Complicación durante una traqueostomía: ligadura de la arteria carótida interna / Complication during tracheostomy: Internal carotid artery ligation

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Radiofrecuencia pulsada para el tratamiento de la neuralgia occipital: análisis de predictores y resultados / Occipital nerve pulsed radiofrequency treatment: analysis predictors and outcomes

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Diagnóstico diferencial del dolor lumbar crónico con radiculopatía bilateral: meningioma intradural extramedular L1-L2 / Differencial diagnosis of chronic back pain with bilateral radiculopathy: spinal extramedullary meningioma L1-L2

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Anestesia tópica de contacto versus anestesia general en cirugía de estrabismo / Contact topical anesthesia versus general anaesthesia in strabismus surgery

OBJETIVO: Evaluar el bloqueo anestésico proporcionado por la anestesia tópica de contacto (ATC) en cirugía de estrabismo en pacientes adultos. Analizar el dolor postoperatorio y el resultado quirúrgico obtenido mediante ATC y compararlo con la anestesia general (AG). METODOLOGÍA: Estudio de cohortes longitudinal prospectivo en pacientes adultos intervenidos de estrabismo mediante ATC o AG. Se midió la intensidad del dolor percibido por los pacientes durante el desarrollo de la intervención y en el periodo postoperatorio mediante la Escala Numérica del Dolor (END). Se evaluó el éxito del resultado quirúrgico, considerado como una desviación ocular residual < 10 dioptrías prismáticas. RESULTADOS: Se intervino a un total de 23 pacientes con ATC y a 26 con AG. Durante el desarrollo de la intervención quirúrgica, la intensidad del dolor padecido por los pacientes del grupo ATC fue de 3,17 ± 2,44. No hubo diferencias entre el grupo ATC y el grupo AG en la intensidad de dolor en el postoperatorio inmediato (2,13 ± 2,39 vs. 2,77 ± 2,18 respectivamente; p = 0,510) ni durante el primer día postoperatorio (3,22 ± 2,84 vs. 3,17 ± 2,73; p = 0,923). El éxito quirúrgico fue significativamente mayor en el grupo ATC que en el grupo AG (78,3 vs. 73,1%; p = 0,019). CONCLUSIONES: La ATC proporciona un adecuado bloqueo sensitivo para poder llevar a cabo la cirugía de estrabismo, logrando un control del dolor postoperatorio similar al obtenido con la AG. La conservación de la motilidad ocular que proporciona la ATC permite obtener un mejor resultado quirúrgico

OBJECTIVE: To evaluate the anesthetic block provided by contact topical anesthesia (CTA) in strabismus surgery in adult patients. To analyze postoperative pain and surgical outcome obtained by CTA compared with general anesthesia (GA). METHODOLOGY: Prospective longitudinal cohort study of adult patients undergoing strabismus surgery by CTA or GA. The intensity of pain perceived by patients during the course of surgery and in the postoperative period was measured using Numerical Pain Scale. The success of the surgical outcome, considered as a residual ocular deviation < 10 prism diopters, was evaluated. RESULTS: Twenty-three patients were operated using CTA and 26 using AG. During the course of surgery, pain intensity experienced by patients in ATC group was 3.17 ± 2.44. There were no differences between CTA group and AG group in the intensity of pain in the immediate postoperative period (2.13 ± 2.39 vs. 2.77 ± 2.18, respectively; P=.510) and during the first postoperative day (3.22 ± 2.84 vs. 3.17 ± 2.73;P=.923). Surgical success was significantly higher in the CTA group than in the GA group (78.3 vs. 73.1%; P=.019). CONCLUSIONS: CTA provides adequate sensory block to perform strabismus surgery. The control of postoperative pain is similar to that obtained with AG. Conservation of ocular motility providing CTA enables better surgical outcome

Contact topical anesthesia versus general anaesthesia in strabismus surgery.

OBJECTIVE: To evaluate the anesthetic block provided by contact topical anesthesia (CTA) in strabismus surgery in adult patients. To analyze postoperative pain and surgical outcome obtained by CTA compared with general anesthesia (GA). METHODOLOGY: Prospective longitudinal cohort study of adult patients undergoing strabismus surgery by CTA or GA. The intensity of pain perceived by patients during the course of surgery and in the postoperative period was measured using Numerical Pain Scale. The success of the surgical outcome, considered as a residual ocular deviation<10 prism diopters, was evaluated. RESULTS: Twenty-three patients were operated using CTA and 26 using AG. During the course of surgery, pain intensity experienced by patients in ATC group was 3.17±2.44. There were no differences between CTA group and AG group in the intensity of pain in the immediate postoperative period (2.13±2.39 vs. 2.77±2.18, respectively; P=.510) and during the first postoperative day (3.22±2.84 vs. 3.17±2.73; P=.923). Surgical success was significantly higher in the CTA group than in the GA group (78.3 vs. 73.1%; P=.019). CONCLUSIONS: CTA provides adequate sensory block to perform strabismus surgery. The control of postoperative pain is similar to that obtained with AG. Conservation of ocular motility providing CTA enables better surgical outcome.

Anestesia tópica de contacto para cirugía de estrabismo / Contact topical anesthesia for strabismus surgery in adult patients

Objetivo: Analizar la eficacia y utilidad de la anestesia tópica de contacto en cirugía de estrabismo en pacientes adultos. Material y método: Estudio prospectivo de 20 pacientes intervenidos de estrabismo utilizando anestesia tópica de contacto más sedación con remifentanilo. Mediante la escala numérica del dolor se registró la intensidad de este en el momento de la aplicación de la anestesia, durante la intervención quirúrgica, a los 30 min y durante el primer día posoperatorio. Se valoró la aparición de reflejo oculocardiaco durante la intervención, la incidencia de náuseas y vómitos posoperatorios, la presencia de úlceras corneales, la satisfacción de los pacientes de forma numérica del 0 al 10, y el grado de desviación ocular residual. Resultados: La intervención quirúrgica se realizó de forma satisfactoria en todos los pacientes. La intensidad del dolor fue de 1,40 ± 1,73 en el momento de la aplicación de la anestesia; 4,20 ± 2,57 durante el desarrollo de la intervención; 2,50 ± 2,54 a los 30 min, y 3,55 ± 2,89 durante el primer día posoperatorio. Se observó aparición de reflejo oculocardiaco en 7 pacientes (35%), náuseas y vómitos posoperatorios en 4 (20%), y úlcera corneal en 4 (20%). La satisfacción de los pacientes alcanzó un valor promedio de 9,53 ± 2,51. El 70% de los pacientes presentaban una desviación ocular residual menor a 10 dioptrías prismáticas. Conclusiones: La anestesia tópica de contacto es una alternativa segura y eficaz para la cirugía del estrabismo en pacientes adultos. Permite un adecuado control del dolor, ofrece una baja incidencia de reflejo oculocardiaco y náuseas y vómitos posoperatorios, y proporciona un ajuste óptimo de la alineación ocular (AU)

Objective: To analyze the effectiveness and usefulness of contact topical anesthesia in strabismus surgery in adult patients. Material and methods: A prospective study was conducted on 20 patients undergoing strabismus surgery using contact topical anesthesia and sedation with remifentanil. The intensity of pain was recorded using a numeric pain rating scale at the time of anesthesia implementation, during the surgical procedure, 30 min afterwards, and during the first postoperative day. The incidence of oculocardiac reflex, postoperative nausea and vomiting, corneal ulcers, patient satisfaction (numerically from 0 to 10) and the degree of residual ocular deviation were also assessed. Results: The operation was performed successfully in all patients. Average pain intensity was 1.40 ± 1.73 during anesthesia implementation, 4.20 ± 2.57 during the surgical procedure, 2.50 ± 2.54 30 min after surgery, and 3.55 ± 2.89 during the first postoperative day. Oculocardiac reflex was observed in 7 patients (35%), postoperative nausea and vomiting in 4 (20%), and corneal ulcer in 4 (20%). The patient satisfaction was 9.53 ± 2.51. More than two-thirds (70%) of patients had a residual ocular deviation less than 10 prism diopters. Conclusions: Contact topical anesthesia is a safe and effective alternative for strabismus surgery in adult patients. Contact topical anesthesia provides adequate pain control, lower incidence of postoperative nausea and vomiting and oculocardiac reflex, and optimal setting of ocular alignment (AU)

Contact topical anesthesia for strabismus surgery in adult patients.

OBJECTIVE: To analyze the effectiveness and usefulness of contact topical anesthesia in strabismus surgery in adult patients. MATERIAL AND METHODS: A prospective study was conducted on 20 patients undergoing strabismus surgery using contact topical anesthesia and sedation with remifentanil. The intensity of pain was recorded using a numeric pain rating scale at the time of anesthesia implementation, during the surgical procedure, 30 min afterwards, and during the first postoperative day. The incidence of oculocardiac reflex, postoperative nausea and vomiting, corneal ulcers, patient satisfaction (numerically from 0 to 10) and the degree of residual ocular deviation were also assessed. RESULTS: The operation was performed successfully in all patients. Average pain intensity was 1.40 ± 1.73 during anesthesia implementation, 4.20 ± 2.57 during the surgical procedure, 2.50 ± 2.54 30 min after surgery, and 3.55 ± 2.89 during the first postoperative day. Oculocardiac reflex was observed in 7 patients (35%), postoperative nausea and vomiting in 4 (20%), and corneal ulcer in 4 (20%). The patient satisfaction was 9.53 ± 2.51. More than two-thirds (70%) of patients had a residual ocular deviation less than 10 prism diopters. CONCLUSIONS: Contact topical anesthesia is a safe and effective alternative for strabismus surgery in adult patients. Contact topical anesthesia provides adequate pain control, lower incidence of postoperative nausea and vomiting and oculocardiac reflex, and optimal setting of ocular alignment.

Uso de la mesoterapia en el tratamiento de dos casos de congelaciones sufridas por porteadores de altura del Karakorum pakistaní / Use of mesotherapy in the frostbite treatment of two sherpas from the Karakorum (Pakistan)

Se describe el tratamiento realizado en un mediorural muy aislado y con escasos medios, dedos casos de congelaciones acaecidas en dos sherpasde altura durante importantes ascensiones aochomiles de la zona del glaciar del Baltoro, en elmacizo del Karakorum en Pakistán.Se destaca el buen resultado obtenido con el usode fármacos vasodilatadores inyectados mediantetécnica de mesoterapia asociado en los dos casosa la medicación oral convencional y complementadoen uno de ellos por una pequeña amputación dela zona residual de necrosis

We describe the treatment of two frostbite casesmade in a very isolated village and with little healthmeans. This happened with two sherpas duringimportant ascents to the eight thousand meterspeaks close to the glacier of Baltoro which arepart of the Karakorum mountains in Pakistan. Wereport the good results obtained using the injectedvasodilator medication by means of mesotherapytechnique associated in both cases to the conventionaloral medication and complemented in one ofthem by a small amputation of the residual zone ofnecrosis