Subject(s)
Analgesia, Epidural/methods , Analgesia, Obstetrical/methods , Charcot-Marie-Tooth Disease/physiopathology , Pregnancy Complications/physiopathology , Anesthesia, Inhalation , Anesthetics, Local/administration & dosage , Bupivacaine/administration & dosage , Contraindications , Female , Fentanyl/administration & dosage , Fetal Membranes, Premature Rupture , Humans , Neural Conduction , Oxytocin/administration & dosage , PregnancyABSTRACT
Objetivos: La sanidad en España ha evolucionado hacia una mejora de la calidad, exigiendo a los profesionales que cumplan los niveles de competencia necesarios para salvaguardar el derecho a la protección de la salud de los ciudadanos. Para alcanzarlos, las Unidades Docentes y los Médicos Residentes demandan un marco común de formación que garantice la calidad y la uniformidad de la docencia. Dado el escaso número de publicaciones en nuestra revista relacionadas con la docencia y tras la Primera Reunión de Tutores de Anestesiología y Reanimación de la SEDAR, surgió la inquietud por dar a conocer cómo tenemos organizada nuestra Unidad Docente. Métodos: Con el objetivo de facilitar el intercambio de experiencia de los implicados en la formación de los Médicos Internos Residentes de Anestesiología, Reanimación y Terapéutica del Dolor realizaremos un análisis descriptivo de la formación en nuestro hospital. Resultados: Se describe la estructura y funcionamiento. Las encuestas anónimas realizadas anualmente por los residentes (9,4 puntos sobre 10) y facultativos (8,7 sobre 10) muestran la aceptación del sistema. Además en una auditoría docente del Ministerio de Sanidad se ha cumplido el 100% de los criterios exigidos(AU)
Background: Health care in Spain has improved progressively and professionals are now required to meet competency levels that safeguard the citizens right to health protection. To achieve this, instructors in residency training programs and resident physicians themselves are calling for a common framework for training to ensure quality and consistency. Given the scarcity of articles related to training in our journal and following the First Meeting of Residency Program Instructors of the Sociedad Española de Anestesiología y Reanimación (SEDAR), there has arisen a need to explain how SEDARs training unit is organized. Methods: In order to facilitate the sharing of experiences of those involved in training anesthesiology medical residents, we undertook a descriptive analysis of our hospitals curriculum. Results: The structure and operation of the department are described in this report. The results of anonymous surveys completed annually show the satisfaction of residents (9.4 out of 10) and physicians (8.7 out of 10). An audit by the Ministry of Health showed that the curriculum met 100% of the required criteria(AU)
Subject(s)
Humans , Male , Female , Anesthesiology/education , Anesthesiology/trends , Cardiopulmonary Resuscitation/education , Cardiopulmonary Resuscitation/methods , Hospitals, University/organization & administration , Hospitals, University/standards , Hospitals, University , Hospitals, Teaching/organization & administration , Hospitals, Teaching/trends , 24419 , Health Knowledge, Attitudes, Practice , Faculty, MedicalABSTRACT
No disponible
Subject(s)
Humans , Female , Adult , Analgesia, Obstetrical/methods , Charcot-Marie-Tooth Disease/complications , Charcot-Marie-Tooth Disease/diagnosis , Charcot-Marie-Tooth Disease/drug therapy , Bupivacaine/therapeutic use , Vasoconstrictor Agents/therapeutic use , Fentanyl/therapeutic use , Analgesia, Obstetrical/trends , Analgesia, Obstetrical , Charcot-Marie-Tooth Disease/surgery , Charcot-Marie-Tooth Disease , Pregnancy Complications/drug therapy , Pregnancy Complications/surgeryABSTRACT
Pheochromocytomas, which derive from chromaffin cells, can secrete catecholamines in large amounts. The incidence of these tumors is low at 2 to 8 cases per million population and only 10% of cases occur in children. A thorough understanding of the pathophysiology of these tumors and the consequent effect of drugs will be necessary for treating these patients during the perioperative period. A great deal has been published on drugs that can be used in this setting, but only a small portion of the information is relevant to children. Esmolol, a short-action beta-blocker, figures among the drugs that have been developed in recent years. We report a case in which esmolol was used during surgery in a 10-year-old girl undergoing scheduled removal of a bilateral pheochromocytoma.
Subject(s)
Adrenal Gland Neoplasms/surgery , Adrenergic beta-Antagonists/therapeutic use , Hemodynamics/drug effects , Intraoperative Care/methods , Pheochromocytoma/surgery , Propanolamines/therapeutic use , Child , Female , HumansABSTRACT
Los feocromocitomas son tumores derivados de lascélulas cromafines, que pueden secretar grandes cantidadesde catecolaminas. Su incidencia es baja, 2-8 casospor millón de habitantes, solamente un 10% de éstos sedan en edad infantil. Para el tratamiento perioperatoriocorrecto se requiere un conocimiento profundo desu fisiopatología, y de la farmacología implicada. Haygran cantidad de información publicada sobre fármacosque pueden utilizarse pero no tan extensa en niños.En los últimos años se han ido desarrollando nuevosfármacos entre los que se encuentran el esmolol, unbeta bloqueante de acción corta. Presentamos un casode tratamiento intraoperatorio con esmolol en unapaciente de 10 años programada para la extirpación deun feocromocitoma bilateral(AU)
Pheochromocytomas, which derive from chromaffincells, can secrete catecholamines in large amounts. Theincidence of these tumors is low at 2 to 8 cases permillion population and only 10% of cases occur inchildren. A thorough understanding of thepathophysiology of these tumors and the consequenteffect of drugs will be necessary for treating thesepatients during the perioperative period. A great dealhas been published on drugs that can be used in thissetting, but only a small portion of the information isrelevant to children. Esmolol, a short-action -blocker,figures among the drugs that have been developed inrecent years. We report a case in which esmolol was usedduring surgery in a 10-year-old girl undergoingscheduled removal of a bilateral pheochromocytoma(AU)
Subject(s)
Humans , Female , Child , Pheochromocytoma/diagnosis , Pheochromocytoma/surgery , Intraoperative Period/instrumentation , Anesthesia/methods , Laparoscopy/methods , Isoflurane/therapeutic use , Hypnosis, Anesthetic/trends , Preanesthetic Medication/methods , Preanesthetic Medication , Hemodynamics , Anesthesia , Intraoperative Period/methods , Hemodynamics/physiology , Laparoscopy/trends , Preoperative Care/instrumentationABSTRACT
Cornelia de Lange syndrome involves multiple malformations with particular phenotypic features (craniofacial abnormalities such as microcephaly or hypertrichosis with synophrys; cutaneous abnormalities such as hirsutism, and limb anomalies) and it is associated with a high percentage of mental retardation and complications such as digestive tract abnormalities, cardiac defects, and endocrine disorders. We report the case of a 2-month-old infant girl who underwent a laparoscopic antireflux procedure, with closure of a diaphragmatic hernia and a gastric stoma. The medical history included repeated episodes of aspiration pneumonia and hypertension. Early in the procedure, 2 episodes of sudden desaturation, hypotension, and bradycardia with a probable diagnosis of air embolism. The complications resolved with specific treatment. Anesthetic management for laparoscopic surgery in these patients is truly complex and must be informed by a thorough understanding of the disease and complications that may develop.
