Propofol-dexmedetomidina

Abril 7, 2016. No. 2289

Comparación de propofol-hidromorfona y propofol-dexmedetomidina en pacientes intubados después de cirugía plástica maxilofacial Comparison of propofol-hydromorphone and propofol-dexmedetomidine in patients with intubation after maxillofacial plastic surgery. Peng W, Zhang T, Wang Y. Ther Clin Risk Manag. 2016 Mar 8;12:373-7. doi: 10.2147/TCRM.S99262. eCollection 2016. Abstract OBJECTIVE: To compare the sedation and analgesic effects between propofol-hydromorphone and propofol-dexmedetomidine in patients with postoperative intubation after maxillofacial plastic surgery. METHODS: Forty-two patients undertaking maxillofacial plastic surgery with intubation were randomly assigned into propofol plus hydromorphone (P-H) group or propofol plus dexmedetomidine (P-D) group, receiving intravenous infusion of P-H or P-D, respectively. Cerebral state index, Ramsay sedation score, arterial blood gas analysis, and physiology indices were recorded before admission (T0), 30 minutes (T1), 1 hour (T2), 2 hours (T3), 6 hours (T4), and 12 hours after admission (T5) to intensive care unit, and 10 minutes after extubation (T6). Blood interleukin-6 was measured with enzyme-linked immunosorbent assay. RESULTS: There was no significant difference in arterial blood gas analysis, oxygen saturation, mean arterial pressure, and respiratory rate between two groups at all time-points (P>0.05). The changes of heart rate (at T4, T5, and T6), cerebral state index (T1, T2, T3, T4, and T5), and Ramsay score (at T3) in P-H group were significantly different from that in P-D group (P<0.05). The plasma interleukin-6 at T4 in P-H group was significantly lower than that in P-D group (P<0.05). CONCLUSION: The P-H approach takes advantages over P-D approach in relieving the pain and discomfort, reducing the overstimulation of sympathetic nerve and the stress level, and enhancing the tolerance of postoperative intubation after maxillofacial plastic surgery. KEYWORDS: dexmedetomidine; hydromorphone; intubation; maxillofacial plastic surgery; propofol PDF Los pacientes varones requieren mayor concentración óptima en el sitio de efecto del propofol durante la inserción i-gel Male patients require higher optimal effect-site concentrations of propofol during i-gel insertion withdexmedetomidine 0.5 μg/kg. Choi JJ, Kim JY, Lee D, Chang YJ, Cho NR, Kwak HJ. BMC Anesthesiol. 2016 Mar 22;16(1):20. doi: 10.1186/s12871-016-0186-1. Abstract BACKGROUND: The pharmacokinetics and pharmacodynamics of an anesthetic drug may be influenced by gender. The purpose of this study was to compare effect-site half maximal effective concentrations (EC50) of propofol in male and female patients during i-gel insertion withdexmedetomidine 0.5 μg/kg without muscle relaxants.  CONCLUSIONS: During i-gel insertion with dexmedetomidine 0.5 μg/kg without muscle relaxant, male patients had higher effect-site EC50 forpropofol using Schnider's model. Based on the results of this study, patient gender should be considered when determining the optimal dose of propofol during supraglottic airway insertion. KEYWORDS: Dexmedetomidine; I-gel; Propofol PDF

Anestesiología y Medicina del Dolor 52 664 6848905 vwhizar@anestesia-dolor.org anestesia-dolor.org Copyright © 2015

Funcionamiento, éxitos y retos de los bancos de leche

Estimado Ciberpediatra te invito al Seminario de Pediatría, Cirugía Pediátrica y Lactancia Materna. El día 1o de Junio 2016 las 21hrs (Centro, México DF, Guadalajara y Lima Perú) a la Conferencia: “Funcionamiento, éxitos y retos de los bancos de leche”, por la “Dra. Silvia Romero Maldonado”, Pediatra de la Cd de México. 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/bancos_leche/
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

VAD y videolaringoscopios / Difficult airway and videolaringoscopes

Mayo 14, 2016. No. 2326

Comparación del video laringoscopio C-MAC con fibroscopio flexible para intubación con inmovilización de columna cervical Comparison of the C-MAC video laryngoscope to a flexible fiberoptic scope for intubation with cervical spine immobilization Roya Yumul MD, PhD (Professor)a , Ofelia L. Elvir-Lazo MD (Clinical Research Coordinator)a , Paul F. White PhD, MD, FANZCA (Professor)a,b, et al Journal of Clinical Anesthesia (2016) 31, 46-52 PDF Comparación del laringoscopio C-Mac con el vídeolaringoscopio McGrath serie 5 en vía aérea extremadamente difícil Comparison of the C-Mac video laryngoscope with the McGrath Series 5 video laryngoscope concerning an extremely difficult airway. Gaszyński T. Anaesthesiol Intensive Ther. 2016;48(1):55-7. doi: 10.5603/AIT.2016.0007. PDF  Comparación de los videolaringoscopios C-MAC y GlideScope en pacientes con enfermedades e inmovilización de la columna cervical Comparison of the C-MAC(®) and GlideScope(®) videolaryngoscopes in patients with cervical spine disorders and immobilisation. Brück S1, Trautner H, Wolff A, Hain J, Mols G, Pakos P, Roewer N, Lange M. Anaesthesia. 2015 Feb;70(2):160-5. doi: 10.1111/anae.12858. Epub 2014 Sep 29. PDF VIII Foro Internacional de Medicina del Dolor y Paliativa  Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán Junio 9-11, Ciudad de México Dra. Argelia Lara Solares Tel. 5513 3782  www.dolorypaliativos.org

Anestesiología y Medicina del Dolor 52 664 6848905 vwhizar@anestesia-dolor.org anestesia-dolor.org Copyright © 2015

Trauma y coagulopatía / Coagulopathy following trauma

Mayo 19, 2016. No. 2331

Guías Europeas del manejo de sangrado mayor y coagulopatía después de trauma: Cuarta edición The European guideline on management of major bleeding and coagulopathy following trauma: fourth edition. Rossaint R1, Bouillon B2, Cerny V3,4,5,6, Coats TJ7, Duranteau J8, Fernández-Mondéjar E9, Filipescu D10, Hunt BJ11, Komadina R12, Nardi G13,Neugebauer EA14, Ozier Y15, Riddez L16, Schultz A17, Vincent JL18, Spahn DR19. Crit Care. 2016 Apr 12;20(1):100. doi: 10.1186/s13054-016-1265-x. Abstract BACKGROUND: Severe trauma continues to represent a global public health issue and mortality and morbidity in trauma patients remains substantial. A number of initiatives have aimed to provide guidance on the management of trauma patients. This document focuses on themanagement of major bleeding and coagulopathy following trauma and encourages adaptation of the guiding principles to each local situation and implementation within each institution. METHODS: The pan-European, multidisciplinary Task Force for Advanced Bleeding Care in Trauma was founded in 2004 and included representatives of six relevant European professional societies. The group used a structured, evidence-based consensus approach to address scientific queries that served as the basis for each recommendation and supporting rationale. Expert opinion and current clinical practice were also considered, particularly in areas in which randomised clinical trials have not or cannot be performed. Existing recommendations were reconsidered and revised based on new scientific evidence and observed shifts in clinical practice; new recommendations were formulated to reflect current clinical concerns and areas in which new research data have been generated. This guideline represents the fourth edition of a document first published in 2007 and updated in 2010 and 2013. RESULTS: The guideline now recommends that patients be transferred directly to an appropriate trauma treatment centre and encourages use of a restricted volume replacement strategy during initial resuscitation. Best-practice use of blood products during further resuscitation continues to evolve and should be guided by a goal-directed strategy. The identification and management of patients pre-treated with anticoagulant agents continues to pose a real challenge, despite accumulating experience and awareness. The present guideline should be viewed as an educational aid to improve and standardise the care of the bleeding trauma patients across Europe and beyond. This document may also serve as a basis for local implementation. Furthermore, local quality and safety management systems need to be established to specifically assess key measures of bleeding control and outcome. CONCLUSIONS: A multidisciplinary approach and adherence to evidence-based guidance are key to improving patient outcomes. The implementation of locally adapted treatment algorithms should strive to achieve measureable improvements in patient outcome. PDF Respuesta inflamatoria al trauma: Implicaciones para la coagulación y la resucitación Inflammatory response to trauma: implications for coagulation and resuscitation. Pierce A1, Pittet JF. Author information Curr Opin Anaesthesiol. 2014 Apr;27(2):246-52. doi: 10.1097/ACO.0000000000000047. Abstract PURPOSE OF REVIEW: Recent studies have changed our understanding of the timing and interactions of the inflammatory processes andcoagulation cascade following severe trauma. This review highlights this information and correlates its impact on the current clinical approach for fluid resuscitation and treatment of coagulopathy for trauma patients. RECENT FINDINGS: Severe trauma is associated with a failure of multiple biologic emergency response systems that includes imbalanced inflammatory response, acute coagulopathy of trauma, and endovascular glycocalyx degradation with microcirculatory compromise. These abnormalities are all interlinked and related. Recent observations show that after severe trauma: proinflammatory and anti-inflammatory responses are concomitant, not sequential and resolution of the inflammatory response is an active process, not a passive one. Understanding these interrelated processes is considered extremely important for the development of future therapies for severe trauma in humans. SUMMARY: Traumatic injuries continue to be a significant cause of mortality worldwide. Recent advances in understanding the mechanisms of end-organ failure, and modulation of the inflammatory response has important clinical implications regarding fluid resuscitation and treatment of coagulopathy. PDF  VIII Foro Internacional de Medicina del Dolor y Paliativa  Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán Junio 9-11, Ciudad de México Dra. Argelia Lara Solares Tel. 5513 3782  www.dolorypaliativos.org

Anestesiología y Medicina del Dolor 52 664 6848905 vwhizar@anestesia-dolor.org anestesia-dolor.org Copyright © 2015