Levobupivacaina al 0, 5% sin epinefrina en anestesia de plexo braquial por via axilar con neuroestimulador: Hospitales Vicente Corral y José Carrasco / 0.5% levobupivacaine without epinephrine anesthetic axillary brachial plexus with neurostimulator: Hospital Vicente Corral and José Carrasco

With a longitudinal descriptive design 101 patient ASA I-II wasincluded, to those who was administered 150 mg of L-Bupivacaína to 0.5% (30 ml) byaxillary route after identifying plexus with neuroestimulator.92.1% (n = 92) blockades were successful. 65.6% (n = 61) of taken part oneswere men. In a rank of 18 to 79 years medium one of age was of 39 years. Half of thesample had between 25 and 48 years (P25 and P75). According to body mass index(BMI) 43% of patients had overweight. Workers (32.3%) and clerks (29%) were themain occupations. The married ones were 57%.Basal constants were: pulse 75.1 ± 12.2 beats/min, SBP 145.8 ± 22.7 mm Hg, DBP79.6 ± 9.8 mm Hg and SpO2 94.1 ± 2.3%. Trans and postoperative blood pressurevaried between 0.6 and 4,7% with respect to basal average. The SpO2 was modifiednot more of 2.5% and variations of pulse were not important either.By 578.9 ± 114.4 min were analgesia (rank 360 to 840 min) and motor blockade by154, 5 ± 116.5 min (rank 460 to 30 min) for a time average of surgery of 25.7 ± 61.5min (rank 140 to 25 min). Complications nor indirect effect were not registered.As it indicates specialized medical literature, hemodinamic stability andabsence of complications turn to the plexus brachial anesthesia by axillary route amethod of election for surgery of the superior member because it avoids thephysiological upheavals and the associated answer of surgical stress to the use of thegeneral anesthesia.

Con un diseño descriptivo longitudinal se incluyeron 101 pacientes ASA I-II, a quienes se administró 150 mg de L-Bupivacaína al 0,5% (30 ml) por vía axilar luego de identificar el plexo con neuroestimulador.El 92,1% (n = 92) de bloqueos fueron exitosos. El 65,6% (n = 61) de los intervenidos fueron varones. En un rango de 18 a 79 años la mediana de edad fue de 39 años. La mitad de la muestra tuvo entre 25 y 48 años (P25 y P75). Según índice de masa corporal (IMC) el 43% de los pacientes tuvo sobrepeso. Obreros (32,3%) y oficinistas (29%) fueron las principales ocupaciones. Los casados fueron el 57%.Las constantes basales fueron: pulso 75,1 ± 12,2 latidos/min, PAS 145,8 ± 22,7 mm Hg, PAD 79,6 ± 9,8 mm Hg y SpO2 94,1 ± 2,3%. La presión sanguínea trans ypostoperatoria varió entre un 0,6 y 4.7% con respecto del promedio basal. La SpO2 se modificó no más del 2,5% y las variaciones del pulso tampoco fueron importantes.Hubo analgesia por 578,9 ± 114,4 min (rango 360 a 840 min) y bloqueo motor por 154,5 ± 116,5 min (rango 30 a 460 min) para un tiempo promedio de cirugía de 61,5 ± 25,7 min (rango 25 a 140 min). No se registraron complicaciones ni efectos secundarios.Como señala la literatura médica especializada, la estabilidadhemodinámica y la ausencia de complicaciones convierten a la anestesia de plexobraquial por vía axilar en un método de elección para cirugía del miembro superiorporque evita los trastornos fisiológicos y la respuesta del estrés quirúrgico asociados al uso de la anestesia general.

Respuesta cardiovascular al ejercicio a gran altura en trabajadores crónicamente expuestos a hipoxia hipobárica intermitente / Cardiovascular response to exercise at high altitude in chronically exposured workers to intermittent hypobaric hypoxia

The isottonic work perfomance was assessed in 34 workers aged 35 ñ 5.8 years old that had working of four days at 4500 m over the sea level and resting periods of other four days at the sea level during at least two years. Subjects were assessed in one occasion at the sea level, and at the first and fourth day of the working shift at 4500 m over the sea level. resting arterial oxygen saturation in theses three periods was 97 ñ 1.1, 88 ñ 18 and 91 ñ 1.1 percent respectively (p<0.01) and markedly decreased during maximal and submaximal exercise at 4500 m over sea level. Evercise duration in the three periods was 931 ñ 210, 775 ñ 105 and 778 ñ 105 seg respectively (p<0.001). Heart rate in the resting period was at least 10 percent higher and maximal and submaxilmal rates were lower at the high altitude. No differences in blood pressure or packed red cell volume were observed. Exercise duration correlated inversely with age (r=-0.49 p=0.03) and directly with maximal heart rate (r=0.44 p=0.009) at the sea level. No correlation between aerobic capacity and other measured parameters was observed. These results show no differences in the cardiovascular response to exercise between the first and fourth day of stay at high altitude in workers chronically exposed to intermittent hypobaric hypoxia