Hipertensión arterial en el paciente quirúrgico. Adecuación de la medicación y criterios de suspensión / Arterial hypertension in the surgical patient. Medication adequacy and suspension criteria

La hipertensión arterial (HTA) es un factor de riesgo modificable para las enfermedades cardiovasculares, que puede tener un impacto en las complicaciones perioperatorias, en función del daño orgánico que sufre el paciente. El manejo perioperatorio del tratamiento farmacológico de la hipertensión arterial es un pilar fundamental en la valoración preanestésica previa a cualquier intervención. No parece razonable retrasar la cirugía únicamente por valores de la presión arterial (PA), aunque en pacientes con PA > 180/110mmHg la decisión de realizar una intervención quirúrgica electiva debe ser valorada cuidadosamente

Arterial hypertension (AHT) is a modifiable risk factor for cardiovascular diseases, which may have an impact on perioperative complications, depending on the organ damage suffered by the patient. The perioperative management of treatment of arterial hypertension, is a mainstay in the preoperative assesment prior to any intervention. It doesn't seem reasonable to delay surgery solely due to blood pressure values, although for patients with BP > 180/110mmHg, the decision to perform scheduled surgeries should be carefully assessed

[Preoperative management of anemia in oncologic surgery]. / Manejo preoperatorio de la anemia en cirugía oncológica.

Preoperative anemia in patients with cancer is highly prevalent, is associated with increased perioperative morbidity and is a risk factor for transfusion. There is evidence that patients who undergo transfusions have higher morbidity, increased cancer recurrence and poorer survival. The pathophysiology of anemia is multifactorial, with an inflammatory component to which chronic blood loss and nutritional deficiencies can be associated. Therefore, preoperative anemia in patients with cancer should be treated appropriately, given that there is sufficient time in the preoperative period. Of the currently available options, parenteral iron is an effective alternative, especially for those types of cancer that have an associated hemorrhagic component.

Manejo preoperatorio de la anemia en cirugía oncológica / Preoperative management of anemia in oncologic surgery

La anemia preoperatoria en los pacientes oncológicos es muy prevalente, se asocia a mayor morbilidad perioperatoria y es un factor de riesgo de transfusión. Existe evidencia de que los pacientes transfundidos tienen mayor morbilidad, mayor recurrencia del cáncer y peor supervivencia. La fisiopatología de la anemia es multifactorial, con un componente inflamatorio al que se puede asociar pérdidas hemáticas crónicas y deficiencias nutricionales. Por ello, la anemia preoperatoria en pacientes con cáncer debería tratarse adecuadamente, ya que se dispone de tiempo suficiente en el preoperatorio. De las opciones disponibles actualmente, el hierro parenteral es una alternativa eficaz, sobre todo en los tipos de cáncer que asocian un componente hemorrágico (AU)

Preoperative anemia in patients with cancer is highly prevalent, is associated with increased perioperative morbidity and is a risk factor for transfusion. There is evidence that patients who undergo transfusions have higher morbidity, increased cancer recurrence and poorer survival. The pathophysiology of anemia is multifactorial, with an inflammatory component to which chronic blood loss and nutritional deficiencies can be associated. Therefore, preoperative anemia in patients with cancer should be treated appropriately, given that there is sufficient time in the preoperative period. Of the currently available options, parenteral iron is an effective alternative, especially for those types of cancer that have an associated hemorrhagic component (AU)

Anestesia subaracnoidea hipobárica metamérica para las técnicas de refuerzo vertebral. Experiencia en 6 casos / Hypobaric metameric subarachnoid anaesthesia for anaesthetic management in vertebral reinforcement techniques. Our experience in 6 cases

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

[Hypobaric metameric subarachnoid anaesthesia for anaesthetic management in vertebral reinforcement techniques. Our experience in 6 cases]. / Anestesia subaracnoidea hipobárica metamérica para las técnicas de refuerzo vertebral. Experiencia en 6 casos.

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.