Controversias en la vía aérea pediátrica perioperatoria

Febrero 2, 2016. No. 2225

Controversias en la vía aérea pediátrica perioperatoria Controversies in Pediatric Perioperative Airways. Klucka J, Stourac P, Soudek R, Toukálková M, Harazim H, Kosinová M. Biomed Res Int. 2015;2015:368761. doi: 10.1155/2015/368761. Epub 2015 Nov 22. Abstract Pediatric airway management is a challenge in routine anesthesia practice. Any airway-related complication due to improper procedure can have catastrophic consequences in pediatric patients. The authors reviewed the current relevant literature using the following data bases: Google Scholar, PubMed, Medline (OVID SP), and Dynamed, and the following keywords: Airway/s, Children, Pediatric, Difficult Airways, and Controversies. From a summary of the data, we identified several controversies: difficult airway prediction, difficult airway management, cuffed versus uncuffed endotracheal tubes for securing pediatric airways, rapid sequence induction (RSI), laryngeal mask versus endotracheal tube, and extubation timing. The data show that pediatric anesthesia practice in perioperative airway management is currently lacking the strong evidence-based medicine (EBM) data that is available for adult subpopulations. A number of procedural steps in airway management are derived only from adult populations. However, the objective is the same irrespective of patient age: proper securing of the airway and oxygenation of the patient. PDF Lo pequeño es el nuevo grande: Una visión general de nuevos dispositivos supraglóticos para niños Small is the new big: An overview of newer supraglottic airways for children. Goyal R. J Anaesthesiol Clin Pharmacol. 2015 Oct-Dec;31(4):440-9. doi: 10.4103/0970-9185.169048. Abstract Almost all supraglottic airways (SGAs) are now available in pediatric sizes. The availability of these smaller sizes, especially in the last five years has brought a marked change in the whole approach to airway management in children. SGAs are now used for laparoscopic surgeries, head and neck surgeries, remote anesthesia; and for ventilation during resuscitation. A large number of reports have described the use of SGAs in difficult airway situations, either as a primary or a rescue airway. Despite this expanded usage, there remains little evidence to support its usage in prolonged surgeries and in the intensive care unit. This article presents an overview of the current options available, suitability of one over the other and reviews the published data relating to each device. In this review, the author also addresses some of the general concerns regarding the use of SGAs and explores newer roles of their use in children. KEYWORDS: 2nd generation device; Air Q; Ambu Aura; i-gel; laryngeal mask airway; laryngeal tube suction; pediatric; pediatric airway management; supraglottic airways PDF

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

Paro cardiaco y anestesia / Cardiac arrest and anaesths

Febrero 3 , 2016. No. 2226

Paro cardiaco perioperatorio y relacionado con anestesia en países de alto y bajo ingreso. Revisión sistemática con meta regresión y meta-análisis proporcional Anesthesia-Related and Perioperative Cardiac Arrest in Low- and High-Income Countries: A Systematic Review With Meta-Regression and Proportional Meta-Analysis. Koga FA, El Dib R, Wakasugui W, Roça CT, Corrente JE, Braz MG, Braz JR, Braz LG. Medicine (Baltimore). 2015 Sep;94(36):e1465. doi: 10.1097/MD.0000000000001465. Abstract The anesthesia-related cardiac arrest (CA) rate is a quality indicator to improve patient safety in the perioperative period. A systematic review with meta-analysis of the worldwide literature related to anesthesia-related CA rate has not yet been performed.This study aimed to analyze global data on anesthesia-related and perioperative CA rates according to country's Human Development Index (HDI) and by time. In addition, we compared the anesthesia-related and perioperative CA rates in low- and high-income countries in 2 time periods.A systematic review was performed using electronic databases to identify studies in which patients underwent anesthesia with anesthesia-related and/or perioperative CA rates. Both anesthesia-related and perioperative CA rates decrease with increasing HDI but not with time. There is a clear and consistent reduction in anesthesia-related and perioperative CA rates in high-HDI countries, but an increase inperioperative CA rates without significant alteration in the anesthesia-related CA rates in low-HDI countries comparing the 2 time periods. PDF

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

Bibliotecas. Noticias

bibliotecas

NOTICIAS


Diario Córdoba

Las bibliotecas municipales de Córdoba recibieron a 430.000 usuarios durante 2015
Diario Córdoba
Los 12 centros que componen la Red Municipal de Bibliotecas de Córdoba han sido utilizados durante el año 2015 por un total de 429.981 personas, ...




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Las bibliotecas municipales proponen 71 actividades hasta mayo
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Cervantes y Roald Dahl serán los protagonistas en las bibliotecas
La Voz de Galicia
El Concello de Arteixo ya ha hecho público el programa de actividades para los próximos tres meses en lasbibliotecas municipales. La mayoría de ...



Rotary Mirador dona 19 bibliotecas virtuales a UASD con 2500 libros cada una
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La donación de las bibliotecas fue recibida por el decano de la Facultad de Ciencias Económicas y Sociales de la UASD, Ramón Desangles Flores, ...




EL DEBATE (Comunicado de prensa) (Registro) (blog)

Presentarán informe del Programa de Bibliotecas Comunitarias
EL DEBATE (Comunicado de prensa) (Registro) (blog)
Ciudad México.- La Secretaría de Cultura del Gobierno Federal, el Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado ...
Continúa el ciclo Orquesta para Todos en Sinaloa - EL DEBATE (Comunicado de prensa) (Registro) (blog)
Cobertura total de la noticia



Invitan a los niños para que acudan a la biblioteca
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SABINAS, COAH.- Sonia Hinojos Soto, quien es Coordinadora de Bibliotecas en el Municipio, invitó a los niños a que sigan acudiendo a las ...



Las actividades en bibliotecas volverán el día 18 con magia
La Opinión A Coruña
Un espectáculo de magia reanudará el próximo día 18 la programación de cuentacuentos y actividades en lasbibliotecas municipales para niños de ...



El Concello organiza talleres de máscaras en las bibliotecas para niños mayores de 5 años
La Opinión A Coruña
El primer taller tuvo lugar ayer en Dorneda, hoy será en la biblioteca de Oleiros y mañana en la de Santa Cruz, el día 4 en Lorbé, en Mera al día ...




el periodic

La biblioteca del Hospital General de Alicante gestiona cerca de 19.000 artículos científicos en 2015
el periodic
La biblioteca del Hospital General Universitario de Alicante tiene su origen con el nacimiento del hospital hace 55 años. Lo que comenzó siendo una ...




Comentemos.com

Biblioteca pública de ANSES en Buenos Aires
Comentemos.com
Ubicada en el barrio porteño de San Telmo, en Balcarce 610, 2º piso, la biblioteca de la ANSES ofrece un servicio de información y asesoramiento ...


WEB

Bibliotecas de la Municipalidad de Miraflores de Lima
Ingenia
La municipalidad de Miraflores (Lima, Perú) apuesta por las bibliotecas de estantería abierta mediante tecnología RFIF.

Bibliotecas populares. Noticias

bibliotecas populares
Notificaciones semanales ⋅ 27 de enero de 2016
NOTICIAS

Refaccionarán bibliotecas populares y edificios oficiales
ADN Río Negro (Sátira) (Comunicado de prensa) (Registro) (blog)
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La biblioteca popular de Correa le regala 2 mil libros a los vecinos
LaCapital.com.ar
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Los roles del Fondo Nacional de las Artes y la Conabip
El Litoral
Otra institución fundamental es “la Comisión Nacional de Bibliotecas Populares (Conabip) que la creó Sarmiento y ahí uno quiere dar un ejemplo de ...

Más de hiperalgesia opioide / More on opioid hyperalgesia

Enero 27, 2016. No. 2219

Hiperalgesia inducida por opioides: Un dilema de diagnóstico Opioid-Induced Hyperalgesia: A Diagnostic Dilemma. Carullo V, Fitz-James I, Delphin E. J Pain Palliat Care Pharmacother. 2015 Dec;29(4):378-84. doi: 10.3109/15360288.2015.1082006. Epub 2015 Nov 2. Abstract Opioids are utilized frequently for the treatment of moderate to severe acute pain in the perioperative setting, as well as in the treatment of cancer-related pain. When prescribing chronic opioid therapy to patients with chronic pain, it is crucial for the practitioner to be aware not only of the issues of tolerance and withdrawal, but also to have knowledge of the possibility for opioid-induced hyperalgesia (OIH). An understanding of the differences between tolerance and OIH when escalating opioid therapy allows the titration of opioid as well as nonopioid analgesics in order to obtain maximum control of both chronic and acute pain. A case study is described to highlight the importance of judicious utilization of opioids in the treatment of cancer-related pain. In this case, high-dose opioid therapy did not improve chronic pain and contributed to a hyperalgesic state in which a young man experienced severe intractable pain postoperatively after two routine thoracotomies, despite aggressive pharmacologic measures to manage his perioperative pain. Furthermore, it illustrates the potential advantages of opioid rotation to methadone when OIH is suspected. KEYWORDS: acute or chronic pain; cancer pain; hyperalgesia; multimodal pain management; opioid; opioid-induced androgen deficiency; physical dependence; tolerance PDF Uso de dosis muy bajas de metadona en el manejo paliativo del dolor y prevención de hiperalgesia opioide The use of very-low-dose methadone for palliative pain control and the prevention of opioid hyperalgesia. Salpeter SR1, Buckley JS, Bruera E. J Palliat Med. 2013 Jun;16(6):616-22. doi: 10.1089/jpm.2012.0612. Epub 2013 Apr 4. CONCLUSION: The use of very-low-dose methadone in conjunction with adjuvant haloperidol resulted in excellent pain control without dose escalation or opioid-induced hyperalgesia, for both cancer and noncancer diseases. We conclude that low-dose methadone should be part of first-line treatment in palliative pain management. PDF Hiperalgesia inducida por opioides en anestesia Opioid induced hyperalgesia in anesthetic settings. Lee HJ1, Yeomans DC2. Korean J Anesthesiol. 2014 Nov;67(5):299-304. doi: 10.4097/kjae.2014.67.5.299. Epub 2014 Nov 26 Abstract Pain is difficult to investigate and difficult to treat, in part, because of problems in quantification and assessment. The use of opioids, combined with classic anesthetics to maintain hemodynamic stability by controlling responses to intraoperative painful events has gained significant popularity in the anesthetic field. However, several side effects profiles concerning perioperative use of opioid have been published. Over the past two decades, many concerns have arisen with respect to opioid-induced hyperalgesia (OIH), which is the paradoxical effect wherein opioid usage may decrease pain thresholds and increase atypical pain unrelated to the original, preexisting pain. This brief review focuses on the evidence, mechanisms, and modulatory and pharmacologic management of OIH in order to elaborate on the clinical implication of OIH. KEYWORDS: Hyperalgesia; Opioid Analgesics; Postoperative pain PDF

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