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Biomedical subjects

S García del Valle

Publications and source records attributed to S García del Valle.

At least 19 recordsLinked to original sources
PubMed2005

[Pulsed radiofrequency treatment in idiopathic and secondary glossopharyngeal neuralgia: preliminary results in 2 cases].

OBJECTIVES: To describe the use of pulsed radiofrequency (PRF) to treat 2 cases of glossopharyngeal neuralgia, 1 idiopathic and 1 secondary. PATIENTS: The first case involved a man diagnosed with Hodgkin's lymphoma involving the tonsils and manifesting as glossopharyngeal neuralgia that was refractory to all treatment approaches tried, including opioids and neuromodulation. The second case involved a patient diagnosed with essential glossopharyngeal neuralgia that was also resistant to drug treatment. The PRF procedure was performed in the operating room on an outpatient basis, under fluoroscopic guidance and with conventional monitoring. No perioperative events were reported. RESULTS: The treatment was effective for both patients, leading to decreases in visual analog scale pain reports between 5 and 7 points that were maintained over 6 months, although improvement for the patient with essential neuralgia was less intense and of shorter duration. Overall self-reported improvement assessed subjectively 6 months after PRF was 75% for the patient with Hodgkin's lymphoma and 50% for the patient with essential neuralgia, for whom a second PRF procedure was scheduled. Neither patient suffered complications or side effects that were potentially attributable to the procedure. CONCLUSIONS: PRF seems to be a safe, effective approach to treating neuralgia of the glossopharyngeal nerve, whether the condition is essential or secondary to another process. It is possible that if the condition is secondary, the clinical response may be greater in intensity and last longer.

Electric Stimulation Therapy↗
PubMed2005

[Epidural obstetric analgesia, maternal fever and neonatal wellness parameters].

OBJECTIVE: To study the relation between epidural analgesia and the development of maternal fever during labor and childbirth, and to determine the possible relation between that association and neonatal welfare and in the performance of tests to rule out sepsis in newborns. PATIENTS AND METHODS: Prospective study of all women who gave birth at Fundación Hospital Alcorcón over a period of 3 years. All the women were offered epidural analgesia based on infusion of 0.0625% bupivacaine and 2 microg x mL(-1). Data collected were age, nulliparity, epidural analgesia infusion, induction of labor, uterine stimulation with oxytocin, type of birth, fetal weight, duration of dilation and expulsion, Apgar score (at 1 and 5 minutes), umbilical artery pH, and maternal temperature. RESULTS: Data for 4364 women were analyzed. Fever developed during labor in 5.7%; 93.7% of the fevers occurred in women receiving epidural analgesia (P<0.05). Logistic regression analysis revealed that independent risk factors for the development of fever were epidural analgesia (odds ratio [OR], 1.78; 95% confidence interval [CI], 1.05-3.04), nulliparity (OR, 2,929; 95% CI, 2.005-4.279), fetal weight (OR, 1.484; 95% CI, 1.102-2.001), and duration of labor (OR, 1.003; 95% CI, 1.003-1.004). No significant differences in Apgar score at 5 minutes or umbilical artery pH were found between the women with and without fever. Tests to rule out sepsis were ordered for 85.1% of the infants of mothers with fever after epidural analgesia. CONCLUSIONS: Epidural analgesia was associated with greater risk of developing fever in mothers giving birth, but that association had no repercussion on the neonatal wellness parameters studied.

Adult↗
PubMed2004

[Obstetric epidural analgesia: relationship between obstetric variables and the course of labor].

OBJECTIVES: To analyze the relationship between epidural analgesia and diverse obstetric and fetal variables as well as the impact of epidural analgesia on the rates of instrumental and cesarean delivery. PATIENTS AND METHODS: Observational study of women who gave birth at Fundación Hospital Alcorcón over a period of 3 years. All the women were offered obstetric epidural analgesia based on 0.0625% bupivacaine plus 2 microg/mL of fentanyl. The following data were recorded: age, nulliparity (yes/no) administration of epidural analgesia (yes/no), induction of labor (yes/no), stimulation of uterine activity with oxytocin (yes/no), type of delivery, fetal weight, duration of dilation, duration of expulsion, cause of cesarean. RESULTS: The records of 4364 women were gathered. The percentages of inductions, nulliparas, oxytocin stimulation, and fetal weight greater than 4 kg and less than 2.5 kg were higher among women taking epidural analgesia. The age of women who received epidurals was significantly lower. The durations of dilation and expulsion were longer among women receiving epidural analgesia, and epidural analgesia was associated with greater risk of instrumental and cesarean deliveries. The significant increase in administration of epidural blocks over the 3-year period of the study was not accompanied by an increased rate of instrumentally assisted deliveries or cesareans. CONCLUSIONS: It is difficult to evaluate the real influence of epidural analgesia on certain aspects of labor and its evolution. The strength of the association between epidural analgesia and greater risk of increased rates of instrumental and cesarean deliveries may be influenced by factors not considered in the present study.

Adult↗
PubMed2003

Anaesthesia-related diplopia after cataract surgery.

BACKGROUND: We studied the incidence and clinical characteristics of persistent diplopia related to anaesthesia for cataract surgery in a general hospital. METHODS: This was a retrospective review of anaesthesia for 3587 cataract surgeries. Of all the cases of diplopia referred to the ocular motility clinic after cataract surgery, those involving anaesthesia-related diplopia lasting longer than 1 month were studied. RESULTS: During the study period, 3450 cataract surgeries were performed by phacoemulsification and 137 by extracapsular extraction. Retrobulbar block was used in 2024 cases, peribulbar block in 98, topical anaesthesia in 1420 and general anaesthesia in 43. Twenty-six cases of persistent diplopia were found (0.72% incidence), nine of which (0.25%) were considered to be related to anaesthetic factors; five of the latter involved the left eye. Five were caused by paresis of the inferior rectus muscle and three by fibrosis. In one patient, the inferior oblique muscle was affected. Anaesthesia was by retrobulbar block in eight cases (0.39%) and by peribulbar block in one. No diplopia was found in patients who had topical or general anaesthesia. Treatment was with surgery in two patients and with prisms in six. One patient continues to be studied. CONCLUSIONS: Persistent diplopia can occur after cataract surgery using retrobulbar block predominantly through direct damage to the inferior rectus muscle. The overall incidence of anaesthesia-related diplopia in this series was 0.25%.

Aged↗
PubMed2000

[Combined subarachnoid-epidural technique for obstetric analgesia].

Combined spinal-epidural blockade for labor pain has enjoyed increasing popularity in obstetric anesthesia. The usual procedure is to use a single space and a single needle for dural puncture, inserting a spinal needle through an epidural needle followed by insertion of a catheter. A small dose of one or several substances (usually a lipophilic opioid and a local anesthetic) is first injected in the intrathecal space to provide rapid, effective analgesia with minimal muscle blockade. The epidural catheter is used if labor lasts longer than the spinal block, if the spinal block is insufficient, or in case of cesarean section. Combined spinal-epidural blockade is a safe, valid alternative to conventional epidural analgesia and has become the main technique for providing obstetric analgesia in many hospitals. The most widely-recognized advantage of the technique is high maternal satisfaction with rapid and effective analgesia. Mobility of the lower extremities is preserved and the mother is often able to walk. Because opioids are injected into the intrathecal space and because the technique is more invasive than standard epidural analgesia, the potential risk to mother and fetus increases.

Adjuvants, Anesthesia↗
PubMed1999

[Hospital organization of cardiopulmonary resuscitation].

That hospital cardiopulmonary resuscitation (CPR) should be supported by an organized plan rather than on the skills of individual health care personnel is a universally agreed-upon principle. Such a plan should guarantee that needed materials are available and in working order in all departments and that the team assigned to carry out CPR arrives promptly. Personnel other than the specialized team should also receive CPR training appropriate to their posts. The main features of a CPR plan are related to the five steps in the chain of survival: a) identification of a patient to be resuscitated, a matter that has important ethical ramifications; b) early recognition of cardiac arrest; c) early defibrillation; d) basic CPR, and e) advanced CPR. The CPR plan should incorporate the automatic recording of system, population, event and outcome variables. Task forces responsible for establishing and maintaining the plan and its quality control will periodically review the data with the aim of detecting errors, correcting them or introducing improvements. Various international societies and CPR committees have recently suggested a uniform way (the Utstein style) of recording and presenting data to allow comparisons either from hospital to hospital or over time within a single center.

Cardiopulmonary Resuscitation↗
PubMed1997

Anterior cervical myelopathy in the early postoperative period.

PURPOSE: The onset of anterior cervical myelopathy in the early postoperative period is an unusual complication after cardiac surgery without extracorporeal circulation in which haemodynamic stability was maintained. We report a patient who developed anterior cervical myelopathy after cardiac surgery. CLINICAL FEATURES: A 53-yr-old man with no serious associated medical problems underwent cardiac surgery without extracorporeal circulation to repair a ruptured left ventricle. Haemodynamic stability was maintained throughout the procedure but the patient developed flaccid paraparesis and dissociated sensory loss, three hours later. Early recognition of the clinical picture and prompt initiation of steroid treatment facilitated a successful outcome. The definitive diagnosis was based on magnetic resonance findings days after surgery. CONCLUSION: The onset or aggravation of neurological symptoms in the postoperative period may be avoided by thorough search for medullary pathology in the patient's background and by using particular care when performing manoeuvres during the perioperative period, not only to ensure haemodynamic stability, thus preserving medullary perfusion, but also to avoid mechanical compression of a spinal segment.

Cardiac Surgical Procedures↗
PubMed1996

Left superior vena cava: a vascular abnormality discovered following pulmonary artery catheterization.

PURPOSE: This report deals with the case of a patient who presented persistence of left superior vena cava (LSVC). This disorder was discovered following placement of a catheter in pulmonary artery via the left subclavian vein. CLINICAL FEATURES: The patient was a 67-yr-old woman who, while in the intensive care unit after undergoing coronary revascularization with extracorporeal circulation, required pulmonary artery catheterization to guide resuscitation. Placement of the catheter proved to be difficult as the advance of the catheter was impeded. A normal pulmonary artery pressure wave was eventually detected at a distance of approximately 70 cm. Chest x-ray showed a catheter route suggestive of persistent LSVC. CONCLUSION: A diagnosis of persistent LSVC should be considered whenever there appears to be some obstacle to central venous or pulmonary artery catheterization, especially in patients with congenital heart disease, since this disorder can have important clinical consequences.

Aged↗
PubMed1996

[Comparison of 2 systems for continuous intraoperative monitoring of oxygen saturation in the jugular bulb].

OBJECTIVE: To compare accuracy, precision and stability of two jugular venous blood catheters for continuous monitoring of oxygen saturation during surgery, in a nonrandom, prospective sample. PATIENTS AND METHODS: We studied 47 patients requiring continuous monitoring of SjvO2 during a variety of neurosurgical procedures. Swan-Ganz pediatric 5.5F catheters (Opticath P575-EH) were used in 27 patients; neonatal umbilical artery 4F catheters (Opticath U425C) were used in 20. Both catheters were equipped with a fiberoptic system for continuous monitoring of hemoglobin oxygen saturation. After checking correct placement, readings transmitted were compared with co-oximetry readings for a sample taken from the distal end of the catheter. We also compared time spent placing the catheters and stability of SjvO2 reading during surgery. RESULTS: Insertion time (+/- SD) was 10.3 +/- 2.5 minutes for the 4F catheter and 15.9 +/- 5.5 minutes for the 5.5F model (p < 0.01). Although both systems tended to overestimate, the 5.5F catheters were more accurate: the mean differences were -6.8% for the 4F catheter and -1.2% for the 5.5F. These results made it necessary to calibrate the 4F catheters after placement and before use, a procedure not needed if the 5.5F catheters are used. Stability of SjvO2 readings during surgery was significantly greater (p < 0.01) for the 5.5F catheters, such that only 25.9% were considered clinically useful based on this parameter. However, 70% of the 5.5F catheters provided acceptable SjvO2 readings. Intracranial pressure during insertion and removal of the SjvO2 catheters was measured in only 5 patients; there were no changes greater than 1 mmHg. CONCLUSIONS: Although the 5.5F pediatric catheters take longer to put into position, their greater accuracy, precision and stability makes them preferable to the 4F catheters for continuous monitoring of SjvO2. Long-term vascular effects must be studied further.

Adult↗
PubMed1995

[Anesthesia in a patient with latex allergy].

Anaphylactic reactions triggered by latex-based products are increasingly frequent, particularly in the hospital environment. We describe a patient with a prior history of atopic allergy and documented allergy to latex who was scheduled for abdominal surgery. A great deal of anesthetic and surgical equipment contains latex and substitutes for such material must be used in order to prevent severe hypersensitivity reactions.

Adrenal Cortex Hormones↗