gashi A, Terziqi H, Pervorfi T, Kryeziu A.
Can Urol Assoc J. 2012 Feb;6(1):25-9. doi: 10.5489/cuaj.11078.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3289691/pdf/cuaj-1-25.pdf
Dosis bajas de clonidina y fentanil adicionadas a bupivacaína hiperbárica prolongan la analgesia en cirugía ginecológica
Low dose intrathecal clonidine and fentanyl added to hyperbaric bupivacaine prolongs analgesia in gynecological surgery.
Chopra P, Talwar V.
J Anaesthesiol Clin Pharmacol. 2014 Apr;30(2):233-7. doi: 10.4103/0970-9185.130029.
http://www.joacp.org/downloadpdf.asp?issn=0970-9185;year=2014;volume=30;issue=2;spage=233;epage=237;aulast=Chopra;type=2
Efecto de dosis bajas de dexmedetomidina o clonidina sobre las características de bupivacaína espinal
Effect of low-dose dexmedetomidine or clonidine on the characteristics of bupivacaine spinal block.
Kanazi GE, Aouad MT, Jabbour-Khoury SI, Al Jazzar MD, Alameddine MM, Al-Yaman R, Bulbul M, Baraka AS.
Acta Anaesthesiol Scand. 2006 Feb;50(2):222-7.
http://onlinelibrary.wiley.com/doi/10.1111/j.1399-6576.2006.00919.x/pdf
Estudio comparativo entre clonidina y neostigmina intratecales con bupivacaína en cirugía de abdomen bajo
A comparative study between intrathecal clonidine and neostigmine with intrathecal bupivacaine for lower abdominal surgeries.
Yoganarasimha N, Raghavendra T, Amitha S, Shridhar K, Radha M.
Indian J Anaesth. 2014 Jan;58(1):43-7. doi: 10.4103/0019-5049.126794.
http://www.ijaweb.org/downloadpdf.asp?issn=0019-5049;year=2014;volume=58;issue=1;spage=43;epage=47;aulast=Yoganarasimha;type=2
Efectos analgésicos y simpaticolíticos de dosis bajas de clonidina comparada con bupivacaína. Estudio de dosis respuesta en mujeres voluntarias
Analgesic and sympatholytic effects of low-dose intrathecal clonidine compared with bupivacaine: a dose-response study in female volunteers.
Ginosar Y, Riley ET, Angst MS.
Br J Anaesth. 2013 Aug;111(2):256-63. doi: 10.1093/bja/aet027. Epub 2013 Mar 26.
http://bja.oxfordjournals.org/content/111/2/256.full.pdf
Evaluación del efecto de clonidina intratecal para disminuir el dolor del hombro en laparoacopía con anestesia subaracnoidea
Evaluation of the effect of intrathecal clonidine to decrease shoulder tip pain in laparoscopy under spinal anaesthesia.
Ghodki PS, Sardesai SP, Thombre SK.
Indian J Anaesth. 2010 May;54(3):231-4. doi: 10.4103/0019-5049.65370.Abstract
http://www.ijaweb.org/downloadpdf.asp?issn=0019-5049;year=2010;volume=54;issue=3;spage=231;epage=234;aulast=Ghodki;type=2
Clonidina espinal como adyuvante de bupivacaína hiperbárica en pacientes programados para hernioplastía. Estudio randomizado, doble ciego
Intrathecal clonidine as an adjuvant to hyperbaric bupivacaine in patients undergoing inguinal herniorrhaphy: A randomized double-blinded study.
Thakur A, Bhardwaj M, Kaur K, Dureja J, Hooda S, Taxak S.
J Anaesthesiol Clin Pharmacol. 2013 Jan;29(1):66-70. doi: 10.4103/0970-9185.105804.
http://www.joacp.org/downloadpdf.asp?issn=0970-9185;year=2013;volume=29;issue=1;spage=66;epage=70;aulast=Thakur;type=2
Evaluación comparativa de midazolam y dosis bajas de clonidina intratecales. Eficacia, seguridad y duración de analgesia. Estudio clínico randomizado, doble ciego y prospectivo
Comparative evaluation of intrathecal midazolam and low dose clonidine: efficacy, safety and duration of analgesia. A randomized, double blind, prospective clinical trial.
Joshi SA, Khadke VV, Subhedar RD, Patil AW, Motghare VM.
Indian J Pharmacol. 2012 May;44(3):357-61. doi: 10.4103/0253-7613.96321.
http://www.ijp-online.com/article.asp?issn=0253-7613;year=2012;volume=44;issue=3;spage=357;epage=361;aulast=Joshi
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
Clonidina espinal adicionada a dosis pequeñas de bupivacaína prolonga la analgesia postoperatoria en cirugía transuretral
Intrathecal clonidine added to small-dose bupivacaine prolongs postoperative analgesia in patients undergoing transurethral surgery.
Gecaj-Gashi A, Terziqi H, Pervorfi T, Kryeziu A.
Can Urol Assoc J. 2012 Feb;6(1):25-9. doi: 10.5489/cuaj.11078.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3289691/pdf/cuaj-1-25.pdf
Dosis bajas de clonidina y fentanil adicionadas a bupivacaína hiperbárica prolongan la analgesia en cirugía ginecológica
Low dose intrathecal clonidine and fentanyl added to hyperbaric bupivacaine prolongs analgesia in gynecological surgery.
Chopra P, Talwar V.
J Anaesthesiol Clin Pharmacol. 2014 Apr;30(2):233-7. doi: 10.4103/0970-9185.130029.
http://www.joacp.org/downloadpdf.asp?issn=0970-9185;year=2014;volume=30;issue=2;spage=233;epage=237;aulast=Chopra;type=2
Efecto de dosis bajas de dexmedetomidina o clonidina sobre las características de bupivacaína espinal
Effect of low-dose dexmedetomidine or clonidine on the characteristics of bupivacaine spinal block.
Kanazi GE, Aouad MT, Jabbour-Khoury SI, Al Jazzar MD, Alameddine MM, Al-Yaman R, Bulbul M, Baraka AS.
Acta Anaesthesiol Scand. 2006 Feb;50(2):222-7.
http://onlinelibrary.wiley.com/doi/10.1111/j.1399-6576.2006.00919.x/pdf
Estudio comparativo entre clonidina y neostigmina intratecales con bupivacaína en cirugía de abdomen bajo
A comparative study between intrathecal clonidine and neostigmine with intrathecal bupivacaine for lower abdominal surgeries.
Yoganarasimha N, Raghavendra T, Amitha S, Shridhar K, Radha M.
Indian J Anaesth. 2014 Jan;58(1):43-7. doi: 10.4103/0019-5049.126794.
http://www.ijaweb.org/downloadpdf.asp?issn=0019-5049;year=2014;volume=58;issue=1;spage=43;epage=47;aulast=Yoganarasimha;type=2
Efectos analgésicos y simpaticolíticos de dosis bajas de clonidina comparada con bupivacaína. Estudio de dosis respuesta en mujeres voluntarias
Analgesic and sympatholytic effects of low-dose intrathecal clonidine compared with bupivacaine: a dose-response study in female volunteers.
Ginosar Y, Riley ET, Angst MS.
Br J Anaesth. 2013 Aug;111(2):256-63. doi: 10.1093/bja/aet027. Epub 2013 Mar 26.
http://bja.oxfordjournals.org/content/111/2/256.full.pdf
Evaluación del efecto de clonidina intratecal para disminuir el dolor del hombro en laparoacopía con anestesia subaracnoidea
Evaluation of the effect of intrathecal clonidine to decrease shoulder tip pain in laparoscopy under spinal anaesthesia.
Ghodki PS, Sardesai SP, Thombre SK.
Indian J Anaesth. 2010 May;54(3):231-4. doi: 10.4103/0019-5049.65370.Abstract
http://www.ijaweb.org/downloadpdf.asp?issn=0019-5049;year=2010;volume=54;issue=3;spage=231;epage=234;aulast=Ghodki;type=2
Clonidina espinal como adyuvante de bupivacaína hiperbárica en pacientes programados para hernioplastía. Estudio randomizado, doble ciego
Intrathecal clonidine as an adjuvant to hyperbaric bupivacaine in patients undergoing inguinal herniorrhaphy: A randomized double-blinded study.
Thakur A, Bhardwaj M, Kaur K, Dureja J, Hooda S, Taxak S.
J Anaesthesiol Clin Pharmacol. 2013 Jan;29(1):66-70. doi: 10.4103/0970-9185.105804.
http://www.joacp.org/downloadpdf.asp?issn=0970-9185;year=2013;volume=29;issue=1;spage=66;epage=70;aulast=Thakur;type=2
Evaluación comparativa de midazolam y dosis bajas de clonidina intratecales. Eficacia, seguridad y duración de analgesia. Estudio clínico randomizado, doble ciego y prospectivo
Comparative evaluation of intrathecal midazolam and low dose clonidine: efficacy, safety and duration of analgesia. A randomized, double blind, prospective clinical trial.
Joshi SA, Khadke VV, Subhedar RD, Patil AW, Motghare VM.
Indian J Pharmacol. 2012 May;44(3):357-61. doi: 10.4103/0253-7613.96321.
http://www.ijp-online.com/article.asp?issn=0253-7613;year=2012;volume=44;issue=3;spage=357;epage=361;aulast=Joshi
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
Bibliotecas. Alerta
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Notificaciones semanales ⋅ 12 de octubre de 2014
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