RESUMO
Las técnicas de refuerzo vertebral, como la vertebroplastia y la cifoplastia percutáneas, son técnicas mínimamente invasivas empleadas en el tratamiento de las fracturas-aplastamientos vertebrales. Las técnicas anestésicas empleadas durante estos procedimientos son variadas y con diversos resultados. Presentamos una serie de 6 casos, vertebroplastias y cifoplastias, realizados con anestesia subaracnoidea hipobárica metamérica, en los que la estabilidad hemodinámica y la analgesia obtenidas fueron satisfactorias (AU)
Vertebral reinforcement techniques, such as percutaneous vertebroplasty and kyphoplasty, are minimally invasive procedures used in the treatment of fractured or collapsed vertebras. The anaesthetic techniques employed during these procedures are diverse and with variable results. We report 6 cases, vertebroplasty and kyphoplasty using subarachnoid metameric anaesthesia with a hypobaric technique. Haemodynamic stability and analgesia were satisfactory in all of them
Assuntos
Humanos , Espaço Subaracnóideo , Anestésicos/administração & dosagem , Vertebroplastia/métodos , Cifoplastia/métodos , Doenças da Coluna Vertebral/cirurgia , Bupivacaína/administração & dosagem , Posicionamento do Paciente/métodosRESUMO
Vertebral reinforcement techniques, such as percutaneous vertebroplasty and kyphoplasty, are minimally invasive procedures used in the treatment of fractured or collapsed vertebras. The anaesthetic techniques employed during these procedures are diverse and with variable results. We report 6 cases, vertebroplasty and kyphoplasty using subarachnoid metameric anaesthesia with a hypobaric technique. Haemodynamic stability and analgesia were satisfactory in all of them.
Assuntos
Raquianestesia/métodos , Anestésicos Locais/administração & dosagem , Bupivacaína/administração & dosagem , Vertebroplastia , Idoso , Idoso de 80 Anos ou mais , Cimentos Ósseos , Feminino , Decúbito Inclinado com Rebaixamento da Cabeça , Humanos , Cifoplastia , Masculino , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde , Pressão , Decúbito VentralRESUMO
BACKGROUND: The aim of this study was to describe our experience in managing the new adult color model of the Lo-Pro GlideScope in a diverse group of patients. MATERIAL AND METHODS: Prospective, descriptive study of 350 ASA 1-5 patients who underwent oral or nasal tracheal intubation with the Lo-Pro Adult Color GlideScope. Patients whose maximum mouth opening was inadequate were excluded. We recorded the following data: demographic variables, predictors of difficult direct laryngoscopy, Cormack-Lehane grade, presence of morbid obesity, adjusting maneuvers required, intubations in awake patients, intubations with a selective double lumen tube, rescues of failed intubations, oropharyngeal lesions, postoperative sore throat, and failed intubation. RESULTS: Cormack-Lehane grade was 1 in 80.6% of the cases, 2 in 16.9%, and 3 in 2.6%. There were no Cormack-Lehane 4 patients. Rotation of the tube was necessary when entering the glottis in 38%. There were no significant differences in the incidence of oropharyngeal lesions between oral and nasal intubations. There were no abandoned attempts. CONCLUSIONS: The rate of successful tracheal intubation is high with the new Lo-Pro Adult Color GlideScope when it is used by trained staff, even in patients with difficult airways. It is also a useful device for intubating awake patients.
Assuntos
Intubação/métodos , Laringoscópios , Laringoscopia/métodos , Cirurgia Vídeoassistida/instrumentação , Adulto , Antropometria , Sedação Consciente , Desenho de Equipamento , Feminino , Humanos , Complicações Intraoperatórias/epidemiologia , Complicações Intraoperatórias/etiologia , Complicações Intraoperatórias/prevenção & controle , Intubação/efeitos adversos , Intubação/instrumentação , Intubação Gastrointestinal/efeitos adversos , Intubação Gastrointestinal/instrumentação , Intubação Gastrointestinal/métodos , Intubação Intratraqueal/efeitos adversos , Intubação Intratraqueal/instrumentação , Intubação Intratraqueal/métodos , Masculino , Pessoa de Meia-Idade , Orofaringe/lesões , Estudos Prospectivos , Cirurgia Vídeoassistida/métodos , VigíliaRESUMO
INTRODUCCIÓN: El objetivo del presente estudio hasido describir la experiencia obtenida en el manejo delnuevo modelo de videolaringoscopio GlideScope® LoPro Adult Color en un grupo de pacientes heterogéneo.MATERIAL Y MÉTODOS: Estudio descriptivo con recogidade datos prospectiva de 350 pacientes ASA I a V intubadosvía oro/nasotraqueal con GlideScope® Lo ProAdult Color. Fueron excluidos los pacientes con limitaciónextrema de la apertura bucal. Se recogieron: variablesdemográficas, predictores de laringoscopia difícildirecta, Cormack-Lehane, presencia de obesidad mórbida,maniobras auxiliares de intubación, intubaciones conpacientes despiertos, intubaciones con tubo selectivo dedoble luz, rescates de intubaciones fallidas previas, lesionesorofaríngeas, dolor de garganta postoperatorio yfallos de intubación.RESULTADOS: El Cormack-Lehane fue de I, II y III enel 80,6%,16,9% y el 2,6% de los casos respectivamente.No hubo ningún caso de Cormack-Lehane IV. En un38% de casos fue necesario rotar el tubo endotraquealmientras se introducía en la glotis. Al comparar la vía deintubación oral con la nasal, no hubo diferencias significativasen la aparición de lesiones orofaríngeas. En ningúncaso se tuvo que abandonar la técnica por no poderintubar al paciente.CONCLUSIONES: Con el nuevo modelo de videolaringoscopioGlideScope® Lo Pro Adult Color el porcentajede éxito en intubación traqueal es alta en personal entrenadoen su manejo, incluso en pacientes con vía aéreadifícil. Además, es una herramienta útil en la intubaciónde pacientes despiertos (AU)
BACKGROUND: The aim of this study was to describeour experience in managing the new adult color model ofthe Lo-Pro GlideScope in a diverse group of patients.MATERIAL AND METHODS: Prospective, descriptivestudy of 350 ASA 1-5 patients who underwent oral ornasal tracheal intubation with the Lo-Pro Adult ColorGlideScope. Patients whose maximum mouth openingwas inadequate were excluded. We recorded thefollowing data: demographic variables, predictors ofdifficult direct laryngoscopy, Cormack-Lehane grade,presence of morbid obesity, adjusting maneuversrequired, intubations in awake patients, intubations witha selective double lumen tube, rescues of failedintubations, oropharyngeal lesions, postoperative sorethroat, and failed intubation.RESULTS: Cormack-Lehane grade was 1 in 80.6% ofthe cases, 2 in 16.9%, and 3 in 2.6%. There were noCormack-Lehane 4 patients. Rotation of the tube wasnecessary when entering the glottis in 38%. There wereno significant differences in the incidence oforopharyngeal lesions between oral and nasalintubations. There were no abandoned attempts.CONCLUSIONS: The rate of successful trachealintubation is high with the new Lo-Pro Adult ColorGlideScope when it is used by trained staff, even inpatients with difficult airways. It is also a useful devicefor intubating awake patients (AU)
