[Renal cryopreservation in 2 renal transplant patients undergoing aortic surgery]. / Criopreservación renal en dos trasplantados renales sometidos a cirugía aórtica.

Acute kidney failure is one of the most severe complications of surgery on the aorta. We describe two kidney-transplanted patients diagnosed of aneurysm of the abdominal aorta who underwent resection of the aneurysm and placement of an aorto-aortic graft. Cryopreservation of the renal implant was used with good results. Prevention of kidney damage also requires maintenance of adequate intravascular volume and the use of drugs (dopamine, mannitol and furosemide) to increase renal blood flow and urinary output.

[The use of propofol in carotid surgery]. / Utilización del propofol en cirugía carotídea.

OBJECTIVE: To compare two anesthetic techniques in carotid surgery. The first technique was propofol in continuous perfusion throughout the procedure (group A) and the other used etomidate for anesthetic induction and isoflurane for maintenance (group B). PATIENTS AND METHODS: The patients were assigned randomly either to group A (n = 23) to receive propofol in continuous perfusion for induction (0.8-1 mg/kg) and for maintenance (4-6 mg/kg/h) or to group B (n = 25) to receive etomidate (0.25 mg/kg) for induction and isoflurane 0.6-0.8% for maintenance. Ventilation was maintained with O2/N2O. Systolic and diastolic arterial pressures (SAP and DAP) and heart rate were measured at baseline, during induction (minutes 1, 2, 3, 5 and 10), immediately before and 1 minute after interruption of carotid flow, once flow had been released and after extubation. Other variables recorded were time until awakening and extubation, presence of pain, degree of well-being, need for analgesics and vasodilators, perioperative complications and time until hospital release. RESULTS: The variations in hemodynamic parameters during induction and during maintenance were similar for both techniques. Orotracheal intubation increased SAP in both groups. Time until eye opening and awakening were shorter in group A but the difference was not statistically significant. CONCLUSIONS: The use of propofol for induction and maintenance during carotid surgery was as safe as conventional anesthetic technique with etomidate and isoflurane.

[Anesthetic treatment of periodic familial hypokalemic paralysis. Report of a case]. / Tratamiento anestésico de la parálisis periódica familiar hipopotasémica. A propósito de un caso.

Periodic familiar hypopotassemic paralysis (PFHP) is a rare dominant autosomally transmitted genetic disease characterized by intermittent attacks of muscle weakness. A patient with PFHP was successfully given general anesthesia for 2 operations using atracurium as the muscle relaxant. For a third operation he was given a paravertebral block.

[Anesthesia for brain tumor surgery during pregnancy: presentation of a case]. / Anestesia para cirugía de un tumor cerebral durante el embarazo: a propósito de un caso.

We report the case of a 26th-week pregnant woman undergoing craniotomy for excision of brain tumor. Main considerations for anesthetic management of pregnant women undergoing surgical operations are the following: Each pregnant women patient should be considered as "full stomach" regardless fasting period. All measures should be taken to ensure fetal oxigenation by maintaining an optimal placental blood flow. There is no evidence of teratogenesis of anesthesic agents except for nitrous oxide which should be avoided during first and second trimesters. Fetal monitoring should be instituted from week 16 on as well as uterine dynamics periods whenever possible because of the greater frequency of premature labor or abortion. In Neurosurgery, an exhaustive control of blood pressure and PaCO2 of the mother should be carried out and osmotic diuretic agents should be cautiously administered.

[Usefulness of isoflurane in anesthesia in elective cesarean section]. / Utilidad del isofluorano en la anestesia de la cesárea electiva.

A series of 25 patients undergoing iterative cesarean section under general anesthesia received isoflurane at 0.75% together with a mixture of O2 and N2O at 50% for anesthetic maintenance. The inhalant agent was withdrawn when closing fascia. There was no case of regaining of consciousness during the operations. Uterine contraction was acceptable as evaluated by the surgeon at the end of the operation. Mean hematocrit value was 31.43 (SD 1.27) at 6 hours of operation. Fetal arterial gasometric values and Apgar score at 5 and 10 minutes fell within acceptable limits.

[Effects of postoperative pain on lung volume in patients undergoing aortic surgery]. / Repercusión del dolor postoperatorio sobre los volúmenes pulmonares en pacientes sometidos a cirugía aórtica.

To evaluate the potential advantages of the administration of extradural morphine to control postoperative pain and its effects on respiratory function, 39 patients were randomly assigned to one of two groups before aortic surgery. The first group (20 patients) received intravenous analgesia as required (control group). The second group (19 patients) received extradural morphine in a programmed fashion. During the immediate postoperative period the following parameters were measured in both groups: respiratory rate, vital capacity, peak expiratory volume in the first second, PaO2, PaCO2, arterial pH, heart rate, and systolic and diastolic blood pressure. In the group treated with morphine the postoperative increase in heart and respiratory rate was significantly smaller than in the control group (p less than 0.01). Postoperative forced pulmonary volumes were higher in the morphine group (p less than 0.01). However, there were no differences in time of hospitalization between both groups. There were more complications in the control group, but the difference did not reach statistical significance.

[Obturator nerve block in transurethral surgery]. / Bloqueo del nervio obturador en la cirugía transuretral.

The obturator nerve passes in close proximity to the bladder as it courses through the pelvis. During transurethral operations, resection may result in stimulation of the obturator nerve, causing violent adductor contraction. Bladder perforation and incomplete tumor resection are the most important complications. All techniques proposed since transurethral surgery began, until nowadays are reviewed: neuromuscular blockade, electric circuit modifications, transparietal endoscopic blockade, periprostatic and subvesical infiltration, obturator nerve blockade and the "3 in 1 block" described by Winnie. Practical advices are proposed finally.