Pub Date : 2023-01-01DOI: 10.25237/revchilanestv5203111405
Mario A. Zamudio Burbano, Jacobo Corrales Gómez
{"title":"Coadyuvantes en anestesia espinal","authors":"Mario A. Zamudio Burbano, Jacobo Corrales Gómez","doi":"10.25237/revchilanestv5203111405","DOIUrl":"https://doi.org/10.25237/revchilanestv5203111405","url":null,"abstract":"","PeriodicalId":39813,"journal":{"name":"Revista Chilena de Anestesia","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69447848","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}
Pub Date : 2023-01-01DOI: 10.25237/revchilanestv52n04-06
Luis Figueroa-Restrepo, Diego Sanchez-Martínez, José Sáenz-López, Daniel Díaz-Coronel, Camilo Polanco-Guerra, O. Carrascal-Carrasquilla
Analgesic techniques have evolved and in recent years great advances have been made in the management of acute postoperative pain, which is reflected in the physical, psychological and social well-being of the patient. With their knowledge and relationship with analgesic drugs, anesthesiologists are responsible for the exercise of an evidence-based practice in the management of acute pain, which forces them to know the different techniques and devices developed in the administration of analgesics. There are different drug delivery systems, each with virtues and disadvantages, which require the individualization of each patient to provide effective analgesia. Objectives: To describe the different types of drug pumps used by the anesthesiologist to control acute postoperative pain. Methods: A review of the literature found in PubMed and Science Direct databases and the Google Scholar search engine was performed using the keywords. Articles in English and Spanish were published until August 2022. Results: Different methods and devices for the administration of postoperative analgesia have been described, however, to date, there have been no studies with strong evidence to determine a specific mode of application of said drugs. Conclusion: Effective post-operative acute pain treatment improves the recovery process and brings well-being to the patient. The anesthesiologist must have a heterogeneous plan for the control and treatment of this, therefore he must know the different techniques and devices developed for the administration of analgesics.
{"title":"Actualización en alternativas para control del dolor posoperatorio en cirugía plástica","authors":"Luis Figueroa-Restrepo, Diego Sanchez-Martínez, José Sáenz-López, Daniel Díaz-Coronel, Camilo Polanco-Guerra, O. Carrascal-Carrasquilla","doi":"10.25237/revchilanestv52n04-06","DOIUrl":"https://doi.org/10.25237/revchilanestv52n04-06","url":null,"abstract":"Analgesic techniques have evolved and in recent years great advances have been made in the management of acute postoperative pain, which is reflected in the physical, psychological and social well-being of the patient. With their knowledge and relationship with analgesic drugs, anesthesiologists are responsible for the exercise of an evidence-based practice in the management of acute pain, which forces them to know the different techniques and devices developed in the administration of analgesics. There are different drug delivery systems, each with virtues and disadvantages, which require the individualization of each patient to provide effective analgesia. Objectives: To describe the different types of drug pumps used by the anesthesiologist to control acute postoperative pain. Methods: A review of the literature found in PubMed and Science Direct databases and the Google Scholar search engine was performed using the keywords. Articles in English and Spanish were published until August 2022. Results: Different methods and devices for the administration of postoperative analgesia have been described, however, to date, there have been no studies with strong evidence to determine a specific mode of application of said drugs. Conclusion: Effective post-operative acute pain treatment improves the recovery process and brings well-being to the patient. The anesthesiologist must have a heterogeneous plan for the control and treatment of this, therefore he must know the different techniques and devices developed for the administration of analgesics.","PeriodicalId":39813,"journal":{"name":"Revista Chilena de Anestesia","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69449988","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}
Pub Date : 2023-01-01DOI: 10.25237/revchilanestv52n04-05
{"title":"Atelectasias permisivas en ventilación mecánica","authors":"","doi":"10.25237/revchilanestv52n04-05","DOIUrl":"https://doi.org/10.25237/revchilanestv52n04-05","url":null,"abstract":"","PeriodicalId":39813,"journal":{"name":"Revista Chilena de Anestesia","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69450379","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}
Pub Date : 2023-01-01DOI: 10.25237/revchilanestv52n04-12
{"title":"Cambios demográficos y clínicos de pacientes hospitalizados por cuadros graves de COVID-19 entre la primera y segunda ola: experiencia de una UCI reconvertida","authors":"","doi":"10.25237/revchilanestv52n04-12","DOIUrl":"https://doi.org/10.25237/revchilanestv52n04-12","url":null,"abstract":"","PeriodicalId":39813,"journal":{"name":"Revista Chilena de Anestesia","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69450659","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}
Pub Date : 2023-01-01DOI: 10.25237/revchilanestv52n04-18
N. Mercedes, S. Parada, José Antonio Gasca Aldama, Jessica Garduño López, M. A. Gutiérrez
The incidence of complications during thyroidectomy is approximately 0-5-4% and tracheal injury associated with thyroidectomy occurs in 0.06%. A 48-year-old woman diagnosed with papillary carcinoma of the thyroid, right cervical nodule compatible with metastasis. Total thyroi - dectomy was performed, modified radical bilateral cervical resection, with a combined approach by sterenotomy and post surgical mediastinitis, where tracheal injury was produced and later there was infection at the surgery site that required re-intervention due to sternotomy dehiscence. The purpose of this article is to demonstrate the importance of diagnosing in a timely manner and establishing an adequate treatment to avoid complications.
{"title":"Lesión traqueal después de tiroidectomía. Reporte de caso y revisión de la literatura","authors":"N. Mercedes, S. Parada, José Antonio Gasca Aldama, Jessica Garduño López, M. A. Gutiérrez","doi":"10.25237/revchilanestv52n04-18","DOIUrl":"https://doi.org/10.25237/revchilanestv52n04-18","url":null,"abstract":"The incidence of complications during thyroidectomy is approximately 0-5-4% and tracheal injury associated with thyroidectomy occurs in 0.06%. A 48-year-old woman diagnosed with papillary carcinoma of the thyroid, right cervical nodule compatible with metastasis. Total thyroi - dectomy was performed, modified radical bilateral cervical resection, with a combined approach by sterenotomy and post surgical mediastinitis, where tracheal injury was produced and later there was infection at the surgery site that required re-intervention due to sternotomy dehiscence. The purpose of this article is to demonstrate the importance of diagnosing in a timely manner and establishing an adequate treatment to avoid complications.","PeriodicalId":39813,"journal":{"name":"Revista Chilena de Anestesia","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69450977","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}
La anestesia retrobulbar se usa de forma rutinaria en la cirugía oftalmológica. Además de las complicaciones locales en el lugar de la inyección pueden surgir complicaciones sistémicas como parada cardiorrespiratoria, convulsiones así como afectación del ojo contralateral. Por lo tanto, la anestesia retrobulbar, aunque de forma infrecuente, puede asociarse a la aparición de manifestaciones neurológicas, principalmente por un mecanismo de difusión del anestésico local al espacio subaracnoideo. La presencia del anestesiólogo y monitorización continua del paciente, son requisitos indispensables ante la posibilidad de que maniobras de reanimación sean necesarias por afectación transitoria del anestésico a nivel del sistema nervioso central. Presentamos un caso de afectación troncoencefálica y paresia completa del III y IV par craneal en el ojo contralateral tras anestesia retrobulbar en un paciente varón de 50 años para cirugía programada de cataratas en régimen de cirugía mayor ambulatoria.
{"title":"Anestesia retrobulbar: Anestesia del tronco encefálico y parálisis del nervio craneal contralateral. Reporte de un caso","authors":"Gracia Armenteros Cortés, Concepción Martínez Torres, Isabel Ramos Arroyo, Ana Rodríguez Archilla","doi":"10.25237/revchilanestv52n5-13","DOIUrl":"https://doi.org/10.25237/revchilanestv52n5-13","url":null,"abstract":"La anestesia retrobulbar se usa de forma rutinaria en la cirugía oftalmológica. Además de las complicaciones locales en el lugar de la inyección pueden surgir complicaciones sistémicas como parada cardiorrespiratoria, convulsiones así como afectación del ojo contralateral. Por lo tanto, la anestesia retrobulbar, aunque de forma infrecuente, puede asociarse a la aparición de manifestaciones neurológicas, principalmente por un mecanismo de difusión del anestésico local al espacio subaracnoideo. La presencia del anestesiólogo y monitorización continua del paciente, son requisitos indispensables ante la posibilidad de que maniobras de reanimación sean necesarias por afectación transitoria del anestésico a nivel del sistema nervioso central. Presentamos un caso de afectación troncoencefálica y paresia completa del III y IV par craneal en el ojo contralateral tras anestesia retrobulbar en un paciente varón de 50 años para cirugía programada de cataratas en régimen de cirugía mayor ambulatoria.","PeriodicalId":39813,"journal":{"name":"Revista Chilena de Anestesia","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69451494","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}
Pub Date : 2023-01-01DOI: 10.25237/revchilanestv52n5-08
E. Labos, R. Albite, Á. Golimstok, A. Renato, M. Fernandez, F. Bonofiglio, D. Seinhart, G. G. Fornari, Marcelo Scha-pira, V. Pagotto, Marina Cavagna, Carla Sesarini, Maximiliano Smietniansky, M. Soderlund, W. Berrios, Yasmin Tenaglia, Yanina Esquef, Enriqueta Chouhy Oria, Rubén Vallejos, Lourdes Posadas Martínez, D. Giunta, A. Bonofiglio, Lucas Sánchez, Irene Blanc, Lucila Laudani
Background and Objective: The purpose of this study was to investigate whether anesthetic surgical act is a risk factor that contributes to the development of postoperative cognitive dysfunction (POCD) in elderly patients, or whether there are pre-existing conditions that predispose it. Materials and Methods: The study involved a non-randomized prospective cohort of patients over 65 years of age undergoing surgery/anes- thesia (as well as a group of healthy individuals who were not exposed to either anesthesia or surgery). The study was carried out at the Hospital Italiano Buenos Aires between April 2017 and March 2020, and the data was collected in the anesthesia service. A total of 200 participants were evaluated, 100 in each group. A battery of cognitive tests was administered at baseline and 12 months later. Cognitive impairment was assessed with scales and analyzed by multivariate and principal component analysis. Results: At 12 months, exposed patients had a 36% incidence of deterioration, while unexposed patients had only 8%. The odds ratio was 6.5 (95% CI 2.9-15.8 p < 0.001). Adjusting for increased to 8.6 (95% CI 3.6-22.9 p < 0.001). Main components were identified that were correlated with the cognitive scales. The crude relative risk derived from the odds ratio was 4.5, while the adjusted relative risk was 7.3. Conclusions: The findings validate the existence of durable cognitive performance results in patients who were exposed. It is essential to stress the importance of performing a cognitive assessment before administering anesthesia and/or surgery to identify vulnerable people and continue monitoring their evolution.
背景和目的:本研究的目的是探讨麻醉手术行为是否是导致老年患者术后认知功能障碍(POCD)发生的危险因素，或者是否存在预先存在的疾病易导致POCD的发生。材料和方法:该研究纳入了一组非随机前瞻性队列，包括65岁以上接受手术/麻醉的患者(以及一组未接受麻醉或手术的健康个体)。该研究于2017年4月至2020年3月在布宜诺斯艾利斯意大利医院进行，数据是在麻醉服务中收集的。总共有200名参与者被评估，每组100人。在基线和12个月后进行了一系列认知测试。采用量表评估认知功能障碍，并采用多元分析和主成分分析进行分析。结果:在12个月时，暴露患者的恶化发生率为36%，而未暴露患者的发生率仅为8%。优势比为6.5 (95% CI 2.9-15.8 p < 0.001)。调整后增加到8.6 (95% CI 3.6-22.9 p < 0.001)。确定了与认知量表相关的主要成分。比值比得出的粗相对危险度为4.5，而调整后的相对危险度为7.3。结论:研究结果证实了暴露患者存在持久的认知表现结果。必须强调在麻醉和/或手术前进行认知评估的重要性，以确定易感人群并继续监测其演变。
{"title":"The anesthetic surgical act increases cognitive decline in older patients compared to a healthy population","authors":"E. Labos, R. Albite, Á. Golimstok, A. Renato, M. Fernandez, F. Bonofiglio, D. Seinhart, G. G. Fornari, Marcelo Scha-pira, V. Pagotto, Marina Cavagna, Carla Sesarini, Maximiliano Smietniansky, M. Soderlund, W. Berrios, Yasmin Tenaglia, Yanina Esquef, Enriqueta Chouhy Oria, Rubén Vallejos, Lourdes Posadas Martínez, D. Giunta, A. Bonofiglio, Lucas Sánchez, Irene Blanc, Lucila Laudani","doi":"10.25237/revchilanestv52n5-08","DOIUrl":"https://doi.org/10.25237/revchilanestv52n5-08","url":null,"abstract":"Background and Objective: The purpose of this study was to investigate whether anesthetic surgical act is a risk factor that contributes to the development of postoperative cognitive dysfunction (POCD) in elderly patients, or whether there are pre-existing conditions that predispose it. Materials and Methods: The study involved a non-randomized prospective cohort of patients over 65 years of age undergoing surgery/anes- thesia (as well as a group of healthy individuals who were not exposed to either anesthesia or surgery). The study was carried out at the Hospital Italiano Buenos Aires between April 2017 and March 2020, and the data was collected in the anesthesia service. A total of 200 participants were evaluated, 100 in each group. A battery of cognitive tests was administered at baseline and 12 months later. Cognitive impairment was assessed with scales and analyzed by multivariate and principal component analysis. Results: At 12 months, exposed patients had a 36% incidence of deterioration, while unexposed patients had only 8%. The odds ratio was 6.5 (95% CI 2.9-15.8 p < 0.001). Adjusting for increased to 8.6 (95% CI 3.6-22.9 p < 0.001). Main components were identified that were correlated with the cognitive scales. The crude relative risk derived from the odds ratio was 4.5, while the adjusted relative risk was 7.3. Conclusions: The findings validate the existence of durable cognitive performance results in patients who were exposed. It is essential to stress the importance of performing a cognitive assessment before administering anesthesia and/or surgery to identify vulnerable people and continue monitoring their evolution.","PeriodicalId":39813,"journal":{"name":"Revista Chilena de Anestesia","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69451849","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}
A 21-year-old male patient who was admitted in the ICU after multiple traumas suffered hemodynamic and respiratory deterioration requiring peripheral veno-venous extracorporeal membrane oxygenation (VV ECMO) support as a bridge to recovery within the first forty-eight hours of his hospital admission. Thanks to this therapy, he significantly improved allowing the withdrawal of ECMO 144 hours after its implantation. However, the bedside ultrasound exam performed after the ECMO removal reported a hyperechogenic mass inside in the inferior vena cava (IVC). Due to its sonographic characteristics, a molding thrombus of the femoral ECMO cannula was suspected. Subcutaneous enoxaparin was given for 1 mg/ kg every 12 hours until the thrombus disappeared.
{"title":"Molding thrombus of an ECMO cannula in the inferior vena cava","authors":"Daniel Pérez-Ajami, Ignacio Albero, Iratxe Zarragoikoetxea, Elisa Viscasillas Navarro, Pilar Argente Navarro","doi":"10.25237/revchilanestv52n6-11","DOIUrl":"https://doi.org/10.25237/revchilanestv52n6-11","url":null,"abstract":"A 21-year-old male patient who was admitted in the ICU after multiple traumas suffered hemodynamic and respiratory deterioration requiring peripheral veno-venous extracorporeal membrane oxygenation (VV ECMO) support as a bridge to recovery within the first forty-eight hours of his hospital admission. Thanks to this therapy, he significantly improved allowing the withdrawal of ECMO 144 hours after its implantation. However, the bedside ultrasound exam performed after the ECMO removal reported a hyperechogenic mass inside in the inferior vena cava (IVC). Due to its sonographic characteristics, a molding thrombus of the femoral ECMO cannula was suspected. Subcutaneous enoxaparin was given for 1 mg/ kg every 12 hours until the thrombus disappeared.","PeriodicalId":39813,"journal":{"name":"Revista Chilena de Anestesia","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135401069","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}
Pub Date : 2023-01-01DOI: 10.25237/revchilanestv5202021424
María Mora-Aznar, Nora Molina-Torres
{"title":"Intoxicación por histamina: del rash al shock. Revisión de un caso de escombroidosis desde la perspectiva de los cuidados críticos","authors":"María Mora-Aznar, Nora Molina-Torres","doi":"10.25237/revchilanestv5202021424","DOIUrl":"https://doi.org/10.25237/revchilanestv5202021424","url":null,"abstract":"","PeriodicalId":39813,"journal":{"name":"Revista Chilena de Anestesia","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69447699","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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