Fast-track extubation in patients after intracranial hematoma surgery.

Early extubation, also known as fast track, is desirable after intracranial hematoma surgery to avoid ventilator-associated complications associated with admission to an intensive care unit (ICU). The objective of the present study was to determine whether ICU stay and ventilator-associated complications are reduced in patients who received surgery for intracranial hematoma if they are extubated early. A total of 17 patients were randomly assigned to two groups: In Group 1, patients were extubated early or using the fast track method, while those in Group 2 were conventionally extubated at a later stage and were managed at the ICU. Patients from both groups were assessed on admission to the operating room per the established standards and after the selection criteria had been confirmed, general anesthesia was applied. Extubation time and hemodynamic stability (number of anesthetic adjustments required to maintain hemodynamic parameters within 20% of the predicted values) were assessed post-operatively. Patients in the conventional group (n=10) were transferred to the ICU and extubated at 8 h post-operatively; hemodynamic stability and the presence of complications were evaluated. The fast track group had no complications associated with ventilation or any other parameter. All patients extubated in a conventional manner and who were transferred to the ICU presented with complications, including seizures, aspiration, atelectasis or failed extubation. In the future, fast track should be regarded as a routine technique in patients who meet the required criteria, so that they may be discharged quickly and with fewer complications. The present study was authorized by the ethics committee of the hospital and the research sub-directorate with the number AN14-003; it was submitted to and approved by the ISRCTN registry for clinical trials (ID, ISRCTN16924441).

[Efficacy of sedation in outpatient procedures performed by pediatric residents]. / Eficacia de la sedación en procedimientos ambulatorios realizados por residentes de pediatría.

OBJECTIVE: To determine the efficacy of sedation in outpatient procedures performed by Pediatric Residents. MATERIAL AND METHODS: Observational, analytic, cross-sectional study in patients that require diagnostic and therapeutic procedures. Data were collected during the period between June 01 and September 2007 in the Pediatrics Department. Patients from 1 month to 15 years of age that required sedation were included. RESULTS: 97 sedations were carried out, with an average age of 3.5 years. 59.3% were males and 40.7% were females. 100% of the procedures were carried out with 12.3% adverse effects. CONCLUSIONS: The procedures were done successfully; the pediatric residents demonstrated the required preparation for sedating and reverting adverse effects.

Manejo anestésico de pacientes embarazada con síndrome de Osler-Weber-Rendú e insuficiencia cardiaca congestiva / Anesthetic management of pregnant patient with osler weber-rendu syndrome and congestive heart failure

Paciente femenina de 20 años de edad con síndrome de Osler-Weber-Rendú (telangiectasia hemorrágica hereditaria) en trabajo de parto. Se presenta el manejo anestésico y preparación preoperatoria y se discuten los problemas específicos de este síndrome asociado al embarazo

Anestesia para cesárea en unapaciente con siringomielia. Reporte de un caso / Anesthesia for cesarean section in a patient with syringomiella. a case report

Paciente femenina de 39 años de edad con diagnóstico de Siringomielia a la que se le realiza cesárea. Se presenta el manejo anestésico y se discute el caso