[Continuous paravertebral block as an analgesic method in thoracotomy]. / Eficacia del bloqueo paravertebral continuo como método analgésico en la toracotomía.

INTRODUCTION: Open thoracotomy is one of the surgical procedures that is still very painful in the postoperative period, which, in this type of surgery can have on respiratory function and subsequent recovery of the patient. PATIENTS AND METHOD: The aim of the study is to assess continuous paravertebral thoracic block as an analgesic technique in thoracotomy. A total of 139 patients undergoing pulmonary resection surgery by posterolateral thoracotomy received postoperative analgesia using a 1.5% lidocaine infusion (7-10 ml/h) through a thoracic paravertebral catheter for at least 48 h. Pain intensity measured on the visual analogue scale (VAS) both at rest (passive VAS) and during stimulated cough (active VAS) was recorded at time of discharge from the Recovery Unit, and on the second, third and fourth day post-surgery. Postoperative complications and the need for analgesic rescue were studied. RESULTS: On discharge from recovery, 98.6% of the patients had mild pain (passive VAS <3), 1.4% had moderate pain (passive VAS 4-6) and none with severe pain (EVA >6); on the 2nd day post-surgery, 97.9% had mild pain, and 1.2% moderate pain; on the third day 98.6% had mild pain and 0.7% moderate pain; and on the 4th day 100% had mild pain. There were no complications arising from the analgesic technique. CONCLUSIONS: Continuous thoracic paravertebral analgesia is effective and safe in controlling post-thoracotomy pain.

Eficacia del bloqueo paravertebral continuo como método analgésico en la toracotomía / Continuous paravertebral block as an analgesic method in thoracotomy

Introducción: La toracotomía abierta es uno de los procedimientos quirúrgicos con postoperatorio más doloroso, hecho que en este tipo de cirugía puede repercutir sobre la función respiratoria y posterior recuperación del paciente. Paciente y método: El propósito del estudio es evaluar el bloqueo paravertebral contínuo torácico como técnica analgésica en la toracotomía. Ciento treinta y nueve pacientes sometidos a cirugía de resección pulmonar mediante toracotomía posterolateral recibieron analgesia postoperatopria mediante infusión de lidocaína al 1,5% (7–10ml/h) a través de un catéter paravertebral torácico y durante un mínimo de 48h. La intensidad del dolor mediante la escala analógica visual (EVA) tanto en reposo (EVA pasivo) como durante la tos incentivada (EVA activo), fue registrada al alta de la unidad de reanimación, al segundo, tercer y cuarto día postoperatorio. Se estudiaron las complicaciones postoperatorias y la necesidad de analgesia de rescate. Resultados: Al alta de reanimación un 98,6% de los pacientes presentaron un dolor leve (EVA pasivo <3 un 1 4 dolor moderado eva pasivo ndash 6 y 0 severo 6); en el 2.° día postoperatorio un 97,9% tuvieron un dolor leve, y un 1,2% dolor moderado; en el 3.er día un 98,6% un dolor leve y un 0,7% dolor moderado; y al 4° día un 100% presentaron dolor leve. No se encontraron complicaciones derivadas de la técnica analgésica. Conclusiones: La analgesia paravertebral torácica contínua es efectiva y segura en el control del dolor postoracotomía (AU)

Introduction: Open thoracotomy is one of the surgical procedures that is still very painful in the postoperative period, which, in this type of surgery can have on respiratory function and subsequent recovery of the patient. Patients and method: The aim of the study is to assess continuous paravertebral thoracic block as an analgesic technique in thoracotomy. A total of 139 patients undergoing pulmonary resection surgery by posterolateral thoracotomy received postoperative analgesia using a 1.5% lidocaine infusion (7–10ml/h) through a thoracic paravertebral catheter for at least 48h. Pain intensity measured on the visual analogue scale (VAS) both at rest (passive VAS) and during stimulated cough (active VAS) was recorded at time of discharge from the Recovery Unit, and on the second, third and fourth day post-surgery. Postoperative complications and the need for analgesic rescue were studied. Results: On discharge from recovery, 98.6% of the patients had mild pain (passive VAS <3 1 4 had moderate pain passive vas ndash 6 and none with severe eva 6); on the 2nd day post-surgery, 97.9% had mild pain, and 1.2% moderate pain; on the third day 98.6% had mild pain and 0.7% moderate pain; and on the 4th day 100% had mild pain. There were no complications arising from the analgesic technique. Conclusions: Continuous thoracic paravertebral analgesia is effective and safe in controlling post-thoracotomy pain (AU)

[Screening of celiac disease in first-degree relatives]. / Cribado de la enfermedad celíaca en familiares de primer grado.

BACKGROUND AND OBJECTIVE: Our aim was to analyze the prevalence of celiac disease (CD) in first-degree relatives of patients diagnosed with this disorder in Cantabria (Northern Spain). SUBJECTS AND METHOD: A questionnaire was administered and a complete biologic study was performed in 184 relatives. When serum CD-related antibodies were detected, relatives were asked to undergo a jejunal biopsy to confirm the diagnosis. RESULTS: Thirteen relatives had autoantibodies yet only 4 were diagnosed with CD. The biopsy was suggestive of CD in 3 relatives who underwent it. A further relative was diagnosed with CD by the clinical and serological response to a gluten-free diet. CONCLUSIONS: The prevalence found in our study is high enough so that we recommend the screening of autoantibodies, especially anti-gliadin and anti-transglutaminase antibodies, in this risk-population of celiac disease.

Cribado de la enfermedad celíaca en familiares de primer grado / Screening of celiac disease in first-degree relatives

FUNDAMENTO Y OBJETIVO: Dada la elevada prevalencia de la enfermedad celíaca (EC) en familiares de primer grado, nuestro objetivo fue analizar su prevalencia en Cantabria. SUJETOS Y MÉTODO: Se completaron un cuestionario dirigido y un estudio biológico en 184 familiares. En caso de presencia de anticuerpos característicos de EC, se intentó confirmar el diagnóstico mediante biopsia yeyunal. RESULTADOS: Trece familiares tuvieron autoanticuerpos, aunque sólo se diagnosticó EC en 4. La biopsia fue compatible con EC en tres de los 4 que la consintieron. El cuarto diagnóstico de EC se hizo, a pesar de no realizarse la biopsia, dada la respuesta clínica y serológica con la dieta sin gluten. CONCLUSIONES: La prevalencia encontrada recomienda el cribado sistemático en esta población de riesgo mediante la determinación de autoanticuerpos, especialmente antigliadina y antitransglutaminasa (AU)