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Biomedical subjects

A Gutiérrez-Crespo

Publications and source records attributed to A Gutiérrez-Crespo.

6 recordsLinked to original sources

[Activity of ondansetron on the systemic vascular resistance and venous capacitance during cardiopulmonary bypass].

OBJECTIVE: To study the effect of ondansetron administered during cardio-pulmonary bypass surgery, in terms of mean arterial pressure, systemic vascular resistance and venous system capacitance. PATIENTS AND METHOD: Twenty patients scheduled for non coronary cardiac surgery were randomly assigned to 2 groups. The study group received 4 mg ondansetron during the bypass and the control group received the same volume of physiological saline solution. The following parameters were recorded during the 10 minutes following administration of either substance: mean arterial pressure, calculated systemic vascular resistance, and the venous reservoir volume at the beginning and end of the study period. RESULTS: Increased mean arterial pressure and systemic vascular resistance were recorded in both groups from the time of injection, with the highest levels recorded at 10 minutes. There were no statistical differences between the 2 groups. No changes in venous system capacitance were observed in either group, as there were no significant changes in venous reservoir volume of the extracorporeal circulation pump. CONCLUSIONS: Ondansetron at the dose used has no effect on arterial or venous vessels. The increased resistance recorded in both groups can be attributed to the release of catecholamines during non pulsatile extracorporeal circulation with a non pulsatile flow.

Aged↗

[Adrenergic response during general anesthesia with propofol as maintenance agent].

To determine plasma catecholamine levels during the use of propofol for maintenance of anesthesia. We studied 20 randomly chosen patients undergoing elective orthopedic surgery under general intravenous anesthesia with propofol as the agent of maintenance along with pancuronium and fentanyl. Plasma concentrations of dopamine, noradrenalin and adrenalin were measured at the following times: baseline, after intubation and every 15 min during surgery. The levels obtained for the different samples were compared with baseline levels. At the doses used in our study, there were no significant differences in the way dopamine plasma levels varied. This was not the case with the other two hormones, however. Adrenalin levels were significantly higher at the first 3 extractions (post-intubation, 15 min and 30 min), and noradrenalin was significantly higher (p < 0.05) at all extraction times. Total intravenous anesthesia with propofol is associated with a significant increase in plasma concentrations of adrenalin and noradrenalin. Adrenalin returns to baseline levels 45 min after induction.

Adult↗

[Prophylaxis with dantrolene sodium in 2 patients with susceptibility to malignant hyperthermia].

We report 2 patients programmed for elective surgery who were considered susceptible to develop the malignant hyperthermia syndrome. The first patient had two familiarly antecedents of death produced by postanesthetic malignant hyperthermia, whereas the second patient suffered a clinical picture compatible with this syndrome during tonsillectomy, although followed a favourable recovery. The preoperative study including measurement of muscular enzymes, isoenzymes, and muscular biopsy was normal. In both patients an intravenous prophylactic treatment with dantrolene 2.5 mg.kg1 was undertaken before surgery. The first patient underwent hysterectomy under intradural anesthesia with bupivacaine 0.5%. The second patient had a maxillary fracture which was treated with osteosynthesis under general anesthesia. During the intervention and the postoperative follow-up, both patients were free of signs related to malignant hyperthermia. We conclude that prophylaxis with dantrolene is necessary in patients susceptible to develop the syndrome of malignant hyperthermia.

Adult↗

[Body temperature variations during laparoscopic cholecystectomies].

OBJECTIVE: To study changes over time in body temperature related to insufflation of CO2. PATIENTS AND METHOD: Fifty patients were randomly assigned to 2 groups of 25 to undergo cholecystectomy by either laparoscopy or laparotomy. Total intravenous anesthesia with propofol, pancuronium and fentanyl was used in both groups. Ventilation was maintained at 0.5 FiO2. Central temperature was continuously measured by a distal esophageal thermometer and results were recorded every 10 minutes in both groups. All operations lasted approximately 80 min. RESULTS: We found that temperature gradually decreased over time in both groups. In the laparotomy group the decrease reached 0.20 degree C (SD 0.03) at 80 min. During laparoscopy the temperature decrease was 0.43 degree C (SD 0.04) for the same time period. The differences were statistically significant. We observed no pathophysiologic repercussions associated with these results. CONCLUSIONS: Laparoscopic surgery, even when the abdominal cavity is not exposed to room air, induces a loss of temperature that is greater than that of laparotomy, because of insufflation of CO2 at 4 degrees C. The decrease was 0.4 degree C for every 50 l of CO2 insufflated during the study.

Anesthesia, Intravenous↗