Anestesia peridural continua con bomba de infusión elastomérica en mamoplastia de aumento / Continuous epidural anesthesia with elastomeric infusion pump in augmentation mammoplasty

Introducción: La anestesia y analgesia peridural continua, además de proporcionar un adecuado control del dolor posoperatorio, aportan beneficios como la disminución del riesgo de trombosis y de sangrado intraoperatorio. Objetivo: Describir el comportamiento y los resultados de la aplicación de la anestesia peridural continua mediante bomba de infusión elastomérica en pacientes intervenidas de mamoplastia de aumento. Métodos: Se realizó un estudio observacional, descriptivo, prospectivo, longitudinal en el Hospital Clínico Quirúrgico Hermanos Ameijeiras, entre febrero 2014 y febrero 2016. Resultados: 72,8 fueron las pacientes entre 20 y 29 años, 57,6 por ciento era ASA I y 78,3 por ciento normopeso. El 50 por ciento fueron operadas por hipoplasia mamaria. La frecuencia cardiaca, la tensión arterial sistólica y diastólica disminuyeron a los 5 min después de aplicarse la técnica. La media del dolor fue menor de 3 en todos los momentos evaluados. Las complicaciones inmediatas fueron escasas y leves. El 85,9 por ciento calificó la técnica como buena. Conclusiones: El comportamiento y los resultados de la aplicación de la anestesia peridural continua mediante bomba de infusión elastomérica en la mamoplastia de aumento fue estable y segura. Existieron diferencias significativas en el comportamiento de las variables hemodinámicas intraoperatorias y de la intensidad de dolor, la cual fue leve en todas sus mediciones. Las complicaciones mediatas fueron escasas y no complejas. Más de las tres cuartas partes de las pacientes evaluaron de acuerdo al grado de satisfacción de buena la efectividad de la técnica anestésica para este tipo de procedimiento quirúrgico(AU)

Introduction: Continuous epidural anesthesia and analgesia, in addition to providing adequate control of postoperative pain, provide benefits such as decreased risk of thrombosis and intraoperative bleeding. Objective: To describe the behavior and results of the application of continuous epidural anesthesia by means of an elastomeric infusion pump in patients undergoing augmentation mammoplasty. Methods: An observational, descriptive, prospective, longitudinal study was conducted at Hermanos Ameijeiras Clinical Surgical Hospital, between February 2014 and February 2016. Results: 72.8 percent were patients 20-29 years old, 57.6 percent were ASA I, and 78.3 percent had normal weight. 50 percent were operated for mammary hypoplasia. Heart rate, as well as systolic and diastolic blood pressure decreased 5 minutes after the technique was applied. The average pain was less than 3 in all the moments evaluated. The immediate complications were minimal and mild. 85.9 (AU) described the technique as good. Conclusions: The behavior and results of the application of continuous epidural anesthesia using an elastomeric infusion pump in the augmentation mammoplasty was stable and safe. There were significant differences in the behavior of intraoperative hemodynamic variables and pain intensity, which was slight in all its measurements. The mediate complications were scarce and not complex. More than three quarters of the patients evaluated, based on the degree of satisfaction, the effectiveness of the anesthetic technique as good for this type of surgical procedure(AU)

Anestesia epidural y control posoperatorio de la tensión arterial en pacientes con preeclampsia grave cesareadas / Epidural anesthesia and postoperative control of arterial pressure in patients with serious preeclampsia and who have undergone cesarean section

Introducción: La preeclampsia en Cuba tiene una incidencia de 10 a 12 y una mortalidad neonatal de 35 por ciento. Hay escasa evidencia acerca de si es adecuado el tratamiento estándar. Se acepta el uso de anestesia epidural en la preeclampsia grave porque, entre otros beneficios, estabiliza la presión arterial. Objetivo: Evaluar la eficacia de la anestesia epidural continua como coadyuvante en el control posoperatorio de la tensión arterial en pacientes con preeclampsia grave. Métodos: Se realizó un estudio experimental en el hospital Dr. Agostinho Neto en el periodo 2013-2016. Se incluyeron 180 gestantes entre 15 y 40 años con preeclampsia grave intervenidas por cesárea, ASA III; asignadas aleatoriamente a un grupo de estudio y otro de control. En ambos se procedió según la norma cubana de obstetricia para el tratamiento de la preeclampsia. El grupo control recibió analgesia posoperatoria según recomendaciones del protocolo hospitalario, mientras se empleó anestesia epidural continua con 12,5 mg/h de bupivacaína al 0,125 por ciento en el grupo de estudio. Se midió la tensión arterial sistólica, diastólica y media durante las ocho primeras horas posoperatorias: Resultados: La tensión arterial sistólica y diastólica se controló en 93 por ciento y 88 por ciento, respectivamente. En el grupo control, 47 por ciento necesitó tres drogas antihipertensivas, 6 por ciento evolucionó hacia la eclampsia. Se controlaron los síntomas en el 97 por ciento del grupo de estudio. La taquicardia fue el efecto secundario esperado más frecuente de la anestesia epidural. Conclusiones: La anestesia epidural con bupivacaína al 12,5 mg/h es eficaz como coadyuvante en el control de la tensión arterial en el posoperatorio de pacientes con preeclampsia grave(AU)

Introduction: Preeclampsia in Cuba has an incidence of 10 to 12 and a neonatal mortality of 35 percent. There is little evidence about the standard treatment. The use of epidural anesthesia in severe preeclampsia is accepted because, among other benefits, it stabilizes blood pressure. Objective: To evaluate the effectiveness of continuous epidural anesthesia as an adjuvant in the postoperative control of blood pressure in patients with severe preeclampsia. Method: An experimental study was performed at Dr. Agostinho Neto Hospital in the period 2013-2016. We included 180 pregnant women aged 15-40 and with severe preeclampsia undergoing cesarean section (ASA III), randomly assigned to a study group and a control group. In both cases, we used the Cuban obstetrical standard for treating preeclampsia. The control group received postoperative analgesia according to the recommendations of the hospital protocol, while continuous epidural anesthesia was used with 12.5 mg/h of bupivacaine 0.125 percent in the study group. Systolic, diastolic and mean arterial pressure were measured during the first eight postoperative hours. Results: Systolic and diastolic blood pressure was controlled in 93 percent and 88 percent, respectively. In the control group, 47 percent needed three antihypertensive drugs, while 6 percent evolved towards eclampsia. Symptoms were controlled in 97 percent of the study group. Tachycardia was the most common expected side effect of epidural anesthesia. Conclusions: Epidural anesthesia with 12.5 mg/h of bupivacaine is effective as an adjuvant in controlling postoperative blood pressure in patients with severe preeclampsia(AU)

Effect analysis of continuous epidural anesthesia and psychological intervention in painless labor / 中国生化药物杂志

Objective To analyze the clinical effects of continuous epidural anesthesia and psychological intervention in painless labor. Methods From June 2016 to December 2016110 cases of maternal treatment in Ningbo city town of dragon longsai hospital as the research object, randomly divided into control group and observation group, control group of women to provide continuous epidural anesthesia, the observation group in continuous epidural anesthesia combined with psychological intervention measures. Results The two groups of pregnant women at different time scales VAS score, duration and other indicators, the data into the SPSS software, given the corresponding analysis and draw conclusions. Results The two groups of pain VAS score had no significant difference, the observation group each time after analgesia VAS score decreased than the control group(P<0.05); the first stage of the observation group was shorter than the control group (P<0.05), there was no significant difference between the 2 groups of second, third labor time. Conclusion Conclusion Epidural anesthesia and psychological intervention combined with painless labor have good analgesic effect and shorten the first stage of labor. .

Anesthesia on elder patients in hip joint replacement / 中国康复理论与实践

@#ObjectiveTo evaluate the two common anesthesia techniques used in the hip joint replacement surgery (HJRS) and provide references to the most reasonable choice for them. MethodsTo undertake a retrospective study on 34 patients that received continuous epidural anesthesia(CEA) or combined intravenous and inhaled anesthesia(CIIA)respectively in HJRS. Results and Conclusions CEA had higher incidence of bone cement reaction than that of CIIA, whereas there was no significant difference in blood loss and the anesthesia efficacy between them. CIIA seemed to be easier to be performed. CIIA sounds more reasonable than CEA in HJRS although both of them are safe anesthesia techniques.

Severe Clonic Movement of Extremities suspected as Conversion Reaction after Continuous Epidural and General Anesthesia / 대한마취과학회지

Spontaneous shivering-like postanesthetic tremor occurs in about 40% of patients during recovery from all types anesthesia. Although most postoperative tremor is associated with intraoperative hypothermia, some is abnormal, centrally mediated thermoregulatory shivering. Conversion reactions are well known pathologic means to reduce uncontrolled anxiety and one of conversion symptom is clonic movement. 26-year old woman was brought to the operating room for surgery of ovarian cyst torsion. We had done combined continuous epidural and general anesthesia induced by pentothal sodium, succinylcholine, followed endotracheal intubation and maintained by inhalation of N2O-O2 (4: 2) We experienced severe localized clonic movement of upper extremities of the patient during recovery from general anesthesia. Clonic movement was not easily controlled by valium and naloxon. Patient had past history of unstable emotion and experienced pain during early period of epidural anesthesia, but her vital signs including body temperature were stable. We could not find any physical causes. Result of psychological review disclosed patient's clonic movement conversion reaction. Frequency and degree of clonic movement was reduced by psychiatric manipulation and lorazepam after 3 hours of recovery from anesthesia. Several episodes of clonic movement had developed at ward but she could discharged without any other complications.