Subject(s)
Humans , Perioperative Period , Surgical Oncology , Spain , Betacoronavirus , Pandemics , Anesthesiology , General SurgeryABSTRACT
No disponible
Subject(s)
Humans , Health Care Surveys , Coronavirus Infections/epidemiology , Pneumonia, Viral/epidemiology , Pandemics , Health Services Needs and Demand , Health Services Needs and Demand/statistics & numerical data , Critical Care/statistics & numerical data , Anesthesia Department, Hospital/supply & distribution , SpainABSTRACT
No disponible
Subject(s)
Humans , Male , Female , Algorithms , Autonomic Nerve Block/instrumentation , Autonomic Nerve Block/methods , Nerve Block/methods , Ultrasonography/methods , Ultrasonography , Anesthesia/methods , Anesthesia/standards , AnesthesiaABSTRACT
No disponible
Subject(s)
Humans , Male , Female , Analgesia/instrumentation , Analgesia/methods , Infusions, Subcutaneous/instrumentation , Infusions, Subcutaneous/methods , Anesthesia, Local/instrumentation , Anesthesia, Local/methods , Analgesia/trends , Analgesia , Infusions, Subcutaneous , Anesthesia, Local/trends , Anesthesia, LocalABSTRACT
Objetivos: Presentamos una revisión sistemática de los ensayos clínicos que tuvieron como objetivo valorar la eficacia de la administración de anestésico local con catéter en la incisión quirúrgica, en pacientes sometidos a cirugía abdominal. Método: Selección de los estudios siguiendo los criterios de Jadad. Las variables evaluadas en cada estudio fueron: tipo de intervención y de incisión, tipo, dosis y concentración del anestésico local, sitio de ubicación o localización del catéter, analgesia de rescate, consumo de opioides y la aparición de efectos adversos. Resultados: Se han incluido 15 ensayos con puntuación media de Jadad de 4,6 que incluyen 1.139 pacientes agrupados según la ubicación del catéter: subfascial (6 estudios), subcutánea (8 estudios) y en ambas (1 estudio), y 6 estudios adicionales que están en fase de realización registrados en ClinicalTrials.gov. Discusión: La analgesia incisional es una técnica segura, cuya eficacia se ha observado en cesáreas e histerectomías realizadas mediante incisiones de Pfannenstiel. Los resultados son contradictorios en otras técnicas quirúrgicas. Faltan estudios para conocer la localización óptima del catéter así como la concentración y volumen adecuado (AU)
Objectives: We present a systematic review of clinical trials to evaluate the efficacy of infusing local anesthetic through a catheter placed in the abdominal surgical wound. Methods: The Jadad (Oxford) scoring system was used to select trials. The variables considered in relation to each trial selected were as follows: type of intervention and incision; type, dose, and concentration of local anesthetic; site where the catheter was placed; rescue analgesia required; opioid use; and incidence of adverse events. Results: Fifteen clinical trials with a mean Jadad score of 4.6 were selected. The 1139 patients enrolled in the trials were grouped according to catheter placement: subfascial (6 trials), subcutaneous (8 trials), and both (1 trial). Six additional unpublished trials registered at ClinicalTrials.gov were also located. Conclusions: Surgical wound analgesia is a safe technique whose effectiveness has been observed in cesarean sections and hysterectomies performed with Pfannenstiel incisions. Outcomes for other types of surgery are inconsistent. There is a lack of studies of the optimal site for catheter placement as well as of adequate anesthetic concentration and volume (AU)
Subject(s)
Humans , Female , Anesthesia, Local/instrumentation , Anesthesia, Local/methods , Analgesics, Opioid/adverse effects , /instrumentation , /methods , Catheters , Cesarean Section/methods , Hysterectomy/methodsABSTRACT
OBJECTIVES: We present a systematic review of clinical trials to evaluate the efficacy of infusing local anesthetic through a catheter placed in the abdominal surgical wound. METHODS: The Jadad (Oxford) scoring system was used to select trials. The variables considered in relation to each trial selected were as follows: type of intervention and incision; type, dose, and concentration of local anesthetic; site where the catheter was placed; rescue analgesia required; opioid use; and incidence of adverse events. RESULTS: Fifteen clinical trials with a mean Jadad score of 4.6 were selected. The 1139 patients enrolled in the trials were grouped according to catheter placement: subfascial (6 trials), subcutaneous (8 trials), and both (1 trial). Six additional unpublished trials registered at ClinicalTrials.gov were also located. CONCLUSIONS: Surgical wound analgesia is a safe technique whose effectiveness has been observed in cesarean sections and hysterectomies performed with Pfannenstiel incisions. Outcomes for other types of surgery are inconsistent. There is a lack of studies of the optimal site for catheter placement as well as of adequate anesthetic concentration and volume.
Subject(s)
Abdomen/surgery , Analgesia , Anesthetics, Local/administration & dosage , Pain, Postoperative/prevention & control , Analgesia/methods , Humans , Infusions, IntralesionalABSTRACT
Objetivos: Presentamos una revisión sistemática de los ensayos clínicos que tuvieron como objetivo valorar la eficacia de la administración de anestésico local con catéter en la incisión quirúrgica, en pacientes sometidos a cirugía abdominal. Método: Selección de los estudios siguiendo los criterios de Jadad. Las variables evaluadas en cada estudio fueron: tipo de intervención y de incisión, tipo, dosis y concentración del anestésico local, sitio de ubicación o localización del catéter, analgesia de rescate, consumo de opioides y la aparición de efectos adversos. Resultados: Se han incluido 15 ensayos con puntuación media de Jadad de 4,6 que incluyen 1.139 pacientes agrupados según la ubicación del catéter: subfascial (6 estudios), subcutánea (8 estudios) y en ambas (1 estudio), y 6 estudios adicionales que están en fase de realización registrados en ClinicalTrials.gov. Discusión: La analgesia incisional es una técnica segura, cuya eficacia se ha observado en cesáreas e histerectomías realizadas mediante incisiones de Pfannenstiel. Los resultados son contradictorios en otras técnicas quirúrgicas. Faltan estudios para conocer la localización óptima del catéter así como la concentración y volumen adecuado(AU)
Objectives: We present a systematic review of clinical trials to evaluate the efficacy of infusing local anesthetic through a catheter placed in the abdominal surgical wound. Methods: The Jadad (Oxford) scoring system was used to select trials. The variables considered in relation to each trial selected were as follows: type of intervention and incision; type, dose, and concentration of local anesthetic; site where the catheter was placed; rescue analgesia required; opioid use; and incidence of adverse events. Results: Fifteen clinical trials with a mean Jadad score of 4.6 were selected. The 1139 patients enrolled in the trials were grouped according to catheter placement: subfascial (6 trials), subcutaneous (8 trials), and both (1 trial). Six additional unpublished trials registered at ClinicalTrials.gov were also located. Conclusions: Surgical wound analgesia is a safe technique whose effectiveness has been observed in cesarean sections and hysterectomies performed with Pfannenstiel incisions. Outcomes for other types of surgery are inconsistent. There is a lack of studies of the optimal site for catheter placement as well as of adequate anesthetic concentration and volume(AU)
Subject(s)
Humans , Male , Female , Anesthesia, Local/methods , Anesthesia, Local , Anesthetics, Local/administration & dosage , Efficacy/methods , Treatment Outcome , Evaluation of the Efficacy-Effectiveness of Interventions , /instrumentation , Analgesics, Opioid/adverse effects , Anesthesia, Local/trends , Abdomen/surgery , /instrumentation , /methods , Cesarean Section/instrumentation , HysterectomyABSTRACT
No disponible
Subject(s)
Humans , Male , Female , Competency-Based Education/organization & administration , Competency-Based Education/trends , Pain/therapy , Anesthesia , Competency-Based Education/statistics & numerical data , Competency-Based Education/standards , Anesthesiology/education , 35176 , Faculty , Faculty, Medical/organization & administrationSubject(s)
Catheterization, Central Venous/methods , Jugular Veins/diagnostic imaging , Punctures , Ultrasonography, Interventional , Carotid Artery Injuries/etiology , Carotid Artery Injuries/prevention & control , Catheterization, Central Venous/adverse effects , Humans , Punctures/adverse effects , Research Design , Sampling StudiesABSTRACT
No disponible
Subject(s)
Humans , Male , Female , Biopsy, Needle/methods , Jugular Veins/injuries , Jugular Veins/surgery , Jugular Veins , Anesthesiology/methods , Punctures/instrumentation , Anesthesiology/trends , Punctures/statistics & numerical data , Punctures/trends , PuncturesABSTRACT
We report the intraarterial injection of a flunitrazepam tablet dissolved in water in a patient with intravenous drugs addiction. Several ecchymotic lesions were present at different sites of the arm. In order to achieve analgesia and the sympathetic blockade of the arm, we performed an axillary perivascular block of the brachial plexus by means of the intermittent injection through a catheter of 0.25% bupivacaine with a 1:200,000 epinephrine solution. In addition, an anticoagulant treatment with heparin was started as prophylaxis of the thrombosis of the vessel. There was a satisfactory clinical course even though a distal phalange had to be amputated on the 18th day. We propose the continuous perivascular block as the method of choice of this type of medical problem.
