Anestesia fuera de pabellón, es tiempo de proyectarla al futuro en su debido lugar / Future projection of anesthesia out of the operating room

Anesthesiology and surgical technics have shown great development over the last decades. This caused several changes in anesthesiology practice, one of them is the growing need for anesthesia out of the operating room. Till now, we are facing this issue in the same way that we used to do in the operating room. Nevertheless, it is time to think about anesthesia in remote locations as a different entity, which has to be faced in a specific form, being able to describe it and to achieve the best results in a cost-effective approach.

La anestesiología y las técnicas quirúrgicas han mostrado un gran desarrollo en las últimas décadas. Esto ha causado varios cambios en la práctica de anestesiología, uno de ellos es la creciente necesidad de anestesia fuera del quirófano. Hasta ahora, estamos en-frentando este problema de la misma manera que solíamos hacerlo en la sala de operaciones. Sin embargo, es hora de pensar en la anestesia en lugares remotos como una entidad diferente, que debe afrontarse de forma específica, poder describirla y lograr los mejores resultados en un enfoque rentable.

Registro de paro cardiorrespiratorio perioperatorio en un hospital universitario en el período 2006-2017 / Registry of perioperative cardiac arrests in a clinical hospital in the period 2006-2017

Background: Perioperative cardiac arrest (PCA) is a rare but important event in the operating room. Aim: To describe PCA events at a Clinical Hospital in Santiago, Chile. Material and Methods: Registry of PCA that occurred in the operating room (OR) and during procedures not carried out in the OR between September 2006 and November 2017. Precipitating events, type of anesthesia and results of resuscitation maneuvers were described. Results: Eighty events (five outside of the OR) during 170,431 surgical procedures were recorded, resulting in an incidence of 4.4 events per 10,000 interventions. Hypotension/hypoperfusion was the most frequently found preexisting condition (42.5%). The main cause was the presence of preoperative complications (57.5%). Nineteen cases (23.8%) were attributable to anesthesia, with an incidence of 1.11 per 10,000 anesthetic procedures. Survival rate at hospital discharge was 52.5%. The figure for PCA caused by anesthesia was 84.2%. Conclusions: The incidence of PCA and its survival is similar to that reported abroad. In general, PCA has a better prognosis than other types of cardiac arrest, especially if it has an anesthetic cause.