[Long COVID: Is it really myalgic encephalomyelitis? Bibliographic review and considerations]. / COVID persistente: ¿es en realidad una encefalomielitis miálgica? Revisión bibliográfica y consideraciones.

Clinical sequelae of a disease as widespread as COVID-19 can be of great importance for primary care due to their prevalence and the morbidity they entail. The definition of long COVID and the establishment of its temporality are various, but some authors consider possible that this syndrome is actually myalgic encephalomyelitis. Similarities are observed when comparing the International Consensus Criteria for the diagnosis of myalgic encephalomyelitis with the symptoms described for long COVID. Blood tests, pulse oximetry, chest radiography, and thoracic ultrasound are recommended in patients with persistent symptoms after acute infection. Management in both conditions consists of treating the main symptoms. The possibility that COVID-19 can lead to a chronic condition such as myalgic encephalomyelitis makes long-term follow-up of patients who have suffered from this infection essential.

Safe intrathecal fluorescein use for identification of cerebrospinal fluid leaks: Case-report and perioperative algorithm description. / Uso seguro de fluoresceína intratecal en la localización de las fístulas de líquido cefalorraquídeo: descripción de un caso e implementación de un algoritmo perioperatorio.

Intrathecal injection of fluorescein is a method for repairing cerebrospinal fluid fistulas. The most frequent surgical procedure is endonasal endoscopy and the purpose of injecting this dye is to locate the fistula. The anaesthesiologists usually perform the puncture, therefore it is necessary to review this method and to specify some anaesthetic considerations such as correct dosing, safe management protocols and medical-legal aspects. In this case-report we describe the pre, intra and postoperative protocol of action implemented in our department that basically consists of: obtaining a specific consent, prior neurological/ophthalmologic assessment to rule out hypertension and brain damage, use of corticosteroids and previous antihistamines, choosing the correct dose and concentration of intrathecal sodium fluorescein (maximum 1ml at a concentration of 5% diluted in 9ml of cerebrospinal fluid) and close intra and postoperative monitoring.

[Use of EMLA cream and ropivacaine in dacryocystorhinostomy with locoregional anesthesia and sedation]. / Uso de crema EMLA y ropivacaína en la dacriocistorrinostomía con anestesia locorregional y sedación.

OBJECTIVE: To assess the usefulness of locoregional anesthesia and sedation as an alternative to general anesthesia for dacryocystorhinostomy. PATIENTS AND METHOD: Study of 20 patients undergoing dacryocystorhinostomy between April and October 1999. All the processes were carried out by the same surgeon under locoregional anesthesia plus sedation. We used EMLA cream to anesthetize nasal mucosa and ropivacaine for infiltration and anesthetic block; midazolam and fentanyl were used for sedation. RESULTS: Surgery was possible in all cases under locoregional anesthesia with no noteworthy complications. Anesthesia in the zone was good (assessed by hemodynamic changes and by asking the patient during and after the process). The experience was described as good by 70% of patients and poor by only 5%; the surgeon emphasized that bleeding was less than when the procedure is performed under general anesthesia. All patients were released within 24 hours. CONCLUSIONS: Using locoregional anesthesia and sedation for dacryocystorhinostomy is safe and effective and provides a valid alternative to general anesthesia. We suggest using EMLA cream in the nasal dressing and ropivacaine for infiltration. The process can be considered major outpatient surgery.