Agonistas alfa2 neuraxiales / neuroaxial alpha2 agonist

Julio 18, 2016. No. 2390

Eficacia comparativa de bupivacaína intratecal sola y combinada con clonidina en anestesia espinal Comparative Efficacy of Intrathecal Bupivacaine Alone and Combination of Bupivacaine with Clonidine in Spinal Anaesthesia. Wahi A1, Singh AK2, Syal K3, Sood A4, Pathania J4. J Clin Diagn Res. 2016 Apr;10(4):UC06-8. doi: 10.7860/JCDR/2016/16343.7565. Epub 2016 Apr 1. Abstract INTRODUCTION:Clonidine is an α2 agonist agent that has been used as an adjuvant to local anaesthetics in regional anaesthesia.AIM:This study compared two combinations of bupivacaine and clonidine with bupivacaine alone for surgeries below the level of umbilicus in spinal anaesthesia.MATERIALS AND METHODS:We conducted a randomized double blind study on 90 patients of ASA I and ASA II aged 20-60 years, 30 in each group, undergoing surgery below the level of umbilicus in spinal anaesthesia. For intrathecal block, Group 1 received bupivacaine hydrochloride 12.5mg (2.5ml) in 8% dextrose (0.5% sensorcaine heavy) + 1ml (150μg) of preservative free clonidine. Group 2 received bupivacaine hydrochloride 12.5mg (2.5ml) in dextrose (0.5% sensorcaine heavy) + 0.5ml (75μg) of preservative free clonidine + 0.5ml of normal saline to make the volumes of all the groups same. Group 3 received bupivacaine hydrochloride 2.5ml in 8% dextrose (0.5% sensorcaine heavy) + 1ml of normal saline to make the volumes of all the groups same. Heart rate, NIBP, oxygen saturation and respiratory rate were monitored. The onset and duration of sensory block, the highest dermatomal level of sensory block, motor block, time to complete motor block recovery and duration of spinal anaesthesia were recorded.STATISTICAL ANALYSIS:The data of the study was recorded in the record chart and results were evaluated using statistical tests (ANOVA test, post-hoc turkey hsd test, paired t-test and chi-square test).RESULTS:Demographic data, the incidence and duration of bradycardia were comparable amongst the groups. The duration of sensory and motor block were greatest in group 1, followed by group 2 and group 3 (p <0.01). Decrease in the systolic blood pressure of group 2 and group 3 was noted as compared to group 1. No significant sedation or respiratory depression was observed in any group.CONCLUSION: Addition of clonidine to bupivacaine intrathecally is although a reliable method to prolong spinal anaesthesia but close monitoring for hypotension is desirable. KEYWORDS:ASA 1&2; Adjuvant; Bromage scale; Lower abdominal surgery; Subarachnoid block; α2 agonist PDF Efecto de clonidina epidural sobre las características de anestesia espinal en pacientes de cirugía ginecológica. Estudio clínico Effect of epidural clonidine on characteristics of spinal anaesthesia in patients undergoing gynaecological surgeries: A clinical study. Prasad R1, Rao RR1, Turai A1, Prabha P1, Shreyavathi R1, Harsoor K1. Indian J Anaesth. 2016 Jun;60(6):398-402. doi: 10.4103/0019-5049.183395. Abstract BACKGROUND AND AIMS:Combined spinal-epidural (CSE) anaesthesia is being increasingly used for effective post-operative analgesia. This study was designed to evaluate the effect of epidural clonidine on characteristics of spinal anaesthesia for gynaecological surgeries.METHODS:This was a prospective randomised, double-blind, controlled study involving sixty patients belonging to American Society of Anesthesiologists Physical Status I and II who underwent gynaecological surgeries were randomly divided into clonidine (C) group and saline (S) group of thirty each. All patients received CSE anaesthesia. Ten minutes before subarachnoid block (SAB), Group C received clonidine 150 μg diluted to 5 ml in normal saline (NS) and Group S received NS epidurally. Hyperbaric bupivacaine (15 mg) was administered intrathecally for both groups after epidural injection. Sensory and motor block characteristics, analgesia, sedation and haemodynamics were observed. Statistical analysis was performed using appropriate tests.RESULTS:Epidural clonidine produced faster onset (37.83 ± 8.58 s in Group C compared to 50.33 ± 8.80 s in Group S, P = 0.001) and prolonged duration of sensory block (241.17±18.65 minutes in group C compared to 150.33±19.16 minutes in group S, P = 0.001). Time for two segment regression of sensory block was193.67 ± 19.82 min in Group C and 109.33 ± 18.56 min Group S (P < 0.001). The duration of analgesia was 299.00 ± 43.38 min in Group C and 152.50 ± 21.04 min in Group S (P < 0.001). Haemodynamics and sedation scores were comparable between two groups.CONCLUSION:Administration of clonidine epidurally, 10 min before SAB, caused early onset and prolonged duration of motor blockade and analgesia, without any significant post-operative complication. KEYWORDS:Adjuvant; clonidine; epidural analgesia; gynaecological surgery; spinal anaesthesia PDF Evaluación de dexmedetomidina como adyuvante de bupivacaína intratecal en cirugías infraumbilicales Evaluation of Dexmedetomidine as an Adjuvant to Intrathecal Bupivacaine in Infraumbilical Surgeries. Patro SS1, Deshmukh H2, Ramani YR3, Das G4. J Clin Diagn Res. 2016 Mar;10(3):UC13-6. doi: 10.7860/JCDR/2016/17987.7379. Epub 2016 Mar 1. Abstract INTRODUCTION:Various adjuvants like morphine, buprenorphine and fentanyl, clonidine, ketamine are being used in anaesthetic practice since long for improvement of peri-operative analgesia following spinal anaesthesia. Such adjuvants have been helpful in induction of early ambulation but at the cost of their associated adverse effects. Therefore search for an effective adjuvant is still going on. Currently Dexmedetomidine, a highly selective α2-adrenoreceptor agonist is being studied for its adjuvant action in spinal anaesthesia.AIM:The present study aims to evaluate the efficacy of intrathecal Dexmedetomidine as an adjuvant to Bupivacaine in spinal anaesthesia in patients undergoing infra-umbilical surgeries.MATERIALS AND METHODS:It was a prospective, double blind study among 60 patients undergoing infraumbilical surgeries under spinalanaesthesia. The patients were randomly allocated to 2 groups (Group I and Group II) of 30 each. Group I received hyperbaric bupivacaine (15 mg) alone and Group II received hyperbaric bupivacaine (15 mg) with Dexmedetomidine (5mcg). The onset time of sensory and motor block, regression time of sensory and motor block, duration of analgesia, haemodynamic parameters were recorded both intra and postoperatively. The primary efficacy parameters were to determine the onset and duration of sensory block, motor block and duration of postoperative analgesia. Secondarily any associated haemodynamic changes and adverse effects of Dexmedetomidine were also recorded.STATISTICAL ANALYSIS:Continuous data were analysed using the Student's t-test and categorical variables by two-tailed Fisher-exact test or Chi-square test.RESULTS:Onset of sensory block was 129.33±14.8 seconds in Group II as compared to 208.33±19.18 seconds in Group I with total duration of sensory block as 317.70±16.16 minutes in Group II and 188±11.86 minutes in Group I. Similarly, onset of motor block was 226.33±31.86 minutes and 320.33±29.81 minutes, with total duration of motor block as 286.33±15.15 minutes and 166.5±12.11 minutes in Group II and in Group I respectively. Duration of analgesia was 333.6±20.67 minutes with Dexmedetomidine but 193.67±7.06 minutes in bupivacaine alone group.CONCLUSION:Dexmedetomidine as an adjuvant had shown early onset of sensory and motor block with longer duration of analgesia and haemodynamic stability in the present study as compared to bupivacaine alone. KEYWORDS: Alpha-2 (α2) adrenergic receptor agonists; Anaesthetic-sparing action; Haemodynamic stability; Postoperative analgesia; Spinal anaesthesia PDF Clonidina intratecal como adyuvante de anestesia espinal. ¿Existe una dosis mágica? Intrathecal Clonidine as Spinal Anaesthesia Adjuvant - Is there a Magical Dose? Víctor M. Whizar-Lugo, Juan C. Flores-Carrillo and Susana Preciado-Ramírez Topics in Spinal Anaesthesia, 2014 PDF Comité Europeo de Enseñanza en Anestesiología Curso de Actualización en Anestesiología Anestesia por Especialidades y Simposio Anestesia y Cirugía Plástica Seguras Agosto 5-7, 2016. Tijuana BC, México Información Dr. Sergio Granados Tinajero granadosts@gmail.com  16th World Congress of Anaesthesiologists 28 August - 2 September 2016  Hong Kong Convention and Exhibition Centre World Federation of Societies of Anaesthesiologists http://wca2016.com/

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

Bibliotecas. Noticias

bibliotecas
Notificaciones diarias ⋅ 17 de julio de 2016
NOTICIAS


La Patria.com
Tres de Caldas participan en el Premio Nacional de Bibliotecas Públicas
La Patria.com
Foto | Archivo | LA PATRIA Se preseleccionaron 16 bibliotecas pequeñas, 7 medianas y 2 grandes. En la imagen, Biblioteca Pública Rural de la ...




Diario Democracia
Las bibliotecas populares aun esperan los subsidios que les corresponden
Diario Democracia
Bibliotecarias de nuestra ciudad consultadas por Democracia, se refirieron a la difícil situación que atraviesan las bibliotecas populares, que ...




El Heraldo (Colombia) (blog)
Dos bibliotecas costeñas, entre las 25 mejores del país de carácter público
El Heraldo (Colombia) (blog)
En octubre se darán a conocer las nueve de mayor calidad en el III Premio Nacional de BibliotecasPúblicas. En total 129 entidades se postularon en ...



Biblioteca de Pitalito preseleccionada para el III Premio Nacional de Bibliotecas Públicas
Opanoticias (Comunicado de prensa) (blog)
La biblioteca Monseñor Esteban Rojas de Pitalito fue preseleccionada para aspirar a la tercera edición del Premio Nacional de Bibliotecas Públicas ...




El Siglo de Torreón
Inician los talleres en bibliotecas
El Siglo de Torreón
A partir de este lunes 18 de julio el Instituto Sampetrino de Cultura (Isacult), en coordinación con las tres bibliotecas del municipio, iniciará con los ...




La Prensa De Monclova
Listo “vacaciones en la biblioteca”
La Prensa De Monclova
SAN JUAN DE SABINAS, COAH.- Todo listo para que este próximo lunes 18 de julio inicie el programa “Mis vacaciones en la Biblioteca” en esta ...


WEB

Buenas tardes, soy socio de la Red de Bibliotecas Públicas de Andalucí...
Pregunte: las bibliotecas responden
Buenas tardes, soy socio de la Red de Bibliotecas Públicas de Andalucía. ¿Cómo he de actuar para renovar el préstamo de un libro desde la web?

Medwave edición Julio 2016

Medwave edición Julio 2016 Vea este email en su navegador

---------------------  Contenidos recientemente publicados:  --------------------------- ESTUDIO PRIMARIO Factores asociados al desarrollo de cardiopatía hipertensiva: una cohorte prospectiva, en Bayamo, Cuba Alexis Álvarez Aliaga, Julio César González Aguilera, Liliana del Rosario Maceo Gómez (Cuba) Medwave 2016 Jul;16(6):6492 ARTÍCULO ESPECIAL El sonrojo social: ¿un trastorno neuropsiquiátrico? Enrique Jadresic (Chile) Medwave 2016 Jul;16(6):e6490 REPORTES DE CASO Hemorragia perioperatoria grave asociada a punción del ventrículo izquierdo post pericardiocentesis en un paciente con carcinoma de células renales: reporte de caso Javier Lasala, Miguel Alejandro Patino, Gabriel Mena, Shital Vachhani, Teresa Moon, Thao Bui, January Tsai (United States) Medwave 2016 Jul;16(6):e6494 Fiebre tifoidea: reporte de caso y revisión de la literatura Natalia Carolina Sanhueza Palma, Solange Farías Molina, Jeannette Calzadilla Riveras, Amalia Hermoso (Chile)  Medwave 2016 Jun;16(5):e6474 Infarto agudo de miocardio asociado al uso de terazosina oral en presencia de cardiopatía estructural predisponente: reporte de caso Alejandro Vidal Margenat, Federico Ferrando-Castagnetto, Fabián Martínez, Natalia Lluberas, Gustavo Vignolo (Uruguay) Medwave 2016 Jun;16(5):e6480 Envío de manuscritos originales http://ojs.medwave.cl/index.php/medwave/login ------------------------------------------------ Instrucciones a los autores http://www.medwave.cl/link.cgi/instrucciones.act ----------------------------------------------------------------- Si quiere participar como par revisor de Medwave http://www.medwave.cl/link.cgi/revisor.act ------------------------------------------------------------------ Contacto con la revista: Rodrigo Núñez publishing@medwave.cl

Enfermedades autoinmunes en niños pequeños

Estimado Pediatra te invito al Seminario de Pediatría, Cirugía Pediátrica y Lactancia Materna. El día 20 de Julio 2016 las 21hrs (Centro, México DF, Guadalajara y Lima Perú) a la Conferencia: “Enfermedades autoinmunes en niños pequeños”, por la “Dra Nadina Rubio Perez”, Inmunologa Pediatra de la Cd de Monterrey N.L. 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/autoinmunidad_ninospequenos/

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

Relajantes neuromusculares en geriatría / Neuromuscular blockade in elderly patients

Julio 15, 2016. No. 2387

Bloqueo neuromuscular en el anciano después de cirugía bajo anestesia general con rocuronio Residual neuromuscular block in elderly patients after surgical procedures under general anaesthesia with rocuronium. Pietraszewski P1, Gaszyński T. Anaesthesiol Intensive Ther. 2013 Apr-Jun;45(2):77-81. doi: 10.5603/AIT.2013.0017. Abstract BACKGROUND:Incomplete recovery of neuromuscular function following the administration of medium-acting, non- -depolarising agents is one of the most feared complications in anaesthesia. We assessed the incidence of postoperative residual curarisation (PORC) after general anaesthesia with rocuronium in elderly and young patients, and we evaluated possible complications of postoperative residual curarisation.METHODS:This observational study included 415 patients (ASA physical status I-III) who were undergoing different surgical procedures: 184 patients were aged ≥ 65 (range: 65-89) years, and 231 patients were aged 19-57 years. No patients had renal or hepatic disorders. Patients received rocuronium for relaxation. Neuromuscular monitoring was not used intraoperatively. Neuromuscular function recovery was spontaneous. Patients were transferred to the post-anaesthesia care unit (PACU) after anaesthesia. During the first ten minutes in the post-anaesthesia care unit, the presence of postoperative residual curarisation was assessed by acceleromyography and train-of-four (TOF) stimulation. Patient well-being was monitored continuously. During hospitalisation, patient medical documentation was assessed for postoperative residual curarisation-related complications.RESULTS:TOF ratios were < 0.7 in 31% of all patients, whereas the block was clinically completely recovered in all patients. Postoperative residual curarisation was more frequent in elderly (44%) than younger patients (20%) (P < 0.05). Only 73 patients (21 elderly, 52 younger patients) had TOF ratios ≥ 0.9. Hypoxia was more frequent in elderly patients in the PACU: 17.9% vs. 8.2% (P < 0.05). Postoperative residual curarisation-related pneumonia was observed in one elderly patient. CONCLUSION:Residual paralysis remains a major problem in geriatric clinical anaesthesia. Neuromuscular function monitoring is obligatory, and pharmacological reversal of relaxation should be advised in geriatric patients after using relaxants for general anaesthesia. PDF Comparación de la variabilidad de incio y recuperación de la relajación neuromuscular con cisatracurio versus rocuronio en ancianos bajo TIVA Comparison of the variability of the onset and recovery from neuromuscular blockade with cisatracurium versus rocuronium in elderly patients under total intravenous anesthesia. Xiaobo F1, Jianjuan K, Yanlin W. Braz J Med Biol Res. 2012 Jul;45(7):676-80. Epub 2012 May 17.Abstract This study was designed to compare the variability of the onset and offset of the effect of two neuromuscular blocking drugs with different elimination pathways in adult and elderly patients during total intravenous anesthesia (TIVA). After Ethics Committee approval and patients' informed consent, the drugs were compared in 40 adult and 40 elderly patients scheduled for elective surgery under TIVA with tracheal intubation who were randomized to receive a single bolus dose of 0.15 mg/kg cisatracurium or 0.9 mg/kg rocuronium. The time of onset of maximum depression, duration of action, and recovery index time were measured and recorded for each patient and variability is reported as means ± standard deviation. Time of onset was significantly shorter for rocuronium than cisatracurium for the adult and elderly groups (P = 0.000), but the variability of cisatracurium was significantly greater compared with rocuronium for the same age groups (93.25 vs 37.01 s in the adult group and 64.56 vs 33.75 s in the elderly group; P = 0.000). The duration of the effect in the elderly group receiving rocuronium was significantly longer than in the elderly group receiving cisatracurium, and the variability of the duration was significantly greater in the rocuronium group than in the cisatracurium group. Mean time of recovery was significantly longer for the elderly group receiving rocuronium than for the elderly group receiving cisatracurium (P = 0.022), and variability was also greater (P = 0.002). Both drugs favored good intubating conditions. In conclusion, cisatracurium showed less variability in these parameters than rocuronium, especially in the elderly, a fact that may be of particular clinical interest. PDF Recomendaciones anestésicas con el uso de relajantes neuromusculares en el paciente geriátrico Dra. P Isidora Vásquez-Márquez, Dr. Antonio Castellanos-Olivares Revista Mexicana de Anestesiología Vol. 33. Supl. 1, Abril-Junio 2010 pp S93-S98 PDF Comité Europeo de Enseñanza en Anestesiología Curso de Actualización en Anestesiología Anestesia por Especialidades y Simposio Anestesia y Cirugía Plástica Seguras Agosto 5-7, 2016. Tijuana BC, México Información Dr. Sergio Granados Tinajero granadosts@gmail.com  16th World Congress of Anaesthesiologists 28 August - 2 September 2016  Hong Kong Convention and Exhibition Centre World Federation of Societies of Anaesthesiologists http://wca2016.com/

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