Parche peridural en obstetricia / EBP in obstetrics

Abril 26, 2016. No. 2308

Estudio de observación de los cambios en la presión epidural y elasticidad durante parche hemáticoepidural en pacientes obstétricas. Observational study of changes in epidural pressure and elastance during epidural blood patch in obstetric patients. Pratt SD1, Kaczka DW2, Hess PE2. Int J Obstet Anesth. 2014 May;23(2):144-50. doi: 10.1016/j.ijoa.2014.01.003. Epub 2014 Jan 27. Abstract BACKGROUND: During an epidural blood patch, we inject blood until the patient describes mild back pressure, often leading to injection of more than 20 mL of blood. We undertook this study to measure the epidural pressures generated during an epidural blood patch and to identify the impact of volume on epidural elastance in obstetric patients. METHODS: This study was performed in postpartum patients who presented for an epidural blood patch with symptoms consistent with a postdural puncture headache. After identification of the epidural space using loss of resistance to air or saline, we measured static epidural pressure after each 5-mL injection of blood. Models were then fitted to the data and the epidural elastance and compliance calculated. RESULTS: Eighteen blood patches were performed on 17 patients. The mean final volume injected was 18.9±7.8 mL [range 6-38 mL]. The mean final pressure generated was 13.1±13.4 mmHg [range 2-56 mmHg]. A curvilinear relationship existed between volume injected and pressure, which was described by two models: (1) pressure=0.0254×(mL injected)(2)+0.0297 mL, or (2) pressure=0.0679×mL(1.742). The value for r2 was approximately 0.57 for both models. We found no correlation between the final pressure generated and the success of the epidural blood patch. CONCLUSIONS: We found a curvilinear relationship between the volume of blood injected during an epidural blood patch and the pressure generated in the epidural space. However, there was a large variation in both the volume of blood and the epidural pressure generated. The clinical importance of this finding is not known. A larger study would be required to demonstrate whether pressure is a predictor of success. PDF Committee for European Education in Anaesthesiology (CEEA) Colegio de Anestesiólogos de León AC MÓDULO V: Sistema nervioso, fisiología, anestesia locoregional y dolor. Reconocimientos de: CEEA, CLASA, Consejo Nacional Mexicano de Anestesiología.   En la Ciudad de Léon, Guanajuato. México del 6 al 8 de Mayo, 2016. Informes en el tel (477) 716 06 16 y con el Dr. Enrique Hernández kikinhedz@gmail.com

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

Medwave edición Abril 2016

Medwave edición Marzo 2016 completa Vea este email en su navegador

---------------------  Contenidos recientemente publicados:  --------------------------- EPISTEMONIKOS ¿Diuréticos de asa en infusión continua o en bolo en la insuficiencia cardiaca congestiva? Patricio Zepeda, Carmen Rain, Paola Sepúlveda(Chile) Medwave 2016;16(suppl 2):e6426 PROBLEMAS DE SALUD PÚBLICA Alimentación y nutrición, tres vertientes para su comprensión Donovan Casas Patiño, Alejandra Rodríguez Torres, Edgar C. Jarillo Soto (México)  Medwave 2016 Abr;16(2):e6424   ESTUDIO PRIMARIOS ¿Diuréticos de asa en infusión continua o en bolo en la insuficiencia cardiaca congestiva? Gerardo Rogelio Robaina Castellanos; Solangel de la Caridad Riesgo Rodríguez (Cuba) Medwave 2016;16(2):e6422 Ingestas nutricionales y puntaje z del peso en recién nacidos de muy bajo peso al nacer en el Perú Alvaro Proaño, Romina Elena Aragón, Fabiola Rivera, Jaime Zegarra (Perú)  Medwave 2016 Mar;16(2):e6414 NOTA TÉCNICA Evitando irregularidades en el dorso nasal en rinoplastia Fernando Javier Casanueva Lobos, Felipe Cardemil Morales (Chile)  Medwave 2016 Mar;16(2):e6416 AGRADECIMIENTOS Agradecimientos a nuestros pares revisores de 2015 Vivienne C. Bachelet (Chile) Medwave 2016;16(3):e6428 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

¿Quiere cambiar la forma de interactuar con nuestros e-mails? Puede actualizar sus datos o desinscribirse de estas alertas

Anafilaxia y anestesia / Anaphylaxis and anaesthesia

Abril 23, 2016. No. 2305

Anafilaxia perioperatoria Perioperative anaphylaxis. Berrío Valencia MI1. Braz J Anesthesiol. 2015 Jul-Aug;65(4):292-7. doi: 10.1016/j.bjane.2014.09.002. Epub 2015 Apr 28. Abstract BACKGROUND AND OBJECTIVE: Anaphylaxis remains one of the potential causes of perioperative death, being generally unanticipated and quickly progress to a life threatening situation. A narrative review of perioperative anaphylaxis is performed.CONTENT: The diagnostic tests are primarily to avoid further major events. The mainstays of treatment are adrenaline and intravenous fluids. CONCLUSION: The anesthesiologist should be familiar with the proper diagnosis, management and monitoring of perioperative anaphylaxis. PDF  Identificación de factores de riesgo para hipersensibilidad severa en anestesia general Identification of risk factors of severe hypersensitivity reactions in general anaesthesia. Mirone C1, Preziosi D1, Mascheri A1, Micarelli G1, Farioli L2, Balossi LG1, Scibilia J1, Schroeder J1, Losappio LM1, Aversano MG1, Stafylaraki C1, Nichelatti M3,Pastorello EA4. Clin Mol Allergy. 2015 Jun 22;13(1):11. doi: 10.1186/s12948-015-0017-9. eCollection 2015. Abstract BACKGROUND: Hypersensitivity reactions to anaesthetic agents are rare but often severe, with a mortality ranging from 4 to 9% in IgE-mediated events. Identification of the risk factors may contribute to limit the incidence of these reactions. The aim of our study was to search for possible risk factors of severe perioperative hypersensitivity reactions in our study population. CONCLUSIONS: We confirmed the relevance of several clinical features as risk factors for anaphylactic reactions induced by anaesthetic agents: older age, asthma, hypertension and antihypertensive drugs. We observed increased levels of serum basal tryptase in severe reactions: this finding may signify that this biomarker is useful for the identification of patients at risk. KEYWORDS: Age; Anaphylaxis; Angiotensin-converting enzyme inhibitor; General anaesthesia; Hypersensitivity; Hypertension; Neuromuscular blocking agents; Risk factors; Serum tryptase; Severity PDF Committee for European Education in Anaesthesiology (CEEA) Colegio de Anestesiólogos de León AC MÓDULO V: Sistema nervioso, fisiología, anestesia locoregional y dolor. Reconocimientos de: CEEA, CLASA, Consejo Nacional Mexicano de Anestesiología.   En la Ciudad de Léon, Guanajuato. México del 6 al 8 de Mayo, 2016. Informes en el tel (477) 716 06 16 y con el Dr. Enrique Hernández kikinhedz@gmail.com

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