ABSTRACT
Las complicaciones relacionadas con la sedación son, en su enorme mayoría, prevenibles. El presente documento establece unas recomendaciones para que los no anestesiólogos puedan realizar sedaciones nivel I y II con un buen nivel de seguridad. Sus aspectos másimportantes son: administración de la sedación por una persona diferente del operador; recomendaciones en cuanto a la capacitación, la monitorización, el uso de un solo medicamento para la sedación y la disponibilidad de medicamentos y equipos de respaldo;la necesidad de realizar una evaluación previa a la sedación, así como el consentimiento informado y el registro durante el procedimiento; y recomendaciones para considerar un bajo umbral con el fin de solicitar el apoyo de un anestesiólogo.
Most of the complications related to sedation are preventable. This document defines some recommendations for non-anesthesiologists so that they can provide sedation level I and II with adequate safety. The most important recommendations are: that the sedation be provided by someone different from the person who performs the surgical procedure; designation of the training and monitoring of thje person who sedates; the use of only one medication for sedation, and the availability of medications and equipment to manage complications; the mandatory need of an assessment prior to the sedation, as well as informed consent and record of events during the procedure; and the recommendation of having a low threshold to request the support of an anesthesiologist.
Subject(s)
HumansABSTRACT
Surgery in spastic lower extremities among cerebral palsy is reserved for patients with a reasonable chance to ambulate, to correct the spastic deformity and to improve gait. This study aims to assess the local results of various soft tissue operations such as adductor tenotomy, hamstring release, tendon of Achilles lengthening and tendon transfers. From December 1989 to January 1992, twenty one cerebral palsy children were included in this study. Preoperatively, two of these 21 patients were freely ambulatory. After surgery, 14 were free ambulators and 7 were crutch walkers. These results showed that soft tissue surgery is effective. Combined with intensive physical therapy, optimum ambulatory function of spastic cerebral palsy patients can be achieved. (Author)
Subject(s)
Humans , Male , Female , Child , Muscle Spasticity , Cerebral Palsy , Tenotomy , Tendon Transfer , Walkers , Crutches , Gait , Achilles Tendon , Lower ExtremityABSTRACT
Twenty one polio patients with severe knee flexion contractures admitted at the Santo Tomas University Hospital, Clinical Division from 1984 to 1990 were studied. There were 11 males and 10 females with age ranging from 12 to 18 years with a mean of 14.3 years. The degree of knee flexion ranged from 45 to 120 degrees with an average of 62.5 degrees. Clinical data included the ranges of motion, the stability of the hip, knee and ankle. Manual muscle testing as well as limb length and girth were recorded. the technique as described by Huckstep was conducted either as a one or two staged procedure with or without preliminary skeletal tractions. One patient required an internal fixation on the osteotomized fragments for stability. Two patients had residual flexion contracture of 5 ad 10 degrees after removal of cast. Only one patient abandoned her braces and opted to use her wheel chair despite healed osteotomy. (Author)