[Health-care workload and instructional capacity of Spanish hospitals accredited to train residents in anesthesiology]. / Actividad asistencial y capacidad docente de los hospitales españoles acreditados para la formación de residentes de anestesiología.

OBJECTIVES: To describe the health-care workload and instructional capacity of Spanish hospitals accredited to train anesthesiology residents. METHODS: Survey of supervisors of anesthesiology residents in 2008 to determine caseloads in surgery and obstetrics as well as in pain clinics and critical care units. The results are presented for different Spanish autonomous communities. The maximum theoretical capacity for instruction in accordance with European guidelines is calculated. RESULTS: The 100 hospitals surveyed train 325 residents per year and could theoretically increase the training opportunities they offer, within certain limits. Given optimal distribution of resources, the system could train 397 residents per year in pediatric surgery in 3-month rotations, 442 residents in neurosurgery in 2-month rotations, and 479 residents in thoracic surgery in 1-month rotations. Some Spanish communities presently have problems giving training in the settings of pediatric, thoracic, and major outpatient surgery. Furthermore, even though anesthesiologists are presently responsible for 41.6% of available critical care beds, 46 hospitals do not have a sufficient number of beds to give training in this setting. This shortage may have negative repercussions on the accreditation of training programs. CONCLUSIONS: Although certain limitations were found, the survey showed that the training capacity of the system is greater than accreditation suggests. It would therefore be possible to increase the number of residents.

Actividad asistencial y capacidad docente de los hospitales españoles acreditados para la formación de residentes de Anestesiología / Health-care workload and instructional capacity of Spanish hospitals accredited to train residents in anesthesiology

OBJETIVOS: Presentar la actividad asistencial y calcularla capacidad docente de los hospitales españoles acreditadospara la formación de residentes de Anestesiología.MÉTODOS: Encuesta a los tutores de residentes de loshospitales acreditados en 2008, recabando datos de actividadquirúrgica, obstétrica, dolor, procedimientos ydotación de camas de cuidados intensivos. Se describenlos resultados agrupados por comunidades autónomas yse calcula la capacidad docente máxima teórica según lasrecomendaciones europeas.RESULTADOS: Los 100 hospitales encuestados forman a325 residentes al año y podrían teóricamente ampliar suoferta docente, con ciertas limitaciones en las especialidadesde cirugía pediátrica, que con 3 meses de rotaciónsólo permite formar a 397 residentes al año con una distribuciónóptima de recursos; neurocirugía que con 2meses podría formar a 442 residentes y cirugía torácicacon 1 mes a 479 residentes. En la actualidad hay problemasen algunas comunidades autónomas sólo para anestesiaen cirugía pediátrica, cirugía torácica y cirugíamayor ambulatoria. En medicina de cuidados intensivos,aunque la especialidad de Anestesiología tiene 41,6% detodas las camas de críticos, preocupa la existencia de 46hospitales sin dotación adecuada. Este hecho influyenegativamente en la posible acreditación de unidadesdocentes.CONCLUSIONES: A pesar de las limitaciones encontradas,la encuesta muestra que la capacidad docente essuperior a la acreditada y por tanto sería posible aumentarel número de residentes(AU)

OBJECTIVES: To describe the health-care workloadand instructional capacity of Spanish hospitalsaccredited to train anesthesiology residents.METHODS: Survey of supervisors of anesthesiologyresidents in 2008 to determine caseloads in surgery andobstetrics as well as in pain clinics and critical careunits. The results are presented for different Spanishautonomous communities. The maximum theoreticalcapacity for instruction in accordance with Europeanguidelines is calculated.RESULTS: The 100 hospitals surveyed train 325residents per year and could theoretically increase thetraining opportunities they offer, within certain limits.Given optimal distribution of resources, the systemcould train 397 residents per year in pediatric surgery in3-month rotations, 442 residents in neurosurgery in 2-month rotations, and 479 residents in thoracic surgery in1-month rotations. Some Spanish communities presentlyhave problems giving training in the settings ofpediatric, thoracic, and major outpatient surgery.Furthermore, even though anesthesiologists arepresently responsible for 41.6% of available critical carebeds, 46 hospitals do not have a sufficient number ofbeds to give training in this setting. This shortage mayhave negative repercussions on the accreditation oftraining programs.CONCLUSIONS: Although certain limitations werefound, the survey showed that the training capacity ofthe system is greater than accreditation suggests. Itwould therefore be possible to increase the number ofresidents(AU)

Mascarilla laríngea Proseal / Proseal laryngeal mask

La mascarilla laríngea Proseal está introducida en lapráctica clínica desde el año 2000. Son muchos los artículosque se han publicado en este tiempo sobre su utilización,generalmente en casos clínicos concretos. En estetrabajo se presenta una revisión del dispositivo y susposibles indicaciones, contraindicaciones, técnicas deinserción, complicaciones de uso; así como una comparacióncon la mascarilla laríngea clásica o convencional.Para ello hemos revisado la literatura médica existentehasta octubre del 2005 mediante búsqueda en MEDLINE,utilizando los términos de búsqueda “ProSeal laryngealmask airway, anaesthesia”

The Proseal laryngeal mask was introduced into clinicalpractice in 2000. Since then, many publications,most of them case reports, have discussed the use of thismask. This review considers the possible indications andcontraindications for use of this device, techniques forinsertion, and complications. The Proseal is comparedwith the conventional laryngeal mask. We reviewed theliterature indexed on MEDLINE through October 2005using the search terms Proseal laryngeal mask, airway,and anesthesia

[Proseal laryngeal mask]. / Mascarilla laríngea Proseal.

The Proseal laryngeal mask was introduced into clinical practice in 2000. Since then, many publications, most of them case reports, have discussed the use of this mask. This review considers the possible indications and contraindications for use of this device, techniques for insertion, and complications. The Proseal is compared with the conventional laryngeal mask. We reviewed the literature indexed on MEDLINE through October 2005 using the search terms Proseal laryngeal mask, airway, and anesthesia.

Nuevos usos de EMLA®: anestesia para alivio del dolor por trombosis hemorroidal / New uses of EMLA®: anesthesia to treat hemorrhoidal thrombosis pain

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