Over the past seven years, the Colombian Society of Anesthesiology and Resuscitation (Sociedad Colombiana de Anestesiología y Reanimación S.C.A.R.E.) has been at the forefront in the process of anesthesia recertification in Colombia, pursuant to the guidelines of the Colombian Council for Medical Accreditation and Recertification of Specialists and Related Professions (CAMEC). This article aims to provide readers with relevant information regarding some of the milestones achieved and the outlook for what is yet to be done. To fulfill this aim, three aspects that illustrate this valuable experience at S.C.A.R.E. are presented, with the certainty that they will shed light on the road to recertification in Colombia:
在过去的七年里，哥伦比亚麻醉和复苏学会（Sociedad Colombiana de Anestesiología y Reanimación S.C.a.R.E.）根据哥伦比亚专家和相关专业医学认证和再认证委员会（CAMEC）的指导方针，在哥伦比亚麻醉再认证过程中一直处于领先地位。本文旨在为读者提供有关已实现的一些里程碑以及尚未完成的工作前景的相关信息。为了实现这一目标，我们从三个方面阐述了S.C.A.R.E.的宝贵经验，这些经验肯定会为哥伦比亚的重新认证之路指明方向：
{"title":"How are we doing with anesthesiology recertification in Colombia?","authors":"Luz María Gómez-Buitrago","doi":"10.5554/22562087.e1019","DOIUrl":"https://doi.org/10.5554/22562087.e1019","url":null,"abstract":"Over the past seven years, the Colombian Society of Anesthesiology and Resuscitation (Sociedad Colombiana de Anestesiología y Reanimación S.C.A.R.E.) has been at the forefront in the process of anesthesia recertification in Colombia, pursuant to the guidelines of the Colombian Council for Medical Accreditation and Recertification of Specialists and Related Professions (CAMEC). This article aims to provide readers with relevant information regarding some of the milestones achieved and the outlook for what is yet to be done. To fulfill this aim, three aspects that illustrate this valuable experience at S.C.A.R.E. are presented, with the certainty that they will shed light on the road to recertification in Colombia:","PeriodicalId":36529,"journal":{"name":"Colombian Journal of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49536132","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}
Luis Mauricio García Borrero, D. C. Aguirre Acevedo, Carla María Zapata Rueda, H. I. García García
Introduction. Burnout Syndrome is the term used to describe the psychological response to patient care-related chronic work stress. Studies have found that the prevalence of practitioner burnout in Colombia ranges between 17.6% and 45%. Given the importance of this phenomenon in our setting, we decided to carry out a validation and reliability study of the Spanish Burnout Inventory (SBI). Objective. To assess the validity and reliability of the SBI in medical surgical specialists working in fourteen health care facilities in Antioquia (Colombia) in 2018. Methods. The study was conducted in 14 healthcare institutions among 8 surgical specialties. The tool consists of 20 items collected by means of face-to-face interviews under the supervision of a psychologist, and maintaining confidentiality. The psychometric assessment included content validity (CV), construct validity using confirmatory factor analysis (CFA) and reliability using Cronbach’s Alpha. Results. The study sample consisted of 234 participants. CV of the tool was 0.82. The CFA showed acceptable model fit, with the results of goodness-of-fit being χ2=384.578 (p<0.000; df: 165), RMSEA = 0.075 [90% CI: 0.066 – 0.085], CFI = 0.953, TLI = 0.946 and WRMR = 1.074. The SBI Cronbach’s alpha was 0.79. Conclusion. The SBI showed acceptable CV levels for all the items and domains. The SBI is a valid tool with adequate reliability for use in medical surgical specialists of healthcare institutions in Antioquia-Colombia.
{"title":"Validity and reliability of the SBI (Spanish Burnout Inventory) in medical surgical specialists","authors":"Luis Mauricio García Borrero, D. C. Aguirre Acevedo, Carla María Zapata Rueda, H. I. García García","doi":"10.5554/22562087.e1017","DOIUrl":"https://doi.org/10.5554/22562087.e1017","url":null,"abstract":"Introduction. Burnout Syndrome is the term used to describe the psychological response to patient care-related chronic work stress. Studies have found that the prevalence of practitioner burnout in Colombia ranges between 17.6% and 45%. Given the importance of this phenomenon in our setting, we decided to carry out a validation and reliability study of the Spanish Burnout Inventory (SBI). \u0000Objective. To assess the validity and reliability of the SBI in medical surgical specialists working in fourteen health care facilities in Antioquia (Colombia) in 2018. \u0000Methods. The study was conducted in 14 healthcare institutions among 8 surgical specialties. The tool consists of 20 items collected by means of face-to-face interviews under the supervision of a psychologist, and maintaining confidentiality. The psychometric assessment included content validity (CV), construct validity using confirmatory factor analysis (CFA) and reliability using Cronbach’s Alpha. \u0000Results. The study sample consisted of 234 participants. CV of the tool was 0.82. The CFA showed acceptable model fit, with the results of goodness-of-fit being χ2=384.578 (p<0.000; df: 165), RMSEA = 0.075 [90% CI: 0.066 – 0.085], CFI = 0.953, TLI = 0.946 and WRMR = 1.074. The SBI Cronbach’s alpha was 0.79. \u0000Conclusion. The SBI showed acceptable CV levels for all the items and domains. The SBI is a valid tool with adequate reliability for use in medical surgical specialists of healthcare institutions in Antioquia-Colombia.","PeriodicalId":36529,"journal":{"name":"Colombian Journal of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49275642","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}
Sebastian Amaya, Marcelino Murillo, Boris Julián Pinto Bustamante, Nubia Sánchez-Bello, María José Mateus Parra, M. J. Andrade, Natalia González Zárate, María Paula Pérez, J. J. Maya, Valentina Monsalve, Nashla Fayad Fayad, Gabriela Rosero Belalcázar, Ilana Charul-Palacio
Introduction: The practice of anesthesiology during the COVID-19 pandemic has had a psychological impact, and has been associated with ethical dilemmas, work overload, and occupational risk. Objective: To understand different problems affecting anesthesiologists, in particular with regards to professional ethics in the decision-making process, increased personal workload, and the potential risk in terms of their own safety and health, as a consequence of working during the COVID-19 pandemic. Methods: Observational, descriptive, cross-sectional study. A survey was administered to the anesthesiologists members of the Colombian Society of Anesthesiology and Resuscitation (S.C.A.R.E.), to enquire about work hours, occupational safety, prevention standards and strategies, and ethical aspects involved in decision making. Results: 218 anesthesiologist participated in the survey. Most of the respondents felt that there was not a significant increase in their workload, except for those in critical care (42.5 %; n = 17). Most of the participants believe that leisure time is not enough. 55.96 % (n = 122) of the participants said they felt moderately safe with the biosecurity measures, but with a higher risk of contagion versus other practitioners, with 72.9 % (n = 159) and they said they used their own money to buy personal protection equipment (PPE). There was also evidence that one fourth of the respondents has faced ethical dilemmas during the resuscitation of SARS-CoV-2 – infected patients. Conclusion: The information gathered is a preliminary approach to the situation arising in Colombia as a result of the pandemic; it is clear that anesthesiologists perceive higher associated lack of safety due to different factors such as higher risk of infection, shortage of PEEs and burnout, inter alia. Hence we believe that it is fundamental to acknowledge the work of all anesthesiologists and understand the impact that the pandemic has had on this group of professionals.
{"title":"Impact of the SARS-CoV-2 pandemic on Colombian anesthesiologists: Survey study","authors":"Sebastian Amaya, Marcelino Murillo, Boris Julián Pinto Bustamante, Nubia Sánchez-Bello, María José Mateus Parra, M. J. Andrade, Natalia González Zárate, María Paula Pérez, J. J. Maya, Valentina Monsalve, Nashla Fayad Fayad, Gabriela Rosero Belalcázar, Ilana Charul-Palacio","doi":"10.5554/22562087.e1016","DOIUrl":"https://doi.org/10.5554/22562087.e1016","url":null,"abstract":"Introduction: The practice of anesthesiology during the COVID-19 pandemic has had a psychological impact, and has been associated with ethical dilemmas, work overload, and occupational risk. \u0000Objective: To understand different problems affecting anesthesiologists, in particular with regards to professional ethics in the decision-making process, increased personal workload, and the potential risk in terms of their own safety and health, as a consequence of working during the COVID-19 pandemic. \u0000Methods: Observational, descriptive, cross-sectional study. A survey was administered to the anesthesiologists members of the Colombian Society of Anesthesiology and Resuscitation (S.C.A.R.E.), to enquire about work hours, occupational safety, prevention standards and strategies, and ethical aspects involved in decision making. \u0000Results: 218 anesthesiologist participated in the survey. Most of the respondents felt that there was not a significant increase in their workload, except for those in critical care (42.5 %; n = 17). Most of the participants believe that leisure time is not enough. 55.96 % (n = 122) of the participants said they felt moderately safe with the biosecurity measures, but with a higher risk of contagion versus other practitioners, with 72.9 % (n = 159) and they said they used their own money to buy personal protection equipment (PPE). There was also evidence that one fourth of the respondents has faced ethical dilemmas during the resuscitation of SARS-CoV-2 – infected patients. \u0000Conclusion: The information gathered is a preliminary approach to the situation arising in Colombia as a result of the pandemic; it is clear that anesthesiologists perceive higher associated lack of safety due to different factors such as higher risk of infection, shortage of PEEs and burnout, inter alia. Hence we believe that it is fundamental to acknowledge the work of all anesthesiologists and understand the impact that the pandemic has had on this group of professionals.","PeriodicalId":36529,"journal":{"name":"Colombian Journal of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41872131","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}
M. Alonso Alonso, Víctor Morales Ariza, Yuri Loaiza Aldeán, Marcos De Miguel Negro, Olga Martínez Silva, A. Casterás Román
Introduction: Pheochromocytomas are neuroendocrine tumors capable of synthetizing, storing and releasing catecholaminergic hormones that may lead to life-threatening hemodynamic instability. The COVID-19 pandemic has increased the risks and perioperative complexity of the patients undergoing pheochromocytoma-associated adrenalectomy. This article discusses the use of adenosine for the management of hypertensive crisis during this intervention, as well as the need to individualize the suitable timing for surgery after recent COVID-19 infection. Case presentation: This article discusses the case of a patient with a finding of right adrenal incidentaloma; further studies determined a metanephrines secreting pheochromocytoma. Following hospital admission for preoperative optimization, the eve of the procedure the patient developed an acute myocardial infarction and subsequently SARS-CoV-2 symptomatic infection. Intraoperatively, hypertensive peaks were managed with continuous adenosine perfusion. The patient was discharged after 48 hours. Conclusions: Preoperative optimization positively influences the intraoperative management of patients with pheochromocytoma. The intraoperative use of adenosine allows for adequate and safe control of hypertensive crises. Each situation must be individualized in patients pending surgery, with a recent COVID-19 infection.
{"title":"Intraoperative adenosine for pheochromocytoma with myocardial infarction and SARS-CoV-2. Case report","authors":"M. Alonso Alonso, Víctor Morales Ariza, Yuri Loaiza Aldeán, Marcos De Miguel Negro, Olga Martínez Silva, A. Casterás Román","doi":"10.5554/22562087.e1015","DOIUrl":"https://doi.org/10.5554/22562087.e1015","url":null,"abstract":"Introduction: Pheochromocytomas are neuroendocrine tumors capable of synthetizing, storing and releasing catecholaminergic hormones that may lead to life-threatening hemodynamic instability. The COVID-19 pandemic has increased the risks and perioperative complexity of the patients undergoing pheochromocytoma-associated adrenalectomy. This article discusses the use of adenosine for the management of hypertensive crisis during this intervention, as well as the need to individualize the suitable timing for surgery after recent COVID-19 infection. \u0000Case presentation: This article discusses the case of a patient with a finding of right adrenal incidentaloma; further studies determined a metanephrines secreting pheochromocytoma. Following hospital admission for preoperative optimization, the eve of the procedure the patient developed an acute myocardial infarction and subsequently SARS-CoV-2 symptomatic infection. Intraoperatively, hypertensive peaks were managed with continuous adenosine perfusion. The patient was discharged after 48 hours. \u0000Conclusions: Preoperative optimization positively influences the intraoperative management of patients with pheochromocytoma. The intraoperative use of adenosine allows for adequate and safe control of hypertensive crises. Each situation must be individualized in patients pending surgery, with a recent COVID-19 infection.","PeriodicalId":36529,"journal":{"name":"Colombian Journal of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48733885","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}
Guillermo Eduardo Aréchiga-Ornelas, J. Ramos-Guerrero, Pablo Humberto Bueno-Acosta, Mariel Del Río-Parra, Oscar Sotelo-Rosero, José Alberto Coria-Márquez, Óscar Contreras-Martínez, José Alejandro Apraez-Erazo
The advent of the erector spinae plane block brought about new therapeutic options as part of a multimodal analgesia strategy, as evidenced in this case, which describes a five-year old pre-school patient who presented with severe abdominal cancer pain, secondary to an abdominal neuroblastoma, with partial high-dose opioid response, undergoing bilateral erector spinal plane block. The technique used did not give rise to complications and proved to be effective in blocking pain and reducing the dose of opioids 36 hours after the procedure. The paper discusses the variables involved in the mode of administration (continuous infusion vs. bolus) and the benefit for optimal analgesia in the pediatric oncology setting.
{"title":"Erector Spinae Plane Block in pediatric cancer pain: Case report","authors":"Guillermo Eduardo Aréchiga-Ornelas, J. Ramos-Guerrero, Pablo Humberto Bueno-Acosta, Mariel Del Río-Parra, Oscar Sotelo-Rosero, José Alberto Coria-Márquez, Óscar Contreras-Martínez, José Alejandro Apraez-Erazo","doi":"10.5554/22562087.e1014","DOIUrl":"https://doi.org/10.5554/22562087.e1014","url":null,"abstract":"The advent of the erector spinae plane block brought about new therapeutic options as part of a multimodal analgesia strategy, as evidenced in this case, which describes a five-year old pre-school patient who presented with severe abdominal cancer pain, secondary to an abdominal neuroblastoma, with partial high-dose opioid response, undergoing bilateral erector spinal plane block. The technique used did not give rise to complications and proved to be effective in blocking pain and reducing the dose of opioids 36 hours after the procedure. The paper discusses the variables involved in the mode of administration (continuous infusion vs. bolus) and the benefit for optimal analgesia in the pediatric oncology setting.","PeriodicalId":36529,"journal":{"name":"Colombian Journal of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47271388","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 Díaz-Bohada, J. C. Segura-Salguero, Nicolás Felipe Garzón-Beltrán, Daniela Salazar-Balcázar, M. Otálora-Estéban
The evidence regarding logistic considerations and safety events associated with prone position ventilation (PPV) is summarized and a flow diagrama for safe provision of mechanical ventilation in the setting of the COVID-19 pandemic is proposed. A review of the literature was conducted in the Medline via Pubmed, Embase, and Lilacs databases, the Cochrane Database of Systematic Reviews, Cochrane Central Register of Randomized Controlled Trials, Cochrane Database of Abstracts of Reviews of Effects, ProQuest Nursing and Allied Health Database, and Google scholar. Overall, 31 articles were selected for the analysis. The incidence of PPV-related safety events varies between 1% and 11.9% and the most frequent complications are pressure ulcers and airway complications. Early initiation of enteral nutrition is recommended, and transfers are possible in patients on PPV. There is controversy regarding contraindications and recommendations for PPV. Recommendations for its safe provision are based on expert opinions and the establishment of protocols for healthcare staff training. Clinical studies are required to determine which are the recommendations that should be considered for safe and reproducible PPV use during this pandemic.
{"title":"Considerations of invasive mechanical ventilation in prone position. A narrative review","authors":"Lorena Díaz-Bohada, J. C. Segura-Salguero, Nicolás Felipe Garzón-Beltrán, Daniela Salazar-Balcázar, M. Otálora-Estéban","doi":"10.5554/22562087.e1013","DOIUrl":"https://doi.org/10.5554/22562087.e1013","url":null,"abstract":"The evidence regarding logistic considerations and safety events associated with prone position ventilation (PPV) is summarized and a flow diagrama for safe provision of mechanical ventilation in the setting of the COVID-19 pandemic is proposed. A review of the literature was conducted in the Medline via Pubmed, Embase, and Lilacs databases, the Cochrane Database of Systematic Reviews, Cochrane Central Register of Randomized Controlled Trials, Cochrane Database of Abstracts of Reviews of Effects, ProQuest Nursing and Allied Health Database, and Google scholar. Overall, 31 articles were selected for the analysis. The incidence of PPV-related safety events varies between 1% and 11.9% and the most frequent complications are pressure ulcers and airway complications. Early initiation of enteral nutrition is recommended, and transfers are possible in patients on PPV. There is controversy regarding contraindications and recommendations for PPV. Recommendations for its safe provision are based on expert opinions and the establishment of protocols for healthcare staff training. Clinical studies are required to determine which are the recommendations that should be considered for safe and reproducible PPV use during this pandemic.","PeriodicalId":36529,"journal":{"name":"Colombian Journal of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46620335","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}
Ana Milena Álvarez Acuña, Ómar Fernando Gomezese Ribero
Introduction: The Advanced Directives Document (ADD) is a bioethical quality benchmark for healthcare and assurance of compliance with the rights of autonomy, self-determination and dignity of the patient. This document was established over the past decade and currently there is no evidence about the attitudes and knowledge of the healthcare professionals with regards to the use of this tool in clinical practice in Colombia. Objective: To describe the knowledge and experiences of healthcare professionals members of six Colombian Scientific Societies regarding the right to sign an ADD and explore the barriers to its applicability in clinical daily practice. Methods: Descriptive, cross-sectional study conducted using an anonymous and voluntary e-survey with the participation of six Colombian Medical Societies. A questionnaire was designed comprising five groups of variables: general, ADD knowledge, medical experiences and personal experiences regarding advanced directives and potential obstacles to its implementation. Results: 533 professionals participated in the survey. 54 % (n = 286) expressed their lack of awareness about the fact that there is law governing the ADD in Colombia; 34.33 % (n = 183) said they were familiar with the requirements of the document. Over the last year, 24 % of the professionals received one or more ADDs from their patients. Only 11.7 % of healthcare practitioners had themselves completed an ADD. 77.1 % of the professionals surveyed believe that the number of individuals with an ADD has not changed after the approval and regulation of the right to an advanced directives document. 86.6 % of the practitioners said they respected the ADD, notwithstanding the fact that the patient could benefit otherwise. Conclusions: The overall perception of healthcare professionals with regards to the number of ADDs signed by patients is that the number has not changed after the approval of the Law in Colombia. This study evidenced that medical practitioners have a poor knowledge about the ADD and that there is a need to educate healthcare professionals about the ADD and to promptly implement institutional programs about Planning of Advanced Directives (PAD). Both strategies are challenging for the applicability of AD in Colombia.
{"title":"Advance Directives Document: knowledge and experiences of healthcare professionals in Colombia","authors":"Ana Milena Álvarez Acuña, Ómar Fernando Gomezese Ribero","doi":"10.5554/22562087.e1012","DOIUrl":"https://doi.org/10.5554/22562087.e1012","url":null,"abstract":"Introduction: The Advanced Directives Document (ADD) is a bioethical quality benchmark for healthcare and assurance of compliance with the rights of autonomy, self-determination and dignity of the patient. This document was established over the past decade and currently there is no evidence about the attitudes and knowledge of the healthcare professionals with regards to the use of this tool in clinical practice in Colombia. \u0000Objective: To describe the knowledge and experiences of healthcare professionals members of six Colombian Scientific Societies regarding the right to sign an ADD and explore the barriers to its applicability in clinical daily practice. \u0000Methods: Descriptive, cross-sectional study conducted using an anonymous and voluntary e-survey with the participation of six Colombian Medical Societies. A questionnaire was designed comprising five groups of variables: general, ADD knowledge, medical experiences and personal experiences regarding advanced directives and potential obstacles to its implementation. \u0000Results: 533 professionals participated in the survey. 54 % (n = 286) expressed their lack of awareness about the fact that there is law governing the ADD in Colombia; 34.33 % (n = 183) said they were familiar with the requirements of the document. Over the last year, 24 % of the professionals received one or more ADDs from their patients. Only 11.7 % of healthcare practitioners had themselves completed an ADD. 77.1 % of the professionals surveyed believe that the number of individuals with an ADD has not changed after the approval and regulation of the right to an advanced directives document. 86.6 % of the practitioners said they respected the ADD, notwithstanding the fact that the patient could benefit otherwise. \u0000Conclusions: The overall perception of healthcare professionals with regards to the number of ADDs signed by patients is that the number has not changed after the approval of the Law in Colombia. This study evidenced that medical practitioners have a poor knowledge about the ADD and that there is a need to educate healthcare professionals about the ADD and to promptly implement institutional programs about Planning of Advanced Directives (PAD). Both strategies are challenging for the applicability of AD in Colombia.","PeriodicalId":36529,"journal":{"name":"Colombian Journal of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44086751","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}
M. León, M. Sánchez-Cárdenas, L. Rodríguez-Campos, J. Moyano, Andrés López Velasco, Oscar Andrés Gamboa Garay, L. Buitrago, L. de Lima
Introduction: Access to essential medicines, including opioids, is a component of the right to health. Objective: To identify barriers to opioid availability and accessibility for pain and palliative care. Methods: Online survey with Colombian prescribers. Availability barriers were analyzed for each facility (distribution and/or dispensing). Accessibility barriers were analyzed by type. Descriptive analyses were conducted using relative frequencies. Significance within categories and regions was measured using Fisher's exact test. Results: Out of 1,208 prescribers invited, 806 (66.7%) completed the survey. Availability: 76.43% reported barriers. The most cited barrier was “Pharmacies authorized by health insurance companies”, where opioids are frequently unavailable. Accessibility: 74.6% reported barriers. Most frequently cited was “Difficulty securing payment authorization for medication from health insurance companies”. Significant differences were observed in terms of regions and “Cost” (p=0.02). Lack of coordination among procuring and distributing agencies affects availability. Limited awareness and bureaucratic procedures affect accessibility. Conclusions: There are barriers to opioid availability and access in Colombia, related to the existing structure for guaranteeing equitable supply. From the perspective of healthcare providers, problems related to pharmacy availability, prescription and cost of medicines hinder pain treatment.
{"title":"Availability and accessibility of opioids for pain and palliative care in Colombia: a survey study","authors":"M. León, M. Sánchez-Cárdenas, L. Rodríguez-Campos, J. Moyano, Andrés López Velasco, Oscar Andrés Gamboa Garay, L. Buitrago, L. de Lima","doi":"10.5554/22562087.e1011","DOIUrl":"https://doi.org/10.5554/22562087.e1011","url":null,"abstract":"Introduction: Access to essential medicines, including opioids, is a component of the right to health. \u0000Objective: To identify barriers to opioid availability and accessibility for pain and palliative care. \u0000Methods: Online survey with Colombian prescribers. Availability barriers were analyzed for each facility (distribution and/or dispensing). Accessibility barriers were analyzed by type. Descriptive analyses were conducted using relative frequencies. Significance within categories and regions was measured using Fisher's exact test. \u0000Results: Out of 1,208 prescribers invited, 806 (66.7%) completed the survey. Availability: 76.43% reported barriers. The most cited barrier was “Pharmacies authorized by health insurance companies”, where opioids are frequently unavailable. Accessibility: 74.6% reported barriers. Most frequently cited was “Difficulty securing payment authorization for medication from health insurance companies”. Significant differences were observed in terms of regions and “Cost” (p=0.02). Lack of coordination among procuring and distributing agencies affects availability. Limited awareness and bureaucratic procedures affect accessibility. \u0000Conclusions: There are barriers to opioid availability and access in Colombia, related to the existing structure for guaranteeing equitable supply. From the perspective of healthcare providers, problems related to pharmacy availability, prescription and cost of medicines hinder pain treatment.","PeriodicalId":36529,"journal":{"name":"Colombian Journal of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43984782","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}
Alfonso Ernesto Albornoz Pardo, D. Keefe, David Neville Levin, A. Lorenzo, Farrukh Munshey
We present a 9-year-old patient with end-stage renal disease, on peritoneal dialysis, who underwent a staged prone retroperitoneoscopic bilateral nephrectomy. Bilateral nephrectomy was indicated in preparation for renal transplant in the context of genetic predisposition malignancy when immunosuppressed. The two mirror-image surgeries enable the comparison of the anesthetic management and outcomes in a single patient. Features of interest to anesthesiologists include approach to a child with chronic kidney disease, different requirements for intraoperative antihypertensives; pain management strategies, including a comparison of erector spinae plane block with and without adjunct dexmedetomidine; anesthetic management of retroperitoneoscopic pediatric surgery and the first description of using a Foley bag attached to a peritoneal dialysis catheter to aid in diagnosis and repair of posterior peritoneal cavity entry.
{"title":"Anesthetic and surgical considerations for staged bilateral nephrectomies in a pediatric patient: A case report","authors":"Alfonso Ernesto Albornoz Pardo, D. Keefe, David Neville Levin, A. Lorenzo, Farrukh Munshey","doi":"10.5554/22562087.E1009","DOIUrl":"https://doi.org/10.5554/22562087.E1009","url":null,"abstract":"We present a 9-year-old patient with end-stage renal disease, on peritoneal dialysis, who underwent a staged prone retroperitoneoscopic bilateral nephrectomy. Bilateral nephrectomy was indicated in preparation for renal transplant in the context of genetic predisposition malignancy when immunosuppressed. The two mirror-image surgeries enable the comparison of the anesthetic management and outcomes in a single patient. Features of interest to anesthesiologists include approach to a child with chronic kidney disease, different requirements for intraoperative antihypertensives; pain management strategies, including a comparison of erector spinae plane block with and without adjunct dexmedetomidine; anesthetic management of retroperitoneoscopic pediatric surgery and the first description of using a Foley bag attached to a peritoneal dialysis catheter to aid in diagnosis and repair of posterior peritoneal cavity entry.","PeriodicalId":36529,"journal":{"name":"Colombian Journal of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71105383","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}
Edwin Enrique Peñate Suárez, Juan Manuel Molina Uribe, María Camila Maya Salazar, María José Cárdenas García, Juan Sebastián Gonzales Quintero, Manuela Mejía-Oquendo
a Medical Program, Anesthesiology Service, School of Health Sciences. Universidad del Quindío. Armenia, Colombia. b ESE San Juan de Dios University Hospital, Quindio Department. Armenia, Colombia. c Medical Program, Anesthesiology Service, School of Medicine, Alexander Von Humboldt University. Armenia, Colombia. d Medical Program, School of Health Sciences, GEPAMOL research group. Universidad del Quindío. Armenia, Colombia. Correspondence: Hospital Departamental Universitario del Quindío San Juan de Dios, segundo piso, quirófano. Carrera 14 Calle 18 Norte, Armenia, Colombia. Email: epenate@gmail.com OPEN
{"title":"Is the erector spinae plane block useful in abdominal surgery?","authors":"Edwin Enrique Peñate Suárez, Juan Manuel Molina Uribe, María Camila Maya Salazar, María José Cárdenas García, Juan Sebastián Gonzales Quintero, Manuela Mejía-Oquendo","doi":"10.5554/22562087.e1010","DOIUrl":"https://doi.org/10.5554/22562087.e1010","url":null,"abstract":"a Medical Program, Anesthesiology Service, School of Health Sciences. Universidad del Quindío. Armenia, Colombia. b ESE San Juan de Dios University Hospital, Quindio Department. Armenia, Colombia. c Medical Program, Anesthesiology Service, School of Medicine, Alexander Von Humboldt University. Armenia, Colombia. d Medical Program, School of Health Sciences, GEPAMOL research group. Universidad del Quindío. Armenia, Colombia. Correspondence: Hospital Departamental Universitario del Quindío San Juan de Dios, segundo piso, quirófano. Carrera 14 Calle 18 Norte, Armenia, Colombia. Email: epenate@gmail.com OPEN","PeriodicalId":36529,"journal":{"name":"Colombian Journal of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49187791","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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