Estudio epidemiológico sobre el tipo de anestesia aplicada en cirugía de hernia inguinal en dos hospitales de nivel I de Castilla y León / Epidemiological study of the type of anesthesia applied in inguinal hernia surgery at two hospitals level I of Castile and Leon

Introducción: La hernia inguinal representa el 20 % de los procedimientos quirúrgicos realizados por el Servicio de Cirugía de los hospitales de Medina del Campo y Santiago Apóstol de Miranda de Ebro. Las técnicas anestésico-analgésicas que se pueden aplicar son variadas, por lo que decidimos realizar un registro de nuestra actividad. Material y métodos: Estudio observacional retrospectivo del tipo de anestesia aplicada a pacientes intervenidos de hernia inguinal abierta, en el periodo comprendido entre el 1 de enero y el 31 de diciembre de 2014. Se recogieron datos demográficos, técnica anestésica, tipo de fármaco anestésico y dosis, tiempo en quirófano y de recuperación postanestésica. Se registraron la analgesia de rescate y los efectos adversos. Resultados: Se incluyeron 215 pacientes en el estudio, 187 hombres y 28 mujeres, con edad media de 65 años (18-92), el régimen de hospitalización ha sido: estancia de 1 día el 66 %, cirugía ambulatoria el 30 % y el resto ingreso superior a 24 horas. Las técnicas anestésicas aplicadas fueron: anestesia subaracnoidea (AS) 83,3 %, bloqueo periférico (BP) 9,3 % y anestesia general (AG) 7,4 %. Los tiempos de recuperación postanestésica variaron en función de la técnica anestésica: AS 94,4 ± 44, BP 63,3 ± 41 y AG 58 ± 12 minutos. La mayoría de los efectos adversos se produjeron en el grupo de AS, fundamentalmente dolor postoperatorio (56) y retención urinaria (54). Conclusiones: Los resultados muestran que AS es la más utilizada, a pesar de asociar un mayor índice de efectos adversos (retención urinaria y peor control del dolor postoperatorio). La recuperación postoperatoria inmediata es más rápida con AG y BP. Las tasas de ambulatorización son bajas y la AS se asocia a ingresos no previstos en pacientes programados para cirugía ambulatoria (AU)

Introduction: The inguinal hernia surgery accounts for 20 % of surgical procedures performed in ours hospitals (Medina del Campo y Santiago Apóstol de Miranda de Ebro). The anesthetic- analgesic techniques that can be applied are varied, so we decided to make a record of our activity. Material and methods: retrospective and observational study of type of anesthesia applied to the patients with inguinal hernia open surgery on the period between 1 january to 31 december in 2014. Demographic data, anesthesia techniques, anesthesic and dose, intraoperative time and the anesthesia recovery time were collected. Also rescue analgesia and adverse effects were registered. Results: Data were collected on 215 patients, 187 males and 28 females, with a mean age of 65 years (18-92). One-day surgery was performed in 66 %, 30 % as day surgery and the rest as impatient surgery. Spinal anesthesia (AS) was the most widely used technique (83,3 %), followed by peripheral nerve block (BP) 9,3 % and general anesthesia (AG) 7,4 %). The postanesthetic recovery time was different depending anesthesia tecnique: AS 94,4 ± 44, BP 63,3 ± 41 y AG 58 ± 12 minutes. Most side effects ocurred on the spinal anesthesia group: pain (56 patient) and urinary retention (54). Conclusions: Spinal anesthesia is the most commonly used technique, however it associates higher index of adverse effects (urinary retention and poorer control of postoperative pain). The inmediate postoperative recovery is faster in general anesthesia and block abdominal wall. All within a small ambulatory surgery system and the spinal anesthesia espinal generates extra admission in patients scheduled for outpatient surgery (AU)

Short communication: effect of dry therapy using an intramammary infusion on bulk tank somatic cell count in sheep.

A total of 3,141 records of bulk tank milk somatic cell counts (BTSCC) and bulk tank milk total bacterial counts (BTTBC) were obtained over 24 mo from 25 dairy flocks of Assaf ewes belonging to the Consortium for Ovine Promotion in Castilla-León, Spain, in which a complete dry therapy program was carried out in 10,313 ewes using an antibiotic infusion containing 100 mg of penethamate hydriodide, 280 mg of benethamine penicillin, and 100 mg of framycetin sulfate. The selection criteria for all flocks were BTSCC mean values > or =1,000 x 10(3) cells/mL and absence of dry therapy before the start of this experiment. Significant effects on log BTSCC were detected for treatment, milking system, flock within milking system, month within flock by treatment, the interactions treatment by milking system and flock by treatment within milking system, and log BTTBC. After dry therapy was implemented, log BTSCC decreased significantly in machine-milked flocks (5.95 +/- 0.007) compared with values before antibiotic treatment (6.13 +/- 0.008). The effect was observed at the beginning of the second lactation posttreatment (5.98 +/- 0.013). However, dry therapy was not effective in hand-milked flocks, suggesting poor hygiene conditions. A significant relationship was found between BTSCC and BTTBC; therefore, programs for improving milk hygiene should be implemented for both BTSCC and BTTBC variables at the same time.

Short communication: bulk tank total bacterial count in dairy sheep: factors of variation and relationship with somatic cell count.

A total of 9,353 records for bulk tank total bacterial count (TBC) were obtained over 1 yr from 315 dairy ewe flocks belonging to the Sheep Improvement Consortium (CPO) in Castilla-León (Spain). Analysis of variance showed significant effects of flock, breed, month within flock, dry therapy, milking type and installation, and logSCC on logTBC. Flock and month within flock were important variation factors as they accounted for 22.0 and 22.1% of the variance, respectively. Considerable repeatability values were obtained for both random factors. Hand milking and bucket-milking machines elicited highest logTBC (5.31), whereas parlor systems with looped milkline (5.01) elicited the lowest logTBC. The implementation of dry therapy practice (5.12) showed significantly lower logTBC than when not used (5.25). Variability in logTBC among breeds ranged from 5.24 (Awassi) to 5.07 (Churra). However, clinical outbreaks of contagious agalactia did not increase TBC significantly. A statistically significant relationship was found between logTBC and logSCC, the correlation coefficient between the variables being r = 0.23. Programs for improving milk hygiene should be implemented for both total bacterial count and somatic cell count variables at the same time.

Factors of variation influencing bulk tank somatic cell count in dairy sheep.

Between January and December 2002, a total of 21,685 records for bulk tank milk somatic cell count (BTSCC) were obtained from 309 dairy ewe herds belonging to the Sheep Improvement Consortium in Castilla-Leon, Spain. Based on the first statistical model, ANOVA detected significant effects of herd, breed, month within herd, dry therapy, type of milking, contagious agalactia, and installations within machine milking on logBTSCC. A second statistical model was used on herds with machine milking to study the effect of the vacuum level and pulsation rate on BTSCC. Herd and month within herd were important variation factors as they explained 48.4 and 16.1% of the variance in BTSCC. Variability in logBTSCC among breeds ranged from 5.84 (Castellana) to 6.09 (Awassi and Spanish Assaf). Implementing dry-ewe therapy (5.91) significantly reduced logBTSCC compared with when it was not implemented (6.10). Hand milking elicited greater logBTSCC (6.07) than machine milking (5.94). Machine milking of ewes in milking parlors (logBTSCC: 5.88 to 5.94) was associated with better udder health than was the use of bucket-milking machines (6.04). Reduced vacuum levels and elevated pulsation rate during machine milking optimized BTSCC. In all cases, clinical outbreaks of contagious agalactia increased BTSCC. As a result, dry therapy was proposed as the main tool to reduce BTSCC. Optimization of milking-machine standards and parlor systems also improved udder health in dairy sheep.