Gárgaras profilácticas con ketamina para reducir el dolor postoperatorio de garganta después de la intubación endotraqueal.
Prophylactic ketamine gargle to reduce post-operative sore throat following endotracheal intubation.
Rajkumar G, Eshwori L, Konyak P Y, Singh L D, Singh TR, Rani M B.
J Med Soc [serial online] 2012 [cited 2013 Jun 10];26:175-9.
Abstract
Objective: To study, the effect of prophylactic ketamine (K) gargle in reduction of post-operative sore throat (POST) following endotracheal intubation. Materials and Methods: 90 adult patients between 18 years and 60 years with American Society of Anesthesiologists I and II, scheduled for elective open cholecystectomy surgery under general anesthesia were randomly assigned into 2 groups of 45 patients each. Group S-received 30 ml of normal saline (NS) and Group K-received 40 mg of K in 30 ml of NS. Then the patients were asked to gargle with the preparation for 30 s after their arrival in the operation room. Anesthesia was induced 5 min later. On arrival in the post-anesthesia care unit (0 h), and at 2 h, 4 h, and 24 h thereafter, the patients were questioned by a blinded investigator whether he/she had experienced sore throat or any other side- effects. POST was graded on a four-point scale (0-3). Results: The incidence of POST was higher in NS group compared with K group at 0 h, 2 h, 4 h, and 24 h. In addition, there is reduced incidence of hoarseness of voice in K group compared to NS group at 0 h, 2 h, 4 h, and 24 h after extubation. Conclusion: In conclusion, gargling with K decreases the incidence and severity of POST and hoarseness of voice.
Keywords: Endotracheal intubation, Ketamine, Post-operative, Sore throat
http://www.jmedsoc.org/text.asp?2012/26/3/175/113242
Analgesia prehospitalaria con S-ketamina nasal. Una serie de casos
Prehospital analgesia using nasal administration of S-ketamine - a case series.
Johansson J, Sjöberg J, Nordgren M, Sandström E, Sjöberg F, Zetterström H.
The research and development unit, Jämtland county council, Östersund, Sweden. joakim.johansson@jll.se.
Scand J Trauma Resusc Emerg Med. 2013 May 14;21:38. doi: 10.1186/1757-7241-21-38.
Abstract
Pain is a problem that often has to be addressed in the prehospital setting. The delivery of analgesia may sometimes prove challenging due to problems establishing intravenous access or a harsh winter environment. To solve the problem of intravenous access, intranasal administration of drugs is used in some settings. In cases where vascular access was foreseen or proved hard to establish (one or two missed attempts) on the scene of the accident we use nasally administered S-Ketamine for prehospital analgesia. Here we describe the use of nasally administered S-Ketamine in 9 cases. The doses used were in the range of 0,45-1,25 mg/kg. 8 patients were treated in outdoor winter-conditions in Sweden. 1 patient was treated indoor. VAS-score decreased from a median of 10 (interquartile range 8-10) to 3 (interquartile range 2-4). Nasally administered S-Ketamine offers a possible last resource to be used in cases where establishing vascular access is difficult or impossible. Side-effects in these 9 cases were few and non serious. Nasally administered drugs offer a needleless approach that is advantageous for the patient as well as for health personnel in especially challenging selected cases. Nasal as opposed to intravenous analgesia may reduce the time spent on the scene of the accident and most likely reduces the need to expose the patient to the environment in especially challenging cases of prehospital analgesia. Nasal administration of S-ketamine is off label and as such we only use it as a last resource and propose that the effect and safety of the treatment should be further studied.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3660173/pdf/1757-7241-21-38.pdf
Administración preincisional intravenosa o subcutánea de dosis bajas de ketamina para suprimir el dolor postapendicetomía
Preincisional administration of intravenous or subcutaneous infiltration of low-dose ketamine suppresses postoperative pain after appendectomy.
Honarmand A, Safavi M, Karaky H.
Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
J Pain Res. 2012;5:1-6. doi: 10.2147/JPR.S26476. Epub 2011 Dec 30.
Abstract
BACKGROUND: Ketamine, an N-methyl-D-aspartate receptor antagonist, can suppress hyperalgesia and allodynia. The purpose of the present study was to evaluate the clinical efficacy of preincisional intravenous or subcutaneous infiltration of ketamine for postoperative pain relief after appendectomy. METHODS: Ninety patients, aged 18-60 years, scheduled for appendectomy was enrolled in this study. Patients were divided into three groups of 30 each and received subcutaneous infiltration of ketamine 0.5 mg/kg (KS), intravenous ketamine 0.5 mg/kg (KI), or subcutaneous infiltration of normal saline 3 mL (C) before surgery. Visual analog scale (VAS) values and analgesic consumption were evaluated for 24 hours after surgery. RESULTS: VAS scores were significantly lower at the time of arrival in the recovery room, and at 10, 20, and 30 minutes thereafter in group KI and group KS compared with group C (P < 0.05). VAS scores were not significantly different between group KI and group KS at these intervals. Postoperative VAS scores were significantly lower at 6, 12, 18, and 24 hours in group KI compared with group C (P < 0.05). In group KS, the postoperative VAS score was significantly lower at 6 hours (P < 0.05). VAS scores were significantly lower at 12, 18, and 24 hours after surgery in group KI compared with group KS (P < 0.05). CONCLUSION: A 0.5 mg/kg dose of ketamine given at approximately 15 minutes before surgery by the intravenous route provided analgesia for 24 hours after surgery in patients undergoing appendectomy.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3273401/pdf/jpr-5-001.pdf
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
Estimado Pediatra te invito al Seminario de Pediatría, Cirugía Pediátrica y Lactancia Materna. El día 10 de Julio 2013 las 21hrs (Centro, México DF, Guadalajara y Lima Perú) a la Conferencia: “Cirugía Bariátrica en Pediatría” por el “Dr. Fernando Montes Tapia“ Cirujano 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/cirugia_bariatrica_pediatria/
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
Apnea obstructiva del sueño: un riesgo emergente para ateroesclerosis
Obstructive sleep apnea: an emerging risk factor for atherosclerosis.
Drager LF, Polotsky VY, Lorenzi-Filho G.
Hypertension Unit, Sleep Laboratory, Pulmonary Division, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil.geraldo.lorenzi@incor.usp.br
Chest. 2011 Aug;140(2):534-42. doi: 10.1378/chest.10-2223.
Abstract
Obstructive sleep apnea (OSA) is independently associated with death from cardiovascular diseases, including myocardial infarction and stroke. Myocardial infarction and stroke are complications of atherosclerosis; therefore, over the last decade investigators have tried to unravel relationships between OSA and atherosclerosis. OSA may accelerate atherosclerosis by exacerbating key atherogenic risk factors. For instance, OSA is a recognized secondary cause of hypertension and may contribute to insulin resistance, diabetes, and dyslipidemia. In addition, clinical data and experimental evidence in animal models suggest that OSA can have direct proatherogenic effects inducing systemic inflammation, oxidative stress, vascular smooth cell activation, increased adhesion molecule expression, monocyte/lymphocyte activation, increased lipid loading in macrophages, lipid peroxidation, and endothelial dysfunction. Several cross-sectional studies have shown consistently that OSA is independently associated with surrogate markers of premature atherosclerosis, most of them in the carotid bed. Moreover, OSA treatment with continuous positive airway pressure may attenuate carotid atherosclerosis, as has been shown in a randomized clinical trial. This review provides an update on the role of OSA in atherogenesis and highlights future perspectives in this important research area.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3198492/pdf/102223.pdf
Hipertensión arterial refractaria y apnea del sueño
GUSTAVO QUEVEDO, JERÓNIMO HEREDIA, MARÍA ALEJANDRA LASTRA, LUIS LEMA
REV ARGENT CARDIOL 2008;76:229-232
RESUMEN
El síndrome de apnea obstructiva del sueño (SAOS) tiene un papel importante en la morbimortalidad cardiovascular. Se han sugerido muchos mecanismos para explicar la asociación mórbida entre el SAOS y la enfermedad cardiovascular, especialmente la hipertensión
arterial (HTA). Alrededor de la mitad de los pacientes con SAOS padecen hipertensión arterial y la prevalencia de SAOS en pacientes hipertensos es mayor que la existente en la población general. En el presente caso se describe a un paciente con HTA refractaria al tratamiento farmacológico que evolucionó favorablemente luego del diagnóstico y el tratamiento del SAOS.
.
http://www.scielo.org.ar/pdf/rac/v76n3/v76n3a15.pdf
Consecuencias metabólicas y cardiovasculares del síndrome de apnea obstructiva del sueño
José Luis Alva y Pérez
Med Int Mex 2009;25(2):116-28
RESUMEN
Desde la descripción original del síndrome de apnea obstructiva del sueño se sabe que se acompaña de daño cardiovascular. En los últimos 10 años aparecieron suficientes evidencias epidemiológicas y mecanicistas que afirmaron su papel etiológico en la hipertensión arterial sistémica, resistencia a la insulina, obesidad e hiperlipidemia, lo que resulta en aumento de la morbilidad y la mortalidad cardiovasculares, particularmente en personas jóvenes. Los objetivos de esta revisión son: presentar de una manera comprensible y sucinta los datos clínicos más importantes y explicar por qué el síndrome de apnea obstructiva del sueño debe ser una prioridad para el médico internista, con el fin de que pueda ofrecer un mejor tratamiento a estos enfermos.
Palabras clave: apnea obstructiva, sueño, diabetes, hipertensión, obesidad, cardiopatía.
http://www.nietoeditores.com.mx/download/med%20interna/marzo-abril2009/MI%202.7%20CONSECUENCIAS.pdf
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
Actualización en cefalea post punción dural: ¿El hacer y no hacer?
Update in Post-Dural Puncture Headache: the do's and don'ts?
Marcel Vercauteren
Timisoara 2011;183
Post-Dural Puncture Headache (PDPH) is a well-known complication of intended dural puncture (anesthesia, diagnostic), catheterization (anesthesia, neurosurgery, pain therapy, oncology) or inadvertent dural puncture (epidural anesthesia, surgical). While anesthesiologists have anticipated this problem by using needles of smaller size and special design and radiologists have abandoned myelography, neurologists still have continued to use large bore Quincke needles.
http://www.atitimisoara.ro/_files/documents/files/2011/Recomandari-ATI-med-urgenta/Update%20in%20Post-Dural%20Puncture%20Headache.pdf
Cefalea post punción lumbar: diagnóstico y tratamiento
Post lumbar puncture headache: diagnosis and management.
Ahmed SV, Jayawarna C, Jude E.
Tameside General Hospital, Fountain Street, Ashton Under-Lyne OL6 9RW, UK. syed.ahmed@tgh.nhs.uk
Postgrad Med J. 2006 Nov;82(973):713-6.
Abstract
Lumbar puncture is a frequently performed procedure in medical emergencies and anaesthesia. Headache after lumbar puncture is a common occurrence (32%) and carries a considerable morbidity, with symptoms lasting for several days, at times severe enough to immobilize the patient. If untreated, it can result in serious complications such as subdural haematoma and seizures, which could be fatal. Certain factors contribute to the development of headache after lumbar puncture. If these factors are taken into consideration, the incidence of headache could be markedly reduced. It is therefore important that the doctors are aware of the methods available for reducing the incidence of headaches after lumbar puncture. On the other hand, there are several misconceptions that are thought to decrease the incidence of headaches with no scientific basis. This article reviews the scientific literature and highlights the practical issues involved in the diagnosis and management of headaches after lumbar puncture, including the epidural blood patch treatment.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2660496/pdf/713.pdf
No efecto en la duración del decúbito sobre la incidencia de CPPD debida a agujas cortantes G22
No effect of recumbency duration on the occurrence of post-lumbar puncture headache with a 22G cutting needle.
Kim SR, Chae HS, Yoon MJ, Han JH, Cho KJ, Chung SJ.
Department of Nursing, Asan Medical Center, Seoul, South Korea.
BMC Neurol. 2012 Jan 30;12:1. doi: 10.1186/1471-2377-12-1.
Abstract
BACKGROUND: Supine recumbence has been widely performed to prevent post-lumbar puncture headache (PLPH). However, the optimal duration of supine recumbence is controversial. The aim of the study is to compare the occurrence of PLPH according to the duration of supine recumbence in patients with neurological disorders. METHODS: A non-equivalent control/experimental pre-/post-test study design was used. Seventy consecutive patients were prospectively enrolled between July 2007 and July 2008. Thirty-five patients underwent supine recumbence for four hours after lumbar puncture (Group 1) and 35 patients underwent supine recumbence for one hour (Group 2). RESULTS: The overall frequency of PLPH was 31.4%. The frequency of PLPH was not significantly different between the Group 1 (28.6%) and Group 2 (34.3%) (P = 0.607). In patients with PLPH, the median severity (P = 0.203) and median onset time of PLPH (P = 0.582) were not significantly different between the two groups. In a logistic regression analysis, the previous history of post-lumbar puncture headache was a significant risk factor for the occurrence of PLPH (OR = 11.250, 95% CI: 1.10-114.369, P = 0.041). CONCLUSIONS: Our study suggests that short duration (one hour) of supine recumbence may be as efficient as long duration (four hours) of supine recumbence to prevent PLPH.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3292507/pdf/1471-2377-12-1.pdf
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
La biblioteca de Castilla-La Mancha amplía el plazo de préstamo ...
ABC.es
La Biblioteca de Castilla-La Mancha ampliará, durante los meses de julio y agosto, los plazos para los préstamos a domicilio hasta un máximo de un mes, frente a los 21 días actuales. El horario de apertura de la biblioteca se mantiene como durante el ...
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La Biblioteca regional celebró el día de los lectores y los escritores
ABC.es
La Biblioteca de Castilla-La Mancha celebró este martes, el día de los lectores y de los escritores. Por una parte se reunieron buena parte de los integrantes de los 12 clubes de lectores formados en la misma, que recibieron un diploma por su ...
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La biblioteca virtual de Cortázar
El País.com (España)
En la biblioteca personal de Cortázar se encuentran también muchos de los que debieron ser sus primeros libros: primeras ediciones de textos franceses de autores surrealistas o antiguas ediciones de clásicos castellanos. Muchas obras están dedicadas ...
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Biblioteca del Poder Judicial, valioso acervo especializado al ...
Noticias Voz e Imagen de Oaxaca, Chiapas y Tuxtepec
La biblioteca del Poder Judicial del Estado alberga cerca de 12 mil obras entre las que destacan libros, colecciones especializadas, de jurisprudencia, semanarios, tesis, gacetas, informes y folletos relacionados en su gran mayoría con temas jurídicos ...
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Cierran Biblioteca “Mario Briceño Iragorry” por deslizamiento en ...
Diario de Los Andes
La Biblioteca pública central Mario Briceño Iragorry ubicada en pleno corazón de la ciudad capital de Trujillo, y patrimonio cultural del estado, ayer fue cerrada. Los años no pasan en vano, y sin una mano constante que alivie el paso del tiempo todo ...
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Biblioteca pública Ventura López promueve el séptimo arte
www.nssoaxaca.com
Con la finalidad de acercar el séptimo arte a las personas del Municipio de Oaxaca de Juárez, del 26 al 29 de junio se proyectarán documentales, cortometrajes y películas en la Biblioteca Pública Municipal Profesor Ventura López Sánchez, ubicada en la ...
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Paran Biblioteca central: exigen nuevo titular de red
Zacatecas en Línea
Cerca de 45 trabajadores de la biblioteca 'Mauricio Magdaleno' realizaron un paro de labores para exigir el nombramiento de su coordinados, debido a que desde hace 1 mes se encuentra acéfala. A partir de las 9 de la mañana se impidió el acceso a los ...
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Una biblioteca pública por explorar
El Diario de Otún
Cerca de 7000 libros, 9 computadores, un televisor y un DVD donde se proyectan documentales, son los instrumentos con los que la biblioteca pública de Dosquebradas brinda educación a todos los ciudadanos del municipio. Así lo dio conocer José ...
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Biblioteca Morelos oferta sus cursos de verano Esperan beneficiar a ...
El debate
La Biblioteca Pública "Morelos" y la Red Municipal de Bibliotecas públicas, que suman 20 en las 8 sindicaturas, y la Casa de la Cultura Conrado Espinosa, se preparan para recibir a sus huéspedes distinguidos en este verano, donde se oferta una gran ...
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¿Porqué le suciedó esto a mi biblioteca de música? - Yahoo! Respuestas
Resulta que hace mucho en mi biblioteca de música (no en el reproductor de Windows Media) tenía mi música organizada así: Artista-Álbum-Canciones
espanol.answers.yahoo.com/question/index?qid...
2013
Atte.
Dr.Máximo Cuadros Chávez
Estimad@ Víctor Valdés:
Apnea obstructiva del sueño en pacientes con infarto miocárdico: Experiencia en un hospital terciario en el sur de India
Obstructive Sleep Apnea in Patients with Myocardial Infarction: Experience from a Tertiary Care Hospital in South India.
Devaraj U, Ramachandran P, D'souza GA.
Heart India [serial online] 2013 [cited 2013 Jun 17];1:12-6.
Abstract
Aims and Objective: The aim of this study was to describe the occurrence of sleep disordered breathing/obstructive sleep apnea (OSA) in patients admitted with acute myocardial infarction (MI) in a tertiary care hospital. Materials and Methods: All consecutive patients with a recent MI, presenting to the hospital for a period of over 1 year, were administered with a well-designed questionnaire and subjected to polysomnography (PSG) after obtaining a written informed consent. Results: A total of 55 patients were screened with the questionnaire and 44 patients were subjected to PSG. Of the 55 patients 42 (76.4%) were snorers and 14 (25.5%) were insomniacs. OSA was diagnosed in 12 (28.6%) of the 44 patients. There was no significant difference in the presence of hypertension, diabetes mellitus or hypercholesterolemia among the patients diagnosed with OSA and those without OSA. Conclusions: There is a high prevalence of previously undiagnosed OSA in patients admitted to the hospital with acute MI as compared to the general population. OSA is under-recognized in India. Early recognition of undiagnosed OSA in this population of patients with coronary artery disease (CAD), and treatment of the same would help in reducing cardiovascular morbidity and mortality. This study reinforces the need for the routine screening of MI/CAD patients for the presence of OSA.
Keywords: Coronary artery disease, myocardial infarction, obstructive sleep apnea
http://www.heartindia.net/text.asp?2013/1/1/12/113604
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
Ceguera post craniotomía en posición supina: ¿Improbable o ignorada?
Post-craniotomy blindness in the supine position: Unlikely or ignored?
Vahedi P, Meshkini A, Mohajernezhadfard Z, Tubbs R S.
Asian J Neurosurg [serial online] 2013 [cited 2013 Jun 9];8:36-41.
Abstrtact
Immediate visual loss following craniotomy in the supine position is a disastrous complication in neurosurgical patients. The incidence is unknown and little is known on the definite pathogenesis. Also, preventive or restorative interventions are unclear. We describe the rare case of post-craniotomy optic neuropathy and sudden visual loss after craniotomy in the supine position for an olfactory groove meningioma, discuss the possible pathophysiology and review the literature on the pathogenesis, risk factors, and outcome. Although rare, neurosurgeons, as well as neuroanesthesiologists should be aware of the possibility of this devastating complication in the high-risk group of patients.
Keywords: Craniotomy, ischemic optic neuropathy, papilledema, pathophysiology, visual loss
http://www.asianjns.org/text.asp?2013/8/1/36/110278
Mielitis transversa aguda despues de anestesia y analgesia epidural torácica: ¿Debería ser culpada la anestesia y analgesia?
Acute transverse myelitis after thoracic epidural anesthesia and analgesia: Should
anesthesia and analgesia be blamed?
Ming-Che Hsu, Ming-Hui Hung , Jin-Shing Chen, Ya-Jung Cheng
Acta Anaesthesiologica Taiwanica 51 (2013) 37e39
Abstract
A 63-year-old man developed acute transverse myelitis (ATM) with a rapid progression of sensory and motor deficits and autonomic dysfunction 2 days after chest surgery. Thoracic epidural anesthesia/analgesia (TEA) had been administered in this case. Since the temporal and spatial relationships between TEA and ATM are so close, one may easily mistake the TEA as the cause. Therefore, we discuss here the differential diagnoses for cord damage after TEA and the characteristics of ATM, and suggest that it is unlikely that TEA is the cause of ATM in this case.
http://download.journals.elsevierhealth.com/pdfs/journals/1875-4597/PIIS1875459713000246.pdf
Estenosis traqueal no esperada durante anestesia general en posición prona en distrofia muscular de Duchenne: Informe de dos casos
Unexpected tracheal narrowing during general anesthesia in the prone position of Duchenne muscular dystrophy patient -A report of two cases-
Dong Kyu Lee, Byung Gun Lim, Il-Ok Lee, Hye-Ran Oh, Sang Ho Lim, and Mi Kyoung Lee
Department of Anesthesiology and Pain Medicine, Korea University Guro Hospital, Seoul, Korea
Korean J Anesthesiol 2013 May 64(5): 456-459
Unexpected tracheal narrowing was observed in a patient with Duchenne muscular dystrophy during a corrective operation for thoracolumbar scoliosis. As the operating time progressed, peak airway pressure and end-tidal CO2 increased gradually in the prone position. We found a floppy portion of the trachea using fiberoptic bronchoscopy (FB) in the prone position. We advanced a wire-reinforced tube toward the carina beyond the lesion. This allowed correction of the ventilatory abnormalities. We encountered another patient scheduled for the same operation. We performed FB in advance before the position change and observed a narrowed portion of trachea. We advanced the tracheal tube under FB beyond the pathologic portion and then moved the patient into the prone position. The operation was done successfully without any problems.
Key Words: Duchenne muscular dystrophy, Prone position, Tracheal narrowing.
http://ekja.org/Synapse/Data/PDFData/0011KJAE/kjae-64-456.pdf
Imágenes de miopatía de Duchenne
Duchenne muscular dystrophy pictures
http://www.anestesia-dolor.org/imagenes-medicas-anestesia.html
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
E-books, lejos de la realidad poblana
Poblanerías en línea
Sin embargo, para Alma Carrasco, coordinadora General de Consejo de Lectura Puebla AC, el impulso que necesitan los libros electrónicos, también conocidos como e-books, se encuentra en el acceso real que las personas puedan tener a la tecnología e ...
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Planeta venderá eBooks en Perú a través de Apple en setiembre u ...
Diario Gestión
El representante de Planeta resaltó que en España la participación de los eBooks en el mercado creció de 6% a 18% en dos años. “Aquí existe mucho potencial, pero falta el soporte. No todos tienen una tablet o un iPad. Por eso el crecimiento no será tan ...
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Un escritor que venda 1.000 e-books ya es un autor superventas
Aviondepapel.tv
No obstante, las editoriales valoran la frontera del millar de e-books y así destinan más o menos presupuesto a la promoción del escritor que la cruce, según fuentes del sector consultadas. En cambio, los autores que despuntan en la novela física ...
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El mercado de los e-books superará al de los libros impresos en 2017
Media-Tics
La empresa de consultoría PwC (PricewaterhouseCoopers) acaba de publicar su informe anual sobre la industria del entretenimiento y los medios de comunicación estadounidenses. Ofreció detalles sobre lo que está ocurriendo actualmente en el mercado ...
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Apple alega falta de pruebas en juicio antimonopolio por e-books
AFP
Apple alega falta de pruebas en juicio antimonopolio por e-books. Por John BIERS (AFP) – hace 4 minutos. NUEVA YORK — El grupo estadounidense de informática Apple dijo que el gobierno carece de pruebas de una conspiración con las editoriales para ...
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Apple, acusada de manipular precios de e-books; la empresa lo niega
Informador.com.mx
NUEVA YORK, ESTADOS UNIDOS (20/JUN/2013).-Un abogado del Departamento de Justicia instó el jueves a una jueza a señalar que Apple Inc. se confabuló con editoriales en 2010 para aumentar el precio de los libros electrónicos, mientras que un ...
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RBA Libros lanza su catálogo de ebooks
FantasyMundo
Esta misma semana, la editorial RBA informaba a través de un comunicado de prensa, el inminente lanzamiento de su catálogo de libros digitales, tanto de libros ya publicados hace meses (los denominados “de fondo”) como de las novedades de cada uno ...
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Apple responde que actuó legalmente en el caso de e-books
El Mexicano
Nueva York, EU.- Apple dijo que el gobierno estadunidense carece de pruebas de una conspiración con las editoriales para elevar el precio de los libros electrónicos, al pronunciar este jueves sus alegatos finales en un juicio federal antimonopolio.
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Gobierno de EU dice que Apple manipuló precios de e-books
El Heraldo de Tabasco
Gobierno de EU dice que Apple manipuló precios de e-books. Apple es acusado de aliarse con casas editoriales para elevar los precios de los libros electrónicos. Foto: Internet. Organización Editorial Mexicana. 20 de junio de 2013. AP Nueva York, EU.
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Exportación de eBooks | Gestión Cultural Formación y ... - Dosdoce
Desde 2004 dosdoce.com es un observatorio que analiza las nuevas tecnologías en el sector cultural.
www.dosdoce.com/articulo/opinion/.../exportacion-de-ebooks/
'E-book' de EL CORREO sobre 'Redes sociales e industrias culturales'
La autora, Arantxa Serantes, recopila textos sobre la cultura y su relación con las redes sociales // Se puede descargar gratuitamente en ...
www.elcorreogallego.es/ebooks/ecg/.../idNoticia-812730/
Buscan llevar ebooks gratuitos a niños a través de la nube | Clases ...
Buscan llevar ebooks gratuitos a niños a través de la nube. Escrito por @ cdperiodismo en Claves el 22/06/2013 | Comenta · Print Friendly. Tweet Pin It · votar.
www.clasesdeperiodismo.com/.../buscan-llevar-ebooks-gratuit...
Azul de metileno en el tratamiento del shock vasodilatador refractario después de la implantación del dispositivo de asistencia cardiaca: reporte de cuatro casos consecutivos
Use of methylene blue in the treatment of refractory vasodilatory shock after cardiac assist device implantation: report of four consecutive cases.
Michel S, Weis F, Sodian R, Beiras-Fernandez A, Bigdeli AK, Kaczmarek I, Bruegger D.
Department of Cardiac Surgery, Ludwig-Maximilians-University, Munich, Germany.
J Clin Med Res. 2012 Jun;4(3):212-5. doi: 10.4021/jocmr804w. Epub 2012 May 15.
Abstract
Vasodilatory shock frequently occurs after cardiac surgery, particularly after cardiac assist device implantation. This complication is often associated with high mortality, especially if refractory to conventional vasoconstrictor treatment. Methylene blue, a guanylate cyclase inhibitor, has been successfully used in the management of vasodilatory shock associated with cardiopulmonary bypass. We present four successive cases after implantation of cardiac assist devices suffering from norepinephrine and vasopressin refractory severe vasodilatory shock. In all patients, administration of a single dose of methylene blue (2 mg/kg body weight) resulted in an immediate and persistent decrease in vasoconstrictor dosages and serum lactate concentrations. Despite of this benefit, all patients deceased during hospital stay, however, this was not related to the methylene blue treatment. Methylene blue seems to be a promising therapeutical option in patients with otherwise resistant vasodilatory shock after cardiac assist device implantation. However, controlled clinical trials are necessary to substantiate safety and efficacy.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3376881/pdf/jocmr-04-212.pdf
Azul de metileno: revisión
Methylene blue: revisited.
Ginimuge PR, Jyothi SD.
Assistant Professor, Department of Anaesthesiology, Belgaum Institute of Medical Sciences, Belgaum, Karnataka, India.
Ginimuge PR, Jyothi S D. Methylene blue: Revisited.
J Anaesthesiol Clin Pharmacol [serial online] 2010 [cited 2013 Jun 18];26:517-20.
J Anaesthesiol Clin Pharmacol. 2010 Oct;26(4):517-20.
Methylene blue, an inhibitor of nitric oxide synthase and guanylate cyclase has many uses in medicine. It has been found to improve the hypotension associated with various clinical states. [1] It also improves hypoxia and hyper dynamic circulation in cirrhosis of liver and severe hepatopulmonary syndrome. [2] It also results in transient and reproducible improvement in blood pressure and cardiac function in septic shock
http://www.joacp.org/text.asp?2010/26/4/517/74599
Atentamente
Dr. Juan Carlos Flores-Carrillo
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
Manejo perioperatorio de los pacientes para cirugía pituitaria transesfenoidal
Perioperative management of patients undergoing transsphenoidal pituitary surgery.
Zada G, Woodmansee WW, Iuliano S, Laws ER
Asian J Neurosurg [serial online] 2010 [cited 2013 Jun 9];5:1-6.
Abstract
Background: The sellar and parasellar region is a confluence of several critical anatomical structures from various physiological systems located in close proximity to one another. Patients with pathology in this critical region of the central nervous system therefore make up a unique subset of neurosurgical patients that require careful preoperative and postoperative attention to numerous management details involving neurological, visual, and neuroendocrine function. A thorough understanding of the underlying anatomical and physiological principles of each of these systems, as well as the medical and surgical nuances involved in each case, is required to provide optimized management for patients with pituitary pathology. In this review, we discuss the major preoperative and postoperative considerations in patients undergoing resection for pituitary lesions in the modern era of transsphenoidal surgery.
Keywords: Transsphenoidal surgery, pituitary adenoma, endoscopy, sella turcica
http://www.asianjns.org/text.asp?2010/5/1/1/84790
Evolución endocrinológica de la cirugía endoscópica transesfenoidal:Experiencia en un centro de referencia en Croacia
Endocrinological outcomes of pure endoscopic transsphenoidal surgery: a Croatian Referral Pituitary Center experience.
Maric A, Kruljac I, Čerina V, Pecina HI, Sulentic P, Vrkljan M.
Referral Center for Clinical Neuroendocrinology and Pituitary Diseases, Sestre Milosrdnice University Hospital, Zagreb, Croatia.
Croat Med J. 2012 Jun;53(3):224-33.
Abstract
AIM: To analyze early remission, complications, and pituitary function recovery after pure endoscopic endonasal transsphenoidal surgery (PEETS), a novel method in pituitary adenoma treatment. METHODS: Testing of all basal hormone values and magnetic resonance imaging (MRI) were performed preoperatively and postoperatively (postoperative MRI only in nonfunctioning adenomas) in 117 consecutive patients who underwent PEETS in the period between 2007 and 2010. The series consisted of 21 somatotroph adenomas, 61 prolactinomas, and 4 corticotroph and 31 nonfunctioning adenomas. Sixty-three were macroadenomas and 54 were microadenomas. Remission was defined as hormonal excess normalization on the seventh postoperative day in functioning adenomas and as normal MRI findings approximately four months postoperatively in nonfunctioning adenomas. The presence of hypogonadism, growth hormone deficiency, and hypothyroidism was assessed on the seventh postoperative day. Hypocortisolism was assessed through necessity for replacement therapy within 18 months postoperatively. RESULTS: Remission was achieved in 84% of patients: in 100% of microadenoma and 70% of macroadenoma patients (P<0.001, odds ratio [OR], 28.16, 95% confidence interval [CI], 1.61-491.36), respectively. Endocrinological complications occurred in 17.1% of patients: in 9% of microadenoma and 24% of macroadenoma patients (P=0.049, OR, 3.06; 95% CI, 1.03-9.08). Duration of empirical hydrocortisone replacement therapy was significantly shorter in microadenoma patients (P<0.001). Thirty-five percent of preoperatively present hormonal deficiencies improved after the surgery. Between tumor types there were no significant differences in remission, complications, and normal pituitary function recovery.
CONCLUSION: Patients with microadenomas had higher remission and lower complication rates following PEETS, emphasizing the necessity for early detection and treatment of pituitary adenomas. PEETS is a discussion-worthy method for microprolactinoma treatment.
http://www.cmj.hr/2012/53/3/22661135.htm
Comparación de propofol vs sevoflurano sobre la termorregulación en pacientes bajo cirugía hipofisaria transesfenoidal: estudio preliminar
Comparison of propofol versus sevoflurane on thermoregulation in patients undergoing transsphenoidal pituitary surgery: A preliminary study.
Chowdhury T, Prabhakar H, Bharati SJ, Goyal K, Dube SK, Singh GP.
Department of Neuroanesthesiology, Neurosciences Center, All India Institute of Medical Sciences, New Delhi, India.
Saudi J Anaesth. 2012 Jan;6(1):12-5. doi: 10.4103/1658-354X.93046.
Abstract
PURPOSE: General anesthesia causes inhibition of thermoregulatory mechanisms. Propofol has been reported to cause more temperature fall, but in case of deliberate mild hypothermia, both sevoflurane and propofol were comparable. Thermoregulation is found to be disturbed in cases of pituitary tumors. We aimed to investigate which of the two agents, sevoflurane or propofol, results in better preservation of thermoregulation in patients undergoing transsphenoidal excision of pituitary tumors. METHODS: Twenty-six patients scheduled to undergo transsphenoidal removal of pituitary adenomas were randomly allocated to receive propofol or sevoflurane anesthesia. Baseline esophageal temperature was noted. Times for temperature to fall by 1°C or 35°C and to return to baseline were also comparable (P>0.05). After that warmer was started at 43°C and time to rise to baseline was noted. Duration of surgery, total blood loss, and total fluid intake were also noted. If any, side effects such as delayed arousal and recovery from muscle relaxant were noted. RESULTS: The demographics of the patients were comparable. Duration of surgery and total blood loss were comparable in the two groups. The time for temperature to fall by 1°C or 35°C and time to return to baseline was also comparable (P>0.05). No side effects related to body temperature were noted. CONCLUSION: Both propofol and sevoflurane show similar effects in maintaining thermal homeostasis in patients undergoing transsphenoidal pituitary surgery
http://www.saudija.org/temp/SaudiJAnaesh6112-7795748_213917.pdf
http://www.saudija.org/article.asp?issn=1658-354X;year=2012;volume=6;issue=1;spage=12;epage=15;aulast=
Chowdhury
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
La comunicación en vía aérea difícil entre los anestesistas y médicos generales
Difficult airway communication between anaesthetists and general practitioners
M Wilkes, C Beattie, C Gardner and AF McNarry
Scott Med J 2013 58: 2
Background and aims. Advance warning of patients who are difficult to intubate may prevent an airway catastrophe but relies on effective communication between specialties. Anaesthetists aim to inform general practitioners whenever a difficult airway is encountered and expect general practitioners to include this information in subsequent referrals. We investigated how anaesthetists communicated with general practitioners, their knowledge of the Read Code (used by general practitioner computer systems) for difficult tracheal intubation, and how likely general practitioners were to pass the information on. Methods and results. We surveyed 631 consultant anaesthetists and 217 general practitioners. We found only 125 (20%) anaesthetists consistently wrote difficult airway letters to general practitioners. Only 20 (3%) knew the Read Code for difficult intubation (SP2y3), although 454 (72%) thought it to be useful. Most general practitioners (212, 98%) thought airway information to be important, but only half receiving a difficult airway communication forwarded it on. General practitioners recommended including the Read Code SP2y3 and labelling it 'high priority', ensuring that 'Difficult Tracheal Intubation' would be listed in the Emergency Care Summary generated for hospital referrals.
Conclusion Communication between anaesthetists and general practitioners is currently poor, but could be improved by simplifying difficult airway letters and including the SP2y3 code and a statement of priority.
http://scm.sagepub.com/content/58/1/2.full.pdf+html
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
Doscientas mil licencias de ebooks para las bibliotecas públicas ...
ABC.es
El Ministerio de Educación, Cultura y Deporte ha anunciado que a partir de principios de 2014 pondrá a disposición de los usuarios de las bibliotecas públicas 200.000 licencias de uso de libros electrónicos. El desarrollo de la edición electrónica ...
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SiDiM, una escupida sobre los eBooks
InfoBAE.com
SiDiM- iniciativa del proyecto Fraunhofer con ayuda del gobierno alemán – es auspiciado como una solución antipiratería amigable para el lector dado que no impide la copia de los eBooks. Si no impide la copia de eBooks, ¿qué hace exactamente? SiDiM ...
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Telefónica y Círculo de Lectores impulsan los ebooks
Mallorca Confidencial
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Tablet o ebook reader. ¿Cuál es mejor para leer en verano?
ComputerHoy
Ahora tenemos más tiempo para leer libros: en la playa, el parque, en casa cuando aprieta el calor... Los ebooks son más baratos que la versión en papel. Ahorrarás mucho dinero. Tanto la tablet como elebook reader tienen sus ventajas e inconvenientes.
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Wert tan solo compra 'e-books' en castellano para las bibliotecas
El Periódico Extremadura
El Ministerio de Cultura ha practicado este año un ejercicio de prestidigitación con la compra de libros para bibliotecas públicas, que ha rematado con la convocatoria para adquirir 200.000 licencias de uso de libros electrónicos para su préstamo en ...
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El Gobierno concederá 200.000 licencias de eBooks a bibliotecas ...
Expansión.com
Banca · TMT · Energía · Inmobiliario y Construcción · Transporte y Turismo · Automoción e Industria · Distribución · Bolsas · Economía. El Gobierno concederá 200.000 licencias de eBooks a bibliotecas públicas en 2014. Menéame · Tweet. Tags: empresas,tmt.
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Cultura ultima una plataforma de préstamo de e-books para ...
Aviondepapel.tv
Mientras cae drásticamente la inversión de los fondos en papel de las bibliotecas y crecen las listas de espera de algunos megasellers, el Ministerio de Educación, Cultura y Deporte anuncia el lanzamiento de una plataforma de préstamo de e-books para ...
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Cultura promoverá el préstamo de 'e-books' para bibliotecas ...
Noticias de Navarra
Cultura promoverá el préstamo de 'e-books' para bibliotecas públicas en 2014. Habrá 200.000 licencias de uso de libros electrónicos, a las que destinará un presupuesto de 2 millones. EFE - Martes, 2 de Julio de 2013 - Actualizado a las 11:41h.
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Cultura promoverá el préstamo de "e-books" para bibliotecas ...
Madrid, 2 jul (EFE).- El Ministerio de Educación, Cultura y Deporte ha anunciado hoy que a principios de 2014 pondrá a disposición de 12 millones de ciudadanos, socios de las bibliotecas públicas, 200.000 licencias de uso de libros ...
Tecnología Noticias, vídeos...
EBLIDA: E-BOOKS IN LIBRARIES CAMPAIGN | FESABID
EBLIDA puso en marcha en 2012 una campaña europea para los libros electrónicos en las bibliotecas,e-books in libraries. Su objetivo es llamar la atención de ...
www.fesabid.org/.../eblida-e-books-in-libraries-campaign
Descarga y compra ebooks con Kindle y otros - OCU
Si te gusta leer a través de medios digitales, puedes hacerte con cientos de títulos en Internet. Comprar libros con Kindle es fácil e intuitivo y sólo necesitás un ...
www.ocu.org/.../descarga-y-compra-ebooks-con-kindle-y-otro...
Cultura promoverá el préstamo de 'e-books' para bibliotecas ...
El Ministerio de Educación, Cultura y Deporte ha anunciado hoy que a principios de 2014 pondrá a disposición de 12 millones de ciudadanos, socios de las ...
eldia.es/.../13-Cultura-promovera-prestamo-books-bibliotecas-...
Cultura promoverá el préstamo de "e-books" para ... - El Confidencial
Madrid, 2 jul (EFE). El Ministerio de Educación, Cultura y Deporte ha anunciado hoy que a principios de 2014 pondrá a disposición de 12 millones de ...
www.elconfidencial.com/.../cultura-promovera-prestamo-eboo...
La doctora Jomeini: Firma de ebooks
Firma de ebooks · Historia de una dedicatoria · Doña Despistes · La virgen del aceite · Segundas oportunidades · 8 de Junio II · El corazón roto. ▻ mayo (5).
blogdrajomeini.blogspot.com/2013/06/firma-de-ebooks.html
La biblioteca se apunta al sistema de autopréstamo por ...
Diario Vasco
Muestra de ello es la próxima incorporación al sistema de autopréstamo por radiofrecuencia RFID (Radio Frequency Identification). Se trata -según explican responsables de la biblioteca- de un nuevo sistema de identificación de objetos, en este caso ...
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Exhibe Biblioteca Vasconcelos el talento de becarios del Fonca
La Jornada en linea
Exhibe Biblioteca Vasconcelos el talento de becarios del Fonca. La muestra reúne un total de 359 obras de 185 artistas becarios de la generación 2010-2011, generadas en disciplinas como Arquitectura, Artes Visuales, Fotografía, Gráfica, Multimedia, ...
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La Biblioteca Pública sale a la calle los jueves de verano
segoviaudaz.es
La Biblioteca Pública de Segovia propone diversas actividades culturales para el mes de julio. Para empezar, mañana comienza la actividad 'Los jueves de la Patioteca' en la que se van a realizar diversos talleres y actuaciones teatrales durante los ...
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"Biblioteca: Gran Pantalla" arranca el próximo viernes con la ...
Noticias Castilla y León
El ciclo “Biblioteca: Gran Pantalla” arranca el próximo viernes con la proyección de la película “El viaje de Chihiro” a las 22,30 horas en la plaza exterior de la Biblioteca Gonzalo Torrente Ballester (Paseo de los Olivos, 10). El ciclo, que está ...
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'Yo me hice en una biblioteca': poeta Eduardo Carranza
ElTiempo.com
A los 16 años fue director de la biblioteca de la Escuela Normal Central de Instituciones; escribió 'Lasbibliotecas escolares', su tesis de grado para optar a Maestro de Escuela Superior; se desempeñó como director de la Biblioteca Nacional desde 1948 ...
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Biblioteca Vasconcelos exhibe obra de becarios del Fonca
Periódico Correo
Distribuidas en la planta baja de la Biblioteca Vasconcelos, el visitante es testigo del gran talento de cada uno de los participantes involucrados, cuyas obras son resultado de los conocimientos y los trabajos realizados en cada una de las disciplinas ...
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Biblioteca Nacional de Uruguay rompe inercia de medio siglo
Espanol UPI.com
MONTEVIDEO, Uruguay, jul. 2 (UPI) -- La Biblioteca Nacional experimenta una etapa de permanente evolución, que implicó romper con "una inercia de 50 años", dijo a la Secretaría de Comunicación el director de la institución, Carlos Liscano. Entre las ...
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La biblioteca se llena de niños durante el verano
Hoy Digital
La sala infantil de la Biblioteca 'Francisco Valdés' de Don Benito retoma sus actividades diarias de verano, en la que se espera que participen más de 500 niños durante julio y agosto. En los primeros días de mes ya se ha podido comprobar el ajetreo de ...
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La Biblioteca de Verín sale a la calle con los libros más prestados
Faro de Vigo
Durante los días 3, 11 y 23 de julio, y 2, 12 y 23 de agosto, la Biblioteca Pública Municipal del Concello de Verín vuelve a salir a la calle con el objeto de acercar los libros lo más posible a los lectores e incentivar la importancia de la lectura ...
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Donan biblioteca de Alfredo Guevara a Universidad de Oriente
Adelante
(AIN) Cerca de mil 300 libros de la colección personal de Alfredo Guevara fueron donados a labiblioteca central Francisco Martínez Anaya, de la Universidad de Oriente en Santiago de Cuba. La entrega se inscribe como parte del cumplimiento póstumo de ...
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Blogs 1 resultado nuevo de Biblioteca
Bunita anochi dedica na Dr .Ellis Juliana na Biblioteca - Diario Online
según felix
ORANJESTAD(AAN) Den un conferencia teni na Biblioteca Nacional Sr Mirto Lacle a declara cu dia 4 di Juli 2013 e lo organiza Un anochi cu lo duna tributo y homenahe na Dr Ellis Juliana. E programa lo cuminsa pa 730 di anochi y e lo ta ...
Diario Online
Estudio sobre clonidina como premedicación y sus efectos hemodinámicos perioperatorios en pacientes normotensos
A study on clonidine as a premedicant and its effects on perioperative hemodynamic in normotensive patients.
Singh N R, Rajkumar G, Singh S S, Jamatia P, Singh T H, Singh T.
J Med Soc [serial online] 2012 [cited 2013 Jun 10];26:180-3.
Abstract
Background: Hemodynamic instability is one of the most imminent conditions during general anesthesia (GA), especially, during laryngoscopy and intubation. The aim of the study was to study the perioperative hemodynamic effect of clonidine in normotensive patients undergoing elective surgery under GA. Materials and Methods: A randomized double blinded placebo controlled study was conducted in the department of Anesthesiology, Regional Institute of Medical Sciences, Imphal on 150 normotensive adult patients of either sex aged 18-60 years (American Society of Anesthesiologist I and II) undergoing elective surgery under GA. The patients were allocated into three groups viz.: Group 1-2 μg/kg clonidine; group II-3 μg/kg clonidine; and group III - placebo/normal saline. The test drug was administered 30 min before the induction of anesthesia. Upon arrival at theatre, the following data were recorded viz.: (1) Visual analogue score of anxiety, (2) loss of consciousness, and (3) dryness of mouth. Pre-induction heart rate (HR) and blood pressure (BP) were recorded 5 min after resting on the operating table. HR and BP were recorded during the time of intubation every 8 min and ½ h after intubation during the intraoperative period (post-intubation). Postoperative BP and HR on arrival at the post-anesthetic care unit and then every ½ h for 3 h were recorded. Any episodes of nausea and vomiting, shivering and analgesic requirements were noted. Results: Clonidine 2 μg/kg and 3 μg/kg both significantly controlled the perioperative hemodynamics. The hemodynamic changes were statistically significant at all times intervals except at preoperative, at 8 min post-intubation to 1 h post-intubation period. Conclusion: Clonidine is useful as a premedicant in controlling the perioperative hemodynamics changes in normotensive patients undergoing operative procedures under GA.
Keywords: Clonidine, General anesthesia, Hemodynamics, Premedicant
http://www.jmedsoc.org/text.asp?2012/26/3/180/113244
Disminución de la respuesta presora a la laringoscopía directa e intubación traqueal: clonidina oral vs. gabapentina en la premedicación
Attenuation of the pressor response to direct laryngoscopy and tracheal Intubation: oral clonidine vs. oral gabapentin premedication.
Montazeri K, Kashefi P, Honarmand A, Safavi M, Hirmanpour A.
Associate Professor of Anesthesiology, Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
J Res Med Sci. 2011 Mar;16 Suppl 1:S377-86.
Abstract
BACKGROUND: We carried out this study to compare the efficacy of oral gabapentin and clonidine premedication for controlling the pressor responses to laryngoscopy and tracheal intubation. METHODS: In this double-blind clinical trial, ninety-six patients were randomly allocated to one of three groups according to the agents to be used before the induction of anaesthesia: Group P (n = 32) received oral placebo, Group G (n = 32) received 800 mg of gabapentin, and Group C (n = 32) received 0.3 mg of clonidine 90 minutes prior to surgery. Systolic arterial pressure (SAP), diastolic arterial pressure (DAP), mean arterial pressure (MAP), heart rate (HR) and rate pressure product (RPP) were measured at baseline (3 min before induction), just before laryngoscopy, and postintubation (at 1, 3, 5, 10 and 15 min after starting laryngoscopy). Statistical analysis of data was done with repeated measure ANOVA and chi-square test. RESULTS: HR and RPP significantly decreased in Group G and Group C at 5, 10, and 15 minutes after tracheal intubation compared with those just before laryngoscopy (p < 0.05). No significant difference was noted between Group G and Group C considering these variables. SAP, DAP, MAP and RPP at 1, 3, 5, 10, and 15 minutes after intubation were significantly lower in Group G compared with Group P (p < 0.05). There was no significant difference between Group C and Group P in this regard. CONCLUSIONS: The present study demonstrated that premedication with oral gabapentin 800 mg or clonidine 0.3 mg similarly blunted the hyperdynamic response after laryngoscopy and intubation.
KEYWORDS: Premedication, intubation, laryngoscopy, oral clonidine, oral gabapentin, pressor response
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3252769/?report=classic
Respuesta hemodinámica durante la colecistectomía laparoscópica: Efecto de dos dosis diferentes de clonidina intravenosa en la premedicación
Hemodynamic stress response during laparoscopic cholecystectomy: Effect of two different doses of intravenous clonidine premedication.
Tripathi DC, Shah KS, Dubey SR, Doshi SM, Raval PV.
Department of Anaesthesiology, Government Medical College, Bhavnagar, Gujarat, India.
J Anaesthesiol Clin Pharmacol. 2011 Oct;27(4):475-80. doi: 10.4103/0970-9185.86586.
Abstract
BACKGROUND: Clonidine has emerged as an attractive premedication desirable in laparoscopic surgery wherein significant hemodynamic stress response is seen. The minimum safe and effective dose of intravenous clonidine to attenuate the hemodynamic stress response during laparoscopic surgery has however not yet been determined. MATERIALS AND METHODS: This prospective, randomized, double-blind controlled study was conducted on 90 adults of ASA physical status I and II, scheduled for laparoscopic cholecystectomy under general anesthesia. Patients were randomized to one of the three groups (n= 30). Group I received 100 ml of normal saline, while groups II and III received 1 μg/ kg and 2 μg/ kg of clonidine respectively, intravenous, in 100 ml of normal saline along. All patients received glycopyrrolate 0.004 mg/kg and tramadol 1.5 mg/kg intravenously, 30 min before induction. Hemodynamic variables (heart rate, systolic, diastolic, mean arterial pressure), SpO2, and sedation score were recorded at specific timings. MAP above 20% from baseline was considered significant and treated with nitroglycerine. RESULTS: In group I, there was a significant increase in hemodynamic variables during intubation pneumoperitoneum and extubation (P<0.001). Clonidine given 1 μg/kg intravenous attenuated hemodynamic stress response to pneumoperitoneum (P<0.05), but not that associated with intubation and extubation. Clonidine 2 μg/kg intravenous prevented hemodynamic stress response to pneumoperitoneum and that associated with intubation and extubation (P<0.05). As against 14 and 2 patients in groups I and II respectively, no patient required nitroglycerine infusion in group III. CONCLUSIONS: Clonidine, 2 μg/ kg intravenously, 30 min before induction is safe and effective in preventing the hemodynamic stress response during laparoscopic cholecystectomy.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3214551/
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
