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1.
Artigo em Inglês | MEDLINE | ID: mdl-38821379

RESUMO

INTRODUCTION: Hemorrhoidal pathology is the most frequent proctological problem with a prevalence of 44% of the adult population. The most effective treatment is surgery but it also has the highest postoperative pain rate with moderate to severe pain rates of 30-40% during the first 24-48 hours. Here lies the importance of seeking measures to improve this situation, such as the pudendal nerve block with local anesthetic. However, the variability of the pudendal nerve sometimes makes its blockade ineffective and for this reason nerve location methods are sought to achieve a higher rate of success. The main aim of the study is to compare pain in the immediate postoperative period (24 h) after hemorrhoidectomy in patients with pudendal nerve block guided by anatomical references and guided by neurostimulation. METHODS: The present project proposes the performance of a single-center, triple-blind, randomized clinical trial of efficacy, carried out under conditions of routine clinical practice. Patients over 18 years old with hemorrhoids refractory to medical treatment, symptomatic grade III-IV and grade II hemorrhoids that do not respond to conservative procedures in a third level hospital in Spain and that are subsidiaries of surgery in major ambulatory surgery will be included. Demographic variables, variables on hemorrhoidal pathology, details of surgery, verbal numeric pain scale in the preoperative period and surgical complications will be collected. RESULTS: Not avaliable until the end of the study. CONCLUSIONS: The pudendal nerve block guided by anatomical landmarks has been shown to be useful in postoperative pain control after hemorrhoidectomy although the use of the neurostimulator has not been well studied and we believe it may improve outcom.

3.
Cir. mayor ambul ; 16(3): 119-125, jun.-sept. 2011. ilus
Artigo em Espanhol | IBECS | ID: ibc-93144

RESUMO

La consulta de preanestesia en la unidad de cirugía mayor ambulatoria, es un elemento muy importante desde el punto de vista organizativo, ya que gracias a un buen planteamiento de la misma podemos obtener un mayor rendimiento así como mejorar la seguridad del paciente. En este trabajo se presenta de manera descriptiva el modo en el que estamos organizados, que se divide fundamentalmente en tres aspectos: a) el cuestionario de salud, que es rellenado por el paciente, consiguiendo así que participen en su salud; b) los algoritmos o flujo gramas que en base a la edad, estado físico, comorbilidades y tipo de cirugía orientan a la hora de pedir pruebas complementarias, consiguiendo así una indicación más precisa de las mismas; y por último c) la clasificación del tipo de cirugía, realizada en base a la experiencia acumulada en nuestro centro y el tipo de cirugía. Este diseño de entre muchos válidos es muy dinámico, permitiendo su adaptación a las necesidades de cada centro, mejorando así el rendimiento y la seguridad del paciente (AU)


Pre-anaesthetic evaluation constitutes an important organizational component in a day surgery unit. A careful set up may lead to major efficiency and improved patient safety. This work presents a description of the organizational model of our unit, which consists of three fundamental elements: a) the health questionnaire, filled in by the patient, thus achieving implication in her/his health related questions; b)the algorithms or flow-charts which, based on patients’ age, ASA, comorbidities, and type of surgery, indicate more precisely the complementary analyses to be done; and c) finally classification of the surgery to be carried out, based on the body of experience accumulated in our centre. This design is, among many other valid ones, very dynamic and permits being adapted to the necessities of varying centres obtaining better efficiency and patient safety (AU)


Assuntos
Humanos , /métodos , Procedimentos Cirúrgicos Ambulatórios/métodos , Prontuários Médicos , Satisfação do Paciente/estatística & dados numéricos , Sistemas de Apoio a Decisões Clínicas , Gestão da Segurança/métodos
4.
Rev Esp Anestesiol Reanim ; 58(4): 223-9, 2011 Apr.
Artigo em Espanhol | MEDLINE | ID: mdl-21608278

RESUMO

BACKGROUND: Health care in Spain has improved progressively and professionals are now required to meet competency levels that safeguard the citizen's 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 Anestesiologia y Reanimación (SEDAR), there has arisen a need to explain how SEDAR's 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 hospital's 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.


Assuntos
Serviço Hospitalar de Anestesia/estatística & dados numéricos , Anestesiologia/educação , Hospitais Universitários/estatística & dados numéricos , Internato e Residência , Sociedades Médicas , Serviço Hospitalar de Anestesia/organização & administração , Competência Clínica , Currículo , Educação de Pós-Graduação em Medicina/legislação & jurisprudência , Educação de Pós-Graduação em Medicina/organização & administração , Avaliação Educacional , Docentes de Medicina , Hospitais Universitários/organização & administração , Humanos , Internato e Residência/legislação & jurisprudência , Espanha , Materiais de Ensino
5.
Rev. esp. anestesiol. reanim ; 58(4): 223-229, abr. 2011. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-128940

RESUMO

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 citizen’s 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 SEDAR’s 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 hospital’s 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)


Assuntos
Humanos , Masculino , Feminino , Anestesiologia/educação , Anestesiologia/tendências , Reanimação Cardiopulmonar/educação , Reanimação Cardiopulmonar/métodos , Hospitais Universitários/organização & administração , Hospitais Universitários/normas , Hospitais Universitários , Hospitais de Ensino/organização & administração , Hospitais de Ensino/tendências , 24419 , Conhecimentos, Atitudes e Prática em Saúde , Docentes de Medicina
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