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A Carregal

Publications and source records attributed to A Carregal.

8 recordsLinked to original sources
PubMed2000

[Intraoperative control of mean arterial pressure and heart rate with alfentanyl with fuzzy logic].

OBJECTIVES: To describe a fuzzy logic controller that adjust alfentanil infusion during surgery based on changes in mean arterial pressure (MAP) and heart rate (HR). MATERIAL AND METHODS: We designed a fuzzy logic controller using if ... then ... conditions written in C language, to be executed by a 486 PC with a 66 Mhz CPU. The controller was used with eight ASA I-II patients undergoing gynecological surgery under anesthesia with propofol, alfentanil and ventilated with oxygen/air. MAP and HR were input every three minutes, after which the controller generated an infusion based on those figures. We performed a statistical study of alfentanil consumption time until extubation and time of hemodynamic stability. Relative error of MAP was calculated. RESULTS: The controller was used for a total of 373 min with the eight patients. MAP was 15% below the desired level for 2.14% (18 min) of that time and was 15% over the desired level for 5.6% (21 min) of the time. MAP held steady within the range of stability for the remaining 92.26% (334 min) of the time the controller was used. The relative error of MAP was 7.8 +/- 1.5%. Mean time until extubation was 7 min and 2 s. CONCLUSIONS: We believe the controller can be used to automate taks executed by experts. The controller was useful for stabilizing HR and MAP.

Adult↗
PubMedDate not supplied

[Design of an expert system for decision-making in an emergency situation].

OBJECTIVES: To study the clinical applicability of the expert system URGSANT as a help in making up decisions in emergencies. MATERIAL AND METHODS: URGSANT is an expert system implemented in INSIGT 2+ which is structured in a modular and hierarchical form. It contemplates 44 urgent situations relating to the central nervous system, hematopoietic, cardiovascular, respiratory, gastrointestinal, genitourinary, endocrinological, and miscellaneous group. Validation of the program was made by four anesthesiologists who evaluated the performance of the program in 25 emergency cases and in 25 other situations that were treated by other specialists. RESULTS: The rationale of the system was basically correct. In most cases the program was considered efficient or very efficient during the different clinical situations and only in one case its guidance was wrong. CONCLUSIONS: The URGSANT expert system is an efficient and useful method for the clinician during emergency situations.

Anesthesiology↗
PubMedDate not supplied

[History of the introduction of ether anesthesia in Spain. A new contribution to its study].

Ether anesthesia was introduced in Spain on January 13, 1847. Dr. Diego de Argumosa y Obregón, from Madrid, was the first Spanish surgeon who operated with the help of sulphuric ether. Almost at the same time, by the end of January, the dentist Oliverio Machechan administered ether to 2 patients in whom he performed dental operations. Subsequently, ether was used in several parts of Spain: Barcelona, Pamplona, Motril, and by several Madrid surgeons through February and March. In Santiago de Compostela ether was also introduced very soon, and, on the basis of the data from the studies of Dr. José González Olivares (the surgeons who first tried it in that town), most authors dealing with this issue state that it was probably in Santiago de Compostela where these experiments were carried out simultaneously with those by Argumosa in Madrid or even before. We have in some occasions defended that thesis; however, we were not satisfied with it and we decided to reinvestigate the facts. We had access to other sources and we concluded that anesthetics were really used a very early phase in Santiago de Compostela, but in the case of ether it was later than Argumosa and Oliverio Machechan used it in Madrid and Mendoza in Barcelona. In the present article we analyze these facts in detail, with emphasis on those that we consider historically relevant and that had not been previously dealt with by any other author addressing these issues.

Anesthesia, Dental↗
PubMedDate not supplied

[Fuzzy logic and postoperative pain].

OBJECTIVE: To apply a fuzzy logic expert control system for the treatment of postoperative pain in a clinical setting. MATERIAL AND METHODS: A system was designed consisting of a perfusion pump guided by a fuzzy logic computer interface to regulate the perfusion of alfentanil in accordance with the patient's pain response. The system was also equipped with a safety device that halted perfusion in case of desaturation, bradypnea or heart rate or blood pressure variations greater than 25%. The system was used in the first 90 minutes after surgery in a patient who underwent bilateral saphenectomy. RESULTS: All system functions worked properly, maintaining the target analgesic values (visual analog scale < or = 2) 77% of the time. CONCLUSION: It is possible to use fuzzy logic to obtain adequate treatment of postoperative pain.

Adult↗