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C Añez

Publications and source records attributed to C Añez.

7 recordsLinked to original sources
PubMed2005

Comparative study of intubating conditions at the first minute with suxamethonium, rocuronium and different priming techniques of rocuronium.

BACKGROUND AND OBJECTIVE: To evaluate orotracheal intubation conditions after 1 min. PATIENTS AND METHODS: A prospective randomized study with 376 adult American Society of Anesthesiologists (ASA) Grade I-III patients. Each patient received propofol, fentanyl and either suxamethonium (1 mg kg(-1)) or rocuronium. The intubating dose of rocuronium (2 x ED95) was preceded 4 min earlier by saline, or a 0.1 x ED95 priming dose of rocuronium, atracurium, cis-atracurium, vecuronium or mivacurium. Intubating conditions were graded as excellent, good or poor with respect to laryngoscopy, vocal cord position and movement and reaction to intubation and/or cuff inflation. RESULTS: There were significant differences (P < 0.05) in laryngoscopy between suxamethonium and rocuronium primed with saline, atracurium or cis-atracurium. With respect to vocal cord position and movement during intubation, rocuronium without priming differed significantly from all other groups and for reaction to insertion of tracheal tube and/or cuff inflation. Rocuronium without priming differed significantly from all other groups except for rocuronium primed with itself. The mivacurium group showed more signs of pre-curarization than other groups (P < 0.05). There were significant differences between rocuronium alone and the other groups when final intubating conditions were compared. CONCLUSIONS: Priming rocuronium with 0.1 x ED95 of vecuronium, rocuronium, atracurium or cis-atracurium is a safe technique and did not increase risk of pre-curarization in healthy patients.

Adjuvants, Anesthesia↗
PubMed1999

[Fastrach intubation in patients with cervical disease].

The Fastrach laryngeal mask for intubation is a new device designed for blind orotracheal intubation in patients with criteria predictive of difficult airway control. The new device looks like the conventional laryngeal mask but offers a series of design changes that allow orotracheal intubation to be accomplished without visualization of the glottis. The rigid metal tube is bent and incorporates a metal handle; the two fixed bars that prevent the epiglottis from falling and blocking the opening have been replaced by a moveable bar that rises with the passage of the endotracheal tube and the exit of the V-shaped metal tube guides the endotracheal tube that was specially designed for this use. We describe three patients with cervical disease, one with advanced ankylosing spondylitis, one with traumatic luxation of the C6-C7 articulation and one diagnosed of two cervical disk hernias. All their tracheas were intubated without difficulty through the Fastrach mask with the patients' heads in neutral position. Although fiberoptic bronchoscopy is the method of choice in patients with cervical problems, the non-availability of the technique and the need for training in its use make the Fastrach mask an alternative worth considering for such patients.

Aged↗
PubMedDate not supplied

[Comparative study of two methods for laryngeal mask insertion].

OBJECTIVE: To compare two ways of inserting laryngeal airway masks: uninflated and partially inflated to 75% of the volume, as recommended by manufacturers. PATIENTS AND METHOD: We studied 60 ASA I-II patients scheduled for outpatient surgery under general anesthesia with numbers 3 or 4 laryngeal masks, after having obtained informed consent from the patients (or parents in the case of minors). The patients were randomly assigned to two groups. In group A the masks were inserted inflated to 75% of volume as recommended by manufacturers, whereas in group B deflated masks were inserted as described by Brain. Anesthesia was standardized for all patients. One patient was withdrawn from the study when a technical error was detected. We recorded the presence of criteria predictive of difficult airway management, systolic and diastolic blood pressures, heart rate at four times (baseline, before and after induction and after insertion of the mask), number of insertion tries, final mask volume needed for adequate ventilation, need for an additional dose of the hypnotic drug and complications. RESULTS: No statistically significant differences between the two insertion methods were found. Difficult airway management criteria were unrelated to difficulty of mask insertion. Correct insertion of an uninflated mask proved impossible in one patient, in whom we were then able to insert an inflated mask. CONCLUSION: No differences were found between inflated insertion and Brain's uninflated insertion technique. We believe that inflated mask insertion might be useful when uninflated insertion proves impossible.

Adult↗
PubMedDate not supplied

[The effect of encephalogram bispectral index monitoring during total intravenous anesthesia with propofol in outpatient surgery].

OBJECTIVE: To assess the effect of monitoring the encephalogram bispectral index (BIS) during outpatient surgery. Outcome measures were amount of propofol administered, awakening and discharge. MATERIAL AND METHODS: Forty consecutive outpatient surgery patients were studied. The patients gave informed consent and received general intravenous anesthesia with propofol administered through a laryngeal mask using a computerized system (Diprifusor(R)). Two groups were formed: in group A, BIS was monitored, although the information was hidden from the anesthesiologists, who used the usual signs (loss of blinking reflex, pupil size and hemodynamic response) to guide anesthesia; in group B the anesthesiologists used BIS monitoring to guide propofol administration. Measurements were blood pressure, heart rate and BIS at six times during the procedure (T1-T6). Other data recorded were age, weight, height, propofol consumption in relation to weight and duration of procedure, consumption of rocuronium and alfentanil, duration of propofol infusion, time from withdrawal of propofol until eye opening, duration of stay in the post-anesthesia intensive care unit and time until total recovery. A questionnaire assessed the presence of intraoperative awareness and degree of satisfaction. The data were analyzed by Student's t and a chi square tests, with statistical significance at p < 0.05. RESULTS: Demographic variables (age, weight and height) were similar, as were duration of propofol infusion, total dose of alfentanil and rocuronium, evolution of blood pressure and heart rate. Statistically significant differences in BIS were observed at two times, T4 and T5; total propofol administered was 32.6% lower in group B; and time until eye opening was significantly shorter in group B. No significant differences were observed for time until full recovery. No instances of intraoperative awareness were reported and satisfaction was high in both groups. CONCLUSION: BIS monitoring allows for propofol titration that leads to a mean reduction of 32.6% in consumption, shortening the time until eye opening without causing intraoperative awareness or reducing patient satisfaction.

Adult↗
PubMedDate not supplied

[Vascular lesions in surgery of the lumbar spine].

We present two cases of iliac artery damage arising from surgery to correct a lumbar disc hernia due to ventral perforation. The first was a pseudoaneurysm of the left iliac artery with a retroperitoneal hematoma diagnosed by ultrasound and TAC on the third day after surgery. The second was a retroperitoneal hematoma diagnosed by intraoperative ultrasound after the patient was shifted to a new position. Emergency laparotomy was performed on both patients to repair the damage. This is an unusual but serious complication, and in most cases requires intuitive diagnosis and lifesaving surgery.

Adult↗