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INTRODUCCIÓN: la anestesia espinal unilateral (AEU) es una alternativa para el desarrollo de la cirugía ortopédica ambulatoria (COA). el OBJETIVO de este ensayo clínico fue el evaluar una dosis baja de bupivacaína hiperbara (BHB), asociada a fentanilo intratecal (FI) para obtención de AEU en COA. MATERIALES Y MÉTODOS: ensayo clínico, prospectivo, controlado en pacientes ASA I a II. la AEU se efectuó con el paciente en decúbito lateral (DL), con el lado operatorio hacia abajo, a nivel de L3-L4. se inyectó 5 mg de BHB 0,75% asociado a 20 µg de FI. se evaluó el bloqueo sensitivo (BS) y motor (BM) cada 3 minutos, los primeros 20 minutos y luego cada 15 minutos. Se midió el nivel máximo alcanzado, el tiempo de regresión a T12 y el tiempo de regresión de dos segmentos. se registró la incidencia de complicaciones. RESULTADOS: 50 pacientes fueron incluidos, 66% de sexo masculino. Se obtuvo anestesia unilateral en el 84% y BM total unilateral en el 86%. La altura del BS osciló entre T9 y T11. la duración del BS fue 116 min. (SD± 23). la regresión a T12 fue de 47 min (SD±19). No se encontró correlación entre talla, dosis y duración de bloqueo. ningún paciente necesitó anestesia general. 1 paciente presentó bradicardia. DISCUSIÓN: la AEU con dosis bajas de BHB asociado a FI es eficiente en COA. se obtuvo adecuados BS y BM en la mayoría de los pacientes. la AEU mostró ser confiable, permitiendo una alta precoz y segura.
INTRODUCTION: The unilateral spinal anesthesia (USA) is an alternative for orthopedic ambulatory surgery (OAS). The AIM of this study was to evaluate a low dose of hyperbaric bupivacaine (HB) associated with intrathecal fentanyl (ITF) to produce USA. MATERIALS AND METHODS: Prospective, controlled clinical trial in ASA I II patients. The USA was developed in lateral position with the operating side downwards between L3-L4 space with 5 mg of HB + 20 µg ITF. We evaluated sensitive level block (SB), motor level block (MB), maximum level obtained, discharge time (DT) and collateral effects incidence. RESULTS: 50 patients were included, 66% male. The USA was obtained in 84% and total BM was present in 86% of cases. The level obtained of SB was between T9-T11 and the duration was 116 min (SD± 23). No correlation was obtained between patients height, BH dose and block duration. 1 patient presented bradycardia. No general anesthesia was necessary. DISCUSSION: The USA with a low dose of HB and ITF it's safe to developed OAS. Only 11 min were necessary to obtain a good SB and MB.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Bupivacaine/administration & dosage , Orthopedic Procedures/methods , Ambulatory Surgical Procedures/methods , Anesthesia, Spinal/methods , Fentanyl/administration & dosage , Prospective Studies , Anesthesia, LocalABSTRACT
Objective To investigate the minimum dose of contrast medium when using spectral CT in cranial CTA. Methods Three groups of patients were required to undergo head CTA examination because of their condition,but different doses of contrast agents were injected.Among them,group 30 mL, group B, group 40mL, group C and group 50 mL were A. Results In group A,the lowest rate of excellent image (23.33%), B group, C group had higher rate of excellent image (93.33%, 96.67%), comparison of the data P<0.05; C group the highest rate of adverse reaction of contrast agent (P<0.05),data comparison P<0.05, A group, B group significantly adverse reactions of contrast agent there is no difference between the situation (P>0.05). Conclusion The use of 40 mL iodide contrast medium in the procedure of cranial CTA examination is effective and safe.
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Objective To investigate the minimum dose of contrast medium when using spectral CT in cranial CTA. Methods Three groups of patients were required to undergo head CTA examination because of their condition,but different doses of contrast agents were injected.Among them,group 30 mL, group B, group 40mL, group C and group 50 mL were A. Results In group A,the lowest rate of excellent image (23.33%), B group, C group had higher rate of excellent image (93.33%, 96.67%), comparison of the data P<0.05; C group the highest rate of adverse reaction of contrast agent (P<0.05),data comparison P<0.05, A group, B group significantly adverse reactions of contrast agent there is no difference between the situation (P>0.05). Conclusion The use of 40 mL iodide contrast medium in the procedure of cranial CTA examination is effective and safe.