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M Avellanal

Publications and source records attributed to M Avellanal.

10 recordsLinked to original sources
PubMed2004

Bolus application of remifentanil with propofol for dilatation and curettage.

BACKGROUND AND OBJECTIVE: This study was designed to determine which single bolus dose of remifentanil in combination with propofol and nitrous oxide is best to control the haemodynamic, autonomous and somatic responses in patients scheduled for dilatation and curettage of the uterine cervix. We evaluated the adequacy of different bolus doses of remifentanil, associated with propofol and nitrous oxide, for dilatation and curettage in a prospective double-blind study. METHODS: After institutional approval and informed consent, 34 healthy females undergoing curettage to remove material from the uterus after spontaneous abortion were randomized to receive remifentanil 0.5 microg kg(-1) intravenously (i.v.) (Group A; n = 4), 1 microg kg(-1) i.v. (Group B; n = 15) or 1.5 microg kg(-1) i.v. (Group C; n = 15), with propofol 2 mg kg (-1) i.v. in all groups. Anaesthesia was maintained with 60% nitrous oxide in oxygen. Haemodynamic, somatic and autonomic signs of light anaesthesia were registered to assess the response to surgical stress. Recovery times and Aldrete score were recorded at the end of the procedure. RESULTS: The groups were similar with regard to biometric data and duration of surgery. The poor results using the lowest dose of remifentanil obliged us to abandon this dose. The total dose of remifentanil was larger in Group C (100 +/- 5.7 microg vs. 65 +/- 4.1 microg in Group B; P < 0.05), but more patients required extra bolus injections in Group B (69% vs. 38% in Group C; P < 0.01). Recovery times were significantly shorter in Group C. Aldrete scores when leaving the operation room was similar. CONCLUSIONS: Remifentanil 1.5 microg kg(-1) i.v. with propofol 2 mg kg(-1) i.v. and 60% nitrous oxide in oxygen provided the best anaesthetic control with the fastest recovery times.

Adult↗
PubMed2000

Cardiopulmonary resuscitation training for students of odontology: skills acquisition after two periods of learning.

INTRODUCTION: Although life threatening emergencies in dental practice are not frequent, dentists have to be competent in providing basic life support (BLS). OBJECTIVES: The aim of this work was to study the level of skills acquisition among dentistry students in two different periods of one rescuer-BLS training, a first short practice training of 2 h followed by 8 h of practice over a period of 2 months. METHODS: One hundred and sixteen second-year undergraduate students of Anesthesiology at the Dental School of the Complutense University in Madrid were tested at the end of the two periods of learning using a recording manikin with a validated scoring system (Laerdal Resusci-Anne). This manikin recorded the percentage of adequate chest compressions and insuflations, rate of chest compressions and the causes of error in each case. RESULTS: Final global results were, 51.66+/-3.0% adequate chest compressions; and 54.44+/-3.61% adequate insuflations. The kinds of errors where different in both tests were, wrong hand position (26.92+/-2.96 vs. 12.29+/-2.40%, P<0.001); excessive compressions (27.71+/-2.90 vs. 16.02+/-2.33%, P<0.05); and weak compressions (23.28+/-3.24 vs. 16.77+/-2.57%, P<0.05). Regression analysis found a positive correlation among excessive compression, height and weight (P<0.001) and a negative correlation between weak compression, height and weight (P<0.001). CONCLUSIONS: The poor overall results, although similar to those shown in the literature, have made us question the validity of our methods of teaching BLS. We were able to establish a correlation between demographic and sociocultural variables with the typical errors, and to begin the process of improving our teaching methods.

Adult↗
PubMed2000

Continuous monitoring of oesophageal pH during general anaesthesia with laryngeal mask airway in children.

We studied the incidence of gastro-oesophageal reflux (GOR) during general anaesthesia with the laryngeal mask airway (LMA) in a paediatric population with two ventilatory regimes: spontaneous breathing and controlled mechanical ventilation (CMV). Thirty children between 6 months and 15 years, ASA I-II, for routine surgery, were randomly assigned in two groups: spontaneous ventilation (n=14), and CMV (n=16). A pH probe was situated in the central third of the oesophagus. Some 66% of the patients breathing spontaneously had GOR episodes vs. 92% of the patients with CMV (P < 0,01). Reflux took place mainly after LMA removal (21% vs. 68%; P < 0,01) and in the Postanaesthetic Care Unit (PACU) (29% vs. 43%; P < 0,05). There was a high incidence of GOR during general anaesthesia and in the PACU in paediatric patients anaesthetized with the LMA. GOR episodes were significantly more evident in the CMV group, mainly after LMA removal, but without clinical significance.

Adolescent↗
PubMed1999

Presence of a nitric oxide synthase inhibitor in the graft efflux during reperfusion in human liver transplantation.

Involvement of the nitric oxide (NO) system in complications following human orthotopic liver transplants (OLT) has been reported, but the contribution of the graft to the modulation of the NO system during reperfusion in normal OLT has not been characterized. We have studied the contribution of the graft efflux to the modulation of the NO system in 20 consecutive OLT. We evaluated its effects on isolated vascular reactivity of the rabbit and on rat cultured macrophages stimulated with lipopolysaccharide (LPS). In none of the donor liver biopsies was expression of inducible NO synthase (iNOS) activity by Northern or Western blot analysis found. Graft efflux after the onset of liver reperfusion, but not pre-transplant patient plasma, reversibly inhibited the acetylcholine-induced relaxation of norepinephrine-contracted rabbit aortic rings. Moreover, graft efflux reversibly inhibited NO production in rat macrophages treated with LPS, as evidenced by both a decrease in nitrite plus nitrate formation and a decrease in the production of [14C]citrulline from [14C]arginine. Addition of a 10% dilution of graft efflux to cultured rat macrophages incubated with LPS increased iNOS mRNA levels, suggesting direct inhibition of the enzyme but not of its expression. These results cannot be ascribed to the depletion of arginine the iNOS substrate since they can be reproduced even in the presence of an excess (10 mM) of exogenously added arginine. No correlation was found between the iNOS inhibitory activity in each sample and the corresponding clinical parameters related to either the graft function after the OLT or the existence of post-reperfusion syndrome. Our results indicate the existence of a soluble factor in the graft efflux from human OLT that reversibly and unspecifically inhibits NOS activity. Its involvement in the physiology and/or pathology of human liver diseases deserves further study.

Acetylcholine↗
PubMed1998

Protective effects of cyclopiazonic acid on ischemia-reperfusion injury in rabbit hearts.

The cardioprotective effects on myocardial ischemia of the sarcoplasmic reticulum (SR) Ca2+-ATPase (SERCA) inhibitor, cyclopiazonic acid (CPA), were studied. We used the isolated arterially perfused interventricular septum of the rabbit heart submitted to 30-min global ischemia/30-min reperfusion. Mechanical [maximal increase in resting tension (MIRT), and the recovery of developed tension (RDT)], and biochemical parameters [creatine phosphokinase activity (CPK) in the effluent] were analyzed. CPA, 1 microM, perfused 30 min before the ischemia intervention significantly increased RDT by 54% and lessened MIRT by 66%. CPA also decreased CPK in the perfusate by 67.7 and 71.4% at 0-2 and 5-7 min of reperfusion, respectively. No additional benefits were shown either when the drug was perfused, both during ischemia and reperfusion, or with higher CPA concentrations (10-30 microM). The CPA cardioprotection was lost when the drug was present only during the reperfusion period. CPA exhibits functional and biochemical cardioprotective effects on myocardial ischemia. We postulated a decreased SR calcium contribution to the initial cytoplasmic calcium overload as the most probable mechanism involved.

Animals↗