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Biomedical subjects

L M Guerrero Pardos

Publications and source records attributed to L M Guerrero Pardos.

7 recordsLinked to original sources
PubMed2005

[Exchanging and maintaining the airway in hyoid surgery: using a flexible exchanger during new surgical treatments for obstructive sleep apnea syndrome].

OBJECTIVE: To assess the level of intubation difficulty and anatomical changes after hyoid surgery. To evaluate the difficulty of switching from nasotracheal to orotracheal intubation after hyoid and palatopharyngeal surgery using an exchanger. MATERIAL AND METHODS: Prospective study enrolling 30 patients undergoing surgery for obstructive sleep apnea syndrome (OSAS) in 2 consecutive phases. Anatomical features suggesting risk of difficult intubation, anatomical changes caused by surgery, the incidence of failure to intubate upon first attempt during the first surgical session, and upon switching from nasal to oral intubation, and the time required to intubate were recorded. The rate of complications during and after surgery was also noted. RESULTS: The incidence of difficult intubation was 15% and no complications developed in the switch from nasotracheal to orotracheal intubation (100% success rate). CONCLUSION: New surgical treatments for the OSAS patient require new anesthetic maneuvers such as nasotracheal-orotracheal intubation exchange after hyoid surgery. The exchanger used in the present study offers a valid way to achieve airway management in this situation.

Equipment Design↗
PubMed2005

[Anesthesia in intrahepatic cholestasis: Alagille syndrome].

A 42-year-old patient, diagnosed with Alagille syndrome when he was 1 month old, was admitted to the general surgery department to undergo right hepatectomy for right lobe carcinoma. Alagille syndrome, also known as biliary duct hypoplasia, is an extremely rare genetic condition with multiorganic implications. Liver and heart dysfunction will play key roles in the course of the disease and its prognosis. An exhaustive preoperative assessment of liver and heart function, blood chemistry and the skeleton will be essential for managing these patients. This article reviews the main principles underlying the anesthetic management of patients with Alagille syndrome.

Adult↗
PubMed2005

[Anesthetic management of coagulation factor V deficiency].

Factor V deficiency, or Owren's disease, is a rare inherited recessive autonomic disorder that is congenital. The bleeding in patients with this disease depends on plasma levels of factor V. Anesthetic management is similar to that used for patients with other coagulation disorders. On the one hand, it is useful to initiate infusion of plasma if purified concentrates are not available. On the other hand, it is important to monitor hemostasis carefully so that bleeding during postoperative recovery can be prevented. Plasma and antifibrinolytic drugs such as tranexamic acid should continue to be administered in the first few days after surgery. We report the case of a man with homozygotic factor V deficiency who underwent surgery for colon cancer. This article reviews the main aspects of anesthetic management of this coagulation disorder.

Anesthesia, General↗
PubMed2004

[Comparison of 4 techniques for general anesthesia for carotid endarterectomy: inflammatory response, cardiocirculatory complications, and postoperative analgesia].

OBJECTIVE: [corrected] To study the analgesia, hemodynamic stability and inflammatory response in patients undergoing carotid endarterectomy under different types of general anesthesia. MATERIALS AND METHODS: A comparison of 80 patients randomized to 4 groups: group 1, maintenance with sevoflurane at a minimum alveolar concentration (MAC) of 1; group 2, sevoflurane at MAC 1.5; group 3, remifentanil; group 4, propofol. Variables studied were hemodynamic alterations during and after surgery, level of postoperative analgesia, differential white cell counts, levels of interleukin-6 (IL-6), and clinical signs and symptoms of systemic inflammatory response syndrome in the first 24 hours after surgery. RESULTS: The incidences of episodes of intraoperative hypertension were 60% in group 1, 65% in group 2, 50% in group 3, and 60% in group 4. The incidences of episodes of intraoperative hypotension were 85% in group 1, 80% in group 2, 80% in group 3, and 75% in group 4. Patients in groups 3 and 4 had higher incidences of systemic inflammatory response syndrome (p<0.05) in the first 24 hours after surgery and higher levels of IL-6 (p<0.05). Postoperative analgesia was similar in all 4 groups. CONCLUSIONS: Increased levels of IL-6 in peripheral blood and of systemic inflammatory response syndrome were found in the early postoperative period in groups that did not receive halogenated gases. Hemodynamic stability and analgesia were similar in all groups, however.

Aged↗