PubMed Health⌕ Search

Biomedical subjects

M C Unzueta

Publications and source records attributed to M C Unzueta.

16 recordsLinked to original sources
PubMed2003

[Spontaneous pneumothorax: pleurodesis with an iodo-povidone hydroalcoholic solution].

OBJECTIVE: To analyze the efficacy of an iodo-povidone hydroalcoholic solution for the chemical pleurodesis of spontaneous pneumothorax. MATERIAL AND METHOD: A descriptive, retrospective study of 81 patients with spontaneous pneumothorax. The patients were treated by video-assisted thoracoscopy and chemical pleurodesis with an iodo-povidone hydroalcoholic solution at the thoracic surgery unit of Hospital de la Santa Creu i Sant Pau in Barcelona (Spain) between January 1993 and December 1999. RESULTS: Eighty-one patients, 59 men (73%) and 22 women (27%), between 14 and 82 years old (mean age 33 years) were treated. Pneumothorax was most often on the right side (43 cases, 53%). The main indications for surgery were recurrence (52 cases, 64%) and persistent air leaks (25 cases, 31%). All were treated by video-assisted thoracoscopy, with resection of the pulmonary parenchyma in 30 cases (37%) and pleural instillation of the iodo-povidone hydroalcoholic solution as the irritant in all cases. Air leaks were observed during early postoperative recovery in 10 patients (12.3%), self-limited fever in 5 (6.1%) and infection of drainage openings in 2 (2.4%). During the postoperative follow-up period of 6 to 67 months (mean 24 months), 5 recurrences (6.1%) were seen. CONCLUSIONS: An iodo-povidone hydroalcoholic solution is easy to apply by video-assisted thoracoscopy and is highly effective for pleurodesis in cases of spontaneous pneumothorax.

Adolescent↗
PubMed2002

[The creation of the first anesthesiology service in Spain (Hospital de la Santa Cruz y San Pablo, Barcelona 1941)].

On the sixtieth anniversary of the founding of the first Spanish anesthesia department, we review factors that led to its creation and its early development. Hospital de la Santa Cruz y San Pablo in Barcelona was the place where the service was established for several reasons. The first was the growing need for anesthesia to be administered by specialized physicians able to handle problems developing during and after surgery. The second was the presence of a prestigious surgeon, Dr. Juan Soler Juliá, who perceived the need, alongside the only physician in Spain who was completely dedicated to anesthesiology, Dr. José Miguel Martínez. Finally, the fact that professional anesthesiology allowed a physician to earn a decent income triggered interest in the specialty among physicians.

Anesthesia Department, Hospital↗
PubMed1998

[Obstetrical anesthesia in 15 women with myasthenia gravis].

OBJECTIVES: To report our experience in managing anesthesia during obstetric delivery of women with myasthenia gravis (MG) and to review the anesthetic technique of choice for vaginal or cesarean delivery in such cases. PATIENTS AND METHODS: Fifteen pregnancies in 12 patients were recorded between 1980 and 1996; 14 cases were documented. Disease course during pregnancy, delivery and postpartum, the course of pregnancy, the presence of severe neonatal myasthenia and anesthetic treatment during vaginal or cesarean delivery were analyzed. RESULTS: Improvement in MG was observed in 6 cases. No change was seen in 4 patients and 3 worsened. In one woman generalized MG debuted 15 days after delivery. Two neonates were premature and a third suffered severe neonatal myasthenia. Six vaginal deliveries were aided by forceps; 8 deliveries were by cesarean and 1 fetus was aborted. Lumbar epidural anesthesia was employed in 73.33% (5 vaginal deliveries and 6 cesareans) and general anesthesia in 26.66% (1 abortion, 1 vaginal delivery and 2 cesareans). CONCLUSIONS: Continuous lumbar epidural anesthesia is the technique of choice for vaginal as well as cesarean deliveries. The combination of opioids and local anesthetics is considered particularly beneficial for patients, as it allows the motor blockade to be decreased. General anesthesia is only indicated when there is bulbar involvement. Short-acting non depolarizing agents, among them atracurium Besilate, are the muscle relaxants of choice. Succinylcholine is contraindicated. Thanks to current optimization of anesthetic and recovery techniques and administration of non depolarizing muscle relaxants with neuromuscular monitoring, the prognosis for pregnant MG patients has improved considerably.

Adult↗
PubMed1996

Continuous infusion is superior to bolus doses with thoracic paravertebral blocks after thoracotomies.

OBJECTIVES: This study was designed to determine whether a continuous thoracic paravertebral infusion of bupivacaine (continuous TPVI) offers a higher quality of analgesia than a bolus regimen after thoracotomy. DESIGN: A prospective and randomized study. SETTING: It was conducted by an anesthesiology and pain clinic department in a university hospital. PARTICIPANTS: Thirty patients were included in this study. INTERVENTIONS: As postoperative analgesia, the patients received either 20 mL of 0.375% bupivacaine every 6 hours (n = 15; bolus group), or a loading dose of 15 mL of 0.375% bupivacaine, plus an infusion of 5 mL of 0.25% bupivacaine every hour (n = 15; infusion group). MEASUREMENTS AND MAIN RESULTS: Pain intensity was assessed at rest and on movement (coughing) at 0, 1, 4, 10, 20, and 48 hours by means of the visual analog scale. The need for additional rescue analgesia, bupivacaine plasma concentration in the infusion group, blockade level (pinprick), and vital signs were also recorded. There were no significant differences regarding the additional rescue analgesia, vital signs, and pinprick level. However, the pain scores were significantly higher in the bolus group at rest and on movement (p < 0.01). The bupivacaine plasma concentration was low with a Cmax of 1.841 +/- 0.20 micrograms/mL at 15 hours. No systemic toxicity or other side effects were seen. CONCLUSION: Results suggest that continuous TPVI provides better pain control than the bolus regimen after this kind of surgery.

Adult↗
PubMed1996

[Anesthesia for thoracoscopy].

The thoracoscopy is used both for diagnosis and treatment of pleural and lung diseases. We describe our experience in managing anesthesia for such procedures, the number of which is increasing thanks to technical advances. We review 82 thoracoscopic procedures, 48 of which were video assisted. Sixty-two were performed under balanced general anesthesia (GA) with isoflurane, fentanyl and atracurium. Local anesthesia (LA) with fractionated doses of propofol and fentanyl was used in 20 cases. The mean age of patients receiving LA (63 +/- 17 years) was significantly greater (p < 0.05) than those receiving GA (49 +/- 13 years). ASA IV patients were given LA and sedation. Selective bronchial intubation was performed in 46 cases. Complications during surgery were severe hypoxemia (SpO2 < 85%) requiring suspension of selective lung ventilation in 8 cases, moderate hypoxemia (spO2 < 90% and > 85%) in 1 case, coughing in 3 cases and agitation in 1 case. Video-thoracoscopy is a safe technique that is less invasive than conventional thoracotomy. The number of applications is increasing, although its future place in thoracic surgery must still be determined.

Adult↗