J. A. Meléndez-Ordoñez, I. I. Hernández-Ortiz, Raymundo Rojas-Terres, Ismael B Viveros-Peralta
{"title":"Catéter epidural roto, una complicación poco frecuente","authors":"J. A. Meléndez-Ordoñez, I. I. Hernández-Ortiz, Raymundo Rojas-Terres, Ismael B Viveros-Peralta","doi":"10.35366/110201","DOIUrl":"https://doi.org/10.35366/110201","url":null,"abstract":"","PeriodicalId":106683,"journal":{"name":"Revista Mexicana de Anestesiología","volume":"113 10","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133969488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The neuraxial anesthetic technique in the obese class III, pregnant patient, can represent a challenge for the anesthesiologist, due to the difficulty in recognizing the anatomical landmarks. The objective of the study was to determine the difficulty and quality of combined spinal/epidural anesthesia, in 14 pregnant patients with a body mass index ≥ 40 kg/m2 scheduled for cesarean section. For the location of the puncture site, self-identification of the waist was used, a methodology that has not been previously reported. The patients straddled the surgical table, pointing to her waist with both hands. Two lines were drawn on the back. A horizontal line at the waist, indicated by the patient, and a vertical line corresponding to the midline. The intersection of the two lines was the coordinate for the neuraxial puncture. The mean ± SD of the body mass index was 47.5 ± 3.7 kg/m2. A first level success rate of 92.8% was determined, 57.1% of the patients received one puncture, and the average of punctures was 1.5. Spinal/epidural anesthesia failed in two cases, a change from anesthetic technique to epidural and supplementation with infiltration was performed, with adequate analgesia. It was not necessary to convert to general anesthesia in any case. Self-identification of the waist and coordinate marking can be a clinical aid for the identification of the lumbar puncture site, during the installation of neuraxial anesthesia, in obstetric patients with class III obesity, scheduled for cesarean section. Citar como: Gaona-Ramírez MI. Autoidentificación de la cintura-útil en la ubicación del sitio de punción en anestesia neuroaxial de paciente obstétrica con obesidad clase III. Rev Mex Anestesiol. 2021; 44 (4): 250-257. https://dx.doi.
由于难以识别解剖标志，在肥胖III类孕妇中应用轴向麻醉技术对麻醉师来说是一个挑战。本研究的目的是确定14例体重指数≥40 kg/m2的剖宫产孕妇腰麻/硬膜外联合麻醉的难度和质量。对于穿刺部位的位置，采用腰部自我识别，这是一种以前没有报道的方法。病人们跨坐在手术台上，双手指着她的腰。在背面画了两条线。腰上的一条水平线，由病人指示，与中线对应的一条垂直线。两条线的交点为轴向穿刺的坐标。体重指数的平均值±SD为47.5±3.7 kg/m2。一级成功率92.8%，57.1%患者穿刺1次，平均穿刺次数1.5次。2例脊髓/硬膜外麻醉失败，从麻醉技术改为硬膜外麻醉，并辅以充分的镇痛。在任何情况下都没有必要转为全身麻醉。腰的自我识别和坐标标记可以作为临床辅助腰椎穿刺部位的识别，在安装轴向麻醉期间，在产科III类肥胖患者中，预定剖宫产。参考文献:Gaona-Ramírez MI. Autoidentificación de la cintura-útil en la ubicación del sittio de punción en麻醉神经轴性障碍(neuroaxial de paciente ostrica conobesity) III类。Rev Mex anestiol . 2021;44(4): 250-257。https://dx.doi。
{"title":"Autoidentificación de la cintura-útil en la ubicación del sitio de punción en anestesia neuroaxial de paciente obstétrica con obesidad clase III","authors":"Martha Isabel Gaona-Ramírez","doi":"10.35366/100869","DOIUrl":"https://doi.org/10.35366/100869","url":null,"abstract":"The neuraxial anesthetic technique in the obese class III, pregnant patient, can represent a challenge for the anesthesiologist, due to the difficulty in recognizing the anatomical landmarks. The objective of the study was to determine the difficulty and quality of combined spinal/epidural anesthesia, in 14 pregnant patients with a body mass index ≥ 40 kg/m2 scheduled for cesarean section. For the location of the puncture site, self-identification of the waist was used, a methodology that has not been previously reported. The patients straddled the surgical table, pointing to her waist with both hands. Two lines were drawn on the back. A horizontal line at the waist, indicated by the patient, and a vertical line corresponding to the midline. The intersection of the two lines was the coordinate for the neuraxial puncture. The mean ± SD of the body mass index was 47.5 ± 3.7 kg/m2. A first level success rate of 92.8% was determined, 57.1% of the patients received one puncture, and the average of punctures was 1.5. Spinal/epidural anesthesia failed in two cases, a change from anesthetic technique to epidural and supplementation with infiltration was performed, with adequate analgesia. It was not necessary to convert to general anesthesia in any case. Self-identification of the waist and coordinate marking can be a clinical aid for the identification of the lumbar puncture site, during the installation of neuraxial anesthesia, in obstetric patients with class III obesity, scheduled for cesarean section. Citar como: Gaona-Ramírez MI. Autoidentificación de la cintura-útil en la ubicación del sitio de punción en anestesia neuroaxial de paciente obstétrica con obesidad clase III. Rev Mex Anestesiol. 2021; 44 (4): 250-257. https://dx.doi.","PeriodicalId":106683,"journal":{"name":"Revista Mexicana de Anestesiología","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116143559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nathalie Contreras-Ramírez, Kelly Arlett Maldonado-Sánchez, J. M. Alarcón-Almanza, Víctor Fuentes-García
. The anesthetic management for this procedure is quite different from the anesthetic management of a conventional caesarean section. It includes deep general anesthesia with halogenated and narcotic administration, to get adecuate uterine relaxation and preservation of best uteroplacental flow to the fetus during anesthesia and the benefit of general anesthesia to aim the neonate show effects of of anesthetic medication by this way facilitate airway access before umbilical cord clamping. The aim to mantain placental oxigenation to neonate is avoid hypoxia risk during intubation technique. In the Hospital Infantil de Mexico «Federico Gómez» this procedures have been carried out since June 2007, however, there is still no homogeneous management. Material and methods: Through a case report, a perioperative files review was made of pregnant patients who were given anesthetic management for EXIT procedure in June 2007 to May 2018 period . Results: Of the 43 cases, the perioperative anesthetic information obtained allowed to standardize the anesthetic management of the maternal fetal binomial in order to perform an intrahospital protocol. Conclusion: The ability to perform
{"title":"Protocolo para el manejo anestésico del binomio materno fetal en el proyecto EXIT para neonatos con hernia diafragmática","authors":"Nathalie Contreras-Ramírez, Kelly Arlett Maldonado-Sánchez, J. M. Alarcón-Almanza, Víctor Fuentes-García","doi":"10.35366/99011","DOIUrl":"https://doi.org/10.35366/99011","url":null,"abstract":". The anesthetic management for this procedure is quite different from the anesthetic management of a conventional caesarean section. It includes deep general anesthesia with halogenated and narcotic administration, to get adecuate uterine relaxation and preservation of best uteroplacental flow to the fetus during anesthesia and the benefit of general anesthesia to aim the neonate show effects of of anesthetic medication by this way facilitate airway access before umbilical cord clamping. The aim to mantain placental oxigenation to neonate is avoid hypoxia risk during intubation technique. In the Hospital Infantil de Mexico «Federico Gómez» this procedures have been carried out since June 2007, however, there is still no homogeneous management. Material and methods: Through a case report, a perioperative files review was made of pregnant patients who were given anesthetic management for EXIT procedure in June 2007 to May 2018 period . Results: Of the 43 cases, the perioperative anesthetic information obtained allowed to standardize the anesthetic management of the maternal fetal binomial in order to perform an intrahospital protocol. Conclusion: The ability to perform","PeriodicalId":106683,"journal":{"name":"Revista Mexicana de Anestesiología","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116538599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lorena López-Maya, Francisco Lina-Manjarrez, L. Lina-López, Laura López-Gámez
A controlled, prospective, comparative, randomized, simple blind clinical trial was conducted. Objective: Determine the correlation and predictive value of the airway assessment and difficult intubation scales, obesity, McCoy sheet and Airtraq® type videolaryngoscope. Material and methods: 152 patients scheduled for surgery, with a history of obesity and risk factors for difficult ventilation and intubation under general anesthesia. Two groups were formed: group, intubation with McCoy sheet and group 2, Airtraq® videolaryngoscope. Results: In the contrast statistics of difficult ventilation, statistical significance was obtained with p < 0.05 for all factors except snoring. In predictors of difficult intubation, the Mallampati and Cormack-Lehane classification obtained p < 0.05, with sensitivity of 63 and 68% respectively, with a high negative predictive value for all factors. The average of attempts was 1 and duration 55-59 seconds, in both groups. There were not differences with the use of McCoy sheet and Airtraq®. Conclusions: Orotracheal intubation was successful in 97% of cases, thanks to the use of difficult intubation predictors and devices for managing it. Palabras clave: Predictores de vía aérea difícil, ventilación e intubación difícil, McCoy, Airtraq®.
采用对照、前瞻性、比较性、随机、单盲临床试验。目的:探讨气道评估与插管困难量表、肥胖、McCoy表和Airtraq®型视频喉镜的相关性和预测价值。材料与方法:152例计划手术患者，既往有肥胖史，有全麻下通气插管困难的危险因素。分为两组:McCoy片插管组和Airtraq®视频喉镜插管组。结果:在通气困难的对比统计中，除打鼾外，其他因素均有统计学意义，p < 0.05。在插管困难的预测因素中，Mallampati和Cormack-Lehane分类p < 0.05，敏感性分别为63%和68%，所有因素均具有较高的阴性预测值。两组的平均尝试次数为1次，持续时间为55-59秒。使用McCoy薄板和Airtraq®没有差异。结论:由于使用了困难的插管预测器和管理设备，97%的病例气管插管成功。Palabras clave: Predictores de vía aastrea difícil, ventilación e intubación difícil, McCoy, Airtraq®。
{"title":"Uso de dispositivos (hoja McCoy vs videolaringoscopio Airtraq®) en paciente con obesidad con predictores de vía aérea difícil en cirugía general","authors":"Lorena López-Maya, Francisco Lina-Manjarrez, L. Lina-López, Laura López-Gámez","doi":"10.35366/97774","DOIUrl":"https://doi.org/10.35366/97774","url":null,"abstract":"A controlled, prospective, comparative, randomized, simple blind clinical trial was conducted. Objective: Determine the correlation and predictive value of the airway assessment and difficult intubation scales, obesity, McCoy sheet and Airtraq® type videolaryngoscope. Material and methods: 152 patients scheduled for surgery, with a history of obesity and risk factors for difficult ventilation and intubation under general anesthesia. Two groups were formed: group, intubation with McCoy sheet and group 2, Airtraq® videolaryngoscope. Results: In the contrast statistics of difficult ventilation, statistical significance was obtained with p < 0.05 for all factors except snoring. In predictors of difficult intubation, the Mallampati and Cormack-Lehane classification obtained p < 0.05, with sensitivity of 63 and 68% respectively, with a high negative predictive value for all factors. The average of attempts was 1 and duration 55-59 seconds, in both groups. There were not differences with the use of McCoy sheet and Airtraq®. Conclusions: Orotracheal intubation was successful in 97% of cases, thanks to the use of difficult intubation predictors and devices for managing it. Palabras clave: Predictores de vía aérea difícil, ventilación e intubación difícil, McCoy, Airtraq®.","PeriodicalId":106683,"journal":{"name":"Revista Mexicana de Anestesiología","volume":"154 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122187194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pablo Casas-Reza, María Gestal-Vázquez, David López-López, R. Mato-Búa
{"title":"La terapia electroconvulsiva en el síndrome neuroléptico maligno","authors":"Pablo Casas-Reza, María Gestal-Vázquez, David López-López, R. Mato-Búa","doi":"10.35366/110206","DOIUrl":"https://doi.org/10.35366/110206","url":null,"abstract":"","PeriodicalId":106683,"journal":{"name":"Revista Mexicana de Anestesiología","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129821196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
I. Cordero-escobar, Araceli Chico-Capote, José Escobar-Andarade, Miguel H Estévez-Chico, Isabel Mora-Díaz
. Introduction: The anesthetic technique of choice for arthroscopy is determined by the intraoperative surgical requirements and aims to optimize recovery, postoperative pain control and facilitate early discharge. Objective: To evaluate the results of intra-articular regional block with local anesthetics in arthroscopic knee surgery. Material and methods: An observational, descriptive, cross-sectional study was conducted to evaluate the results of the intraarticular regional block with local anesthetics in arthroscopic knee surgery at the «Hermanos Ameijeiras» Clinical Surgical Hospital, in the period between February 2013 and February 2016. The There significant Complications according to occurred in twice many patients in the as in with significant differences Conclusions: The results of intra-articular regional block with local anesthetics in arthroscopic knee surgery is an anesthetic technique that is easy to perform and provides patient safety.
{"title":"Bloqueo regional intraarticular con anestésicos locales en cirugía artroscópica de rodilla","authors":"I. Cordero-escobar, Araceli Chico-Capote, José Escobar-Andarade, Miguel H Estévez-Chico, Isabel Mora-Díaz","doi":"10.35366/cma201b","DOIUrl":"https://doi.org/10.35366/cma201b","url":null,"abstract":". Introduction: The anesthetic technique of choice for arthroscopy is determined by the intraoperative surgical requirements and aims to optimize recovery, postoperative pain control and facilitate early discharge. Objective: To evaluate the results of intra-articular regional block with local anesthetics in arthroscopic knee surgery. Material and methods: An observational, descriptive, cross-sectional study was conducted to evaluate the results of the intraarticular regional block with local anesthetics in arthroscopic knee surgery at the «Hermanos Ameijeiras» Clinical Surgical Hospital, in the period between February 2013 and February 2016. The There significant Complications according to occurred in twice many patients in the as in with significant differences Conclusions: The results of intra-articular regional block with local anesthetics in arthroscopic knee surgery is an anesthetic technique that is easy to perform and provides patient safety.","PeriodicalId":106683,"journal":{"name":"Revista Mexicana de Anestesiología","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126432816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Evelyn Judith Cruz-Nocelo, Víctor Hugo Zúñiga-Carmona, María Concepción Serratos-Vázquez
Severe burns are characterized by inducing the most severe and sustained metabolic response than any other form of trauma. The treatment of pain in these patients is complex. In this review, the scientific support available in the current literature was integrated from a practical clinical approach in regard to the treatment of pain in the patient with burns; in turn, two representative schemes of the classification of pain and multimodal analgesia for the patient with major burns were integrated. Multimodal analgesia is the technique currently recommended for the treatment of burn pain; however, more research is required mainly with regard to analgesic adjuvants in burned patients. It is likely that the state of intense and persistent inflammation that characterizes these patients, which implies the massive genomic reorganization of the leukocyte transcriptome, contributes to the exceptional quality of the pain of the patient with burn injuries. The foundation of successful analgesic management could be in the search for specific regulatory anti-inflammatories for these patients. It is necessary to undertake the development of effective anti-inflammatoriesanalgesics with properties that allow them to overcome the challenge of the high variability of the pharmacological parameters of the patient with major burns. Palabras clave: Quemaduras, manejo del dolor, inflamación, genómica.
严重烧伤的特点是诱导最严重和持续的代谢反应比任何其他形式的创伤。这些病人疼痛的治疗是复杂的。在这篇综述中，现有文献中的科学支持从烧伤患者疼痛治疗的实际临床方法中得到整合;然后，结合了两种典型的方案，即疼痛分类和多模式镇痛，用于严重烧伤患者。多模式镇痛是目前推荐用于治疗烧伤疼痛的技术;然而，更多的研究主要是关于烧伤患者的镇痛佐剂。这些患者的特征可能是强烈和持续的炎症状态，这意味着白细胞转录组的大规模基因组重组，这有助于烧伤患者的特殊疼痛质量。成功止痛管理的基础可能是为这些患者寻找特定的调节抗炎药。有必要开发有效的抗炎镇痛药，使其能够克服严重烧伤患者药理学参数的高度可变性的挑战。Palabras clave: Quemaduras, manejo del dolor, inflamación, genómica。
{"title":"Tratamiento del dolor en pacientes con quemaduras severas","authors":"Evelyn Judith Cruz-Nocelo, Víctor Hugo Zúñiga-Carmona, María Concepción Serratos-Vázquez","doi":"10.35366/97778","DOIUrl":"https://doi.org/10.35366/97778","url":null,"abstract":"Severe burns are characterized by inducing the most severe and sustained metabolic response than any other form of trauma. The treatment of pain in these patients is complex. In this review, the scientific support available in the current literature was integrated from a practical clinical approach in regard to the treatment of pain in the patient with burns; in turn, two representative schemes of the classification of pain and multimodal analgesia for the patient with major burns were integrated. Multimodal analgesia is the technique currently recommended for the treatment of burn pain; however, more research is required mainly with regard to analgesic adjuvants in burned patients. It is likely that the state of intense and persistent inflammation that characterizes these patients, which implies the massive genomic reorganization of the leukocyte transcriptome, contributes to the exceptional quality of the pain of the patient with burn injuries. The foundation of successful analgesic management could be in the search for specific regulatory anti-inflammatories for these patients. It is necessary to undertake the development of effective anti-inflammatoriesanalgesics with properties that allow them to overcome the challenge of the high variability of the pharmacological parameters of the patient with major burns. Palabras clave: Quemaduras, manejo del dolor, inflamación, genómica.","PeriodicalId":106683,"journal":{"name":"Revista Mexicana de Anestesiología","volume":"53 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129043322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fabio Andrés Avellaneda-Suárez, Edgardo Luis Vizcaíno-Ramírez, Juan Carlos Ramírez-Mora
{"title":"Manejo anestésico en neonatos con tumoraciones pulmonares","authors":"Fabio Andrés Avellaneda-Suárez, Edgardo Luis Vizcaíno-Ramírez, Juan Carlos Ramírez-Mora","doi":"10.35366/103890","DOIUrl":"https://doi.org/10.35366/103890","url":null,"abstract":"","PeriodicalId":106683,"journal":{"name":"Revista Mexicana de Anestesiología","volume":"53 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122732768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Análisis retrospectivo del diferimiento quirúrgico a un año de la pandemia COVID-19","authors":"Víctor León-Ramírez, Janaí Santiago-López, Bertha Karina Arrieta-Valdez","doi":"10.35366/110192","DOIUrl":"https://doi.org/10.35366/110192","url":null,"abstract":"","PeriodicalId":106683,"journal":{"name":"Revista Mexicana de Anestesiología","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115710237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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