In the daily practice of ophthalmologic surgery, locoregional anesthesia is predominantly used for cataract surgery. The use of retrobulbar lidocaine was first described in 1885 by Herman Knapp [1] to perform the enucleation of a patient wounded in war; is not until the mid-1950 [2] when retrobulbar block is popularized. AbstractIntroduction: Ophthalmological procedures such as cataract extraction can be carried out with a Peribulbar Block (PBB). The advantages of this anesthetic technique include a lower incidence of coughing, unwanted movements and emesis during awakening, in addition to providing adequate postoperative analgesia.We observed that the use of fentanyl citrate by peribulbar route, when administered with a local anesthetic, shortens the anesthetic latency, does not interfere with the degree of akinesia and provides greater postoperative analgesia. The combined use of local anesthetics and fentanyl citrate in ophthalmic surgery offers great benefits for the patient, also allowing the surgeon an adequate surgical field. We observed in ophthalmic surgery with regional anesthesia that the peribulbar use of fentanyl citrate is an alternative that provides a greater intraoperative and postoperative analgesia when combined with local anesthetics.Objective: Demonstrate that the lidocaine-bupivacaine-fentanyl combination is better than the lidocaine-bupivacaine combination, since the former shortens the latency time of Peribulbar Block (PBB), produces the same degree of akinesia of the eyeball and provides longer postoperative analgesia time. Conclusion:The use of fentanyl citrate peribulbar shortens the latency time, does not interfere with the degree of ocular akinesia and provides better postoperative analgesia, so this combination of anesthetics may be a good alternative for cataract ophthalmic surgery under regional anesthesia.
Introduction:Endoscopic procedures under sedation currently occupy an important place. Sedation allows optimal conditions for the study Objective: To compare the anesthetic efficacy of the inhalation versus intravenous technique for maintenance of sedation in patients undergoing endoscopy. Materials and methods:A longitudinal, randomized clinical study of 32 patients of both sexes ASA I-III, aged 18-80 years undergoing diagnostic colonoscopy, which was randomly divided into 2 groups. In both, intravenous induction with propofol (2-2.5 mg / kg) was performed, Group A remained sedated with propofol infusion (1-2 mg / kg / min); Group B by inhalation with sevoflurane at a concentration of 2 vol% through a nasal cannula with an oxygen flow.Results: Both techniques were performed without registering complications; group A comprised of 15 patients in which only 13% required rescue bolus and a wake-up time of 12 minutes. The group B consisted of 17 patients, with a wake-up time of 7 minutes in whom 35% required salvage bolus. Conclusion:Both anesthetic techniques proved to be safe and effective; patients receiving sevoflurane shortened their stay by 50% in the recovery of the endoscopic unit. Patients who only received propofol presented greater anesthetic depth required a lower rate of rescue boluses. Both techniques evidenced a good comfort level in both the patients and gastroenterologists.
Introduction:The American Society of Anesthesiology (ASA) has developed in recent years an algorithm to follow in case of presenting a difficult or unexpected airway. In said algorithm various techniques or mechanisms different from direct laryngoscopy are men-tioned that can help in a pressing situation. The laryngeal mask for intubation (Fastrach) is a device that has increased its popularity by playing an important role in the management of the airway Objective: To demonstrate that the laryngeal mask for intubation (Fastrach) is a useful device for the management of the airway and that it causes fewer complications than traditional intubation in patients undergoing general anesthesia. Materials and methods:We studied 100 patients of both sexes and ages between 20 and 90 years, physical status ASA I, II and III, scheduled for elective surgery and general anesthetic technique. The time of Fastrach intubation and endotracheal intubation in seconds, hemodynamic and oxygen saturation values and finally the complications during and at the end of the procedure (oral bleeding, mucosal laceration, and impossibility of intubation, odynophagia and dysphonia) were measured.Results: A statistically significant intubation time was obtained with p < 0.05 for the EIT with a time of 25.38 sec ± 13.68 sec and for the ML (Fastrach) of 57.04 sec ± 32.68 sec, the hemodynamic behavior remained practically the same in both cases. Groups and complications presented were more notable in the EIT mainly odynophagia and dysphonia. Conclusion:The use of the laryngeal mask for Fastrach intubation as an alternative in direct laryngoscopy for endotracheal intubation in patients with easy airway is viable, demonstrating fewer complications than traditional intubation, as well as being safe, useful and effective.
There is unanimous agreement that if planning is done for the management of the airway, the vast majority of complications can be prevented or solved. The American Society of Anesthesiology in recent years has developed an algorithm to follow in case of presenting a difficult and unexpected airway. In this algorithm, various techniques or mechanisms other than direct laryngoscopy are mentioned, which may at a certain moment resolve a pressing situation. The laryngeal mask for intubation (Fastrach) is a device that has increased its popularity by playing an important role in the management of the anatomically difficult airway allowing adequate oxygenation. It offers advantages such as simplicity and versatility in its placement, as well as being a traumatic for the patient. We decided to carry out this project to obtain an initial experience in the management of the airway with this type of devices whose successful results in other countries have not been corroborated in our hospital. Objective: To demonstrate that the laryngeal mask for intubation (Fastrach) is a useful device for the management of the airway in patients undergoing general anesthesia. Material and method: We studied 50 patients of both genders and ages between 22 and 85 years, physical status ASA I, II or III, scheduled for elective surgery and general anesthetic technique. The number of attempts of Fastrach placement and orotracheal intubation through it, the time in seconds, the hemodynamic and SpO2 values, and finally the complications during and after the procedure (oral bleeding, impossibility to place Fastrach and/or IOT, odynophagia and/or dysphonia). Results: A success rate was obtained for the placement of Fastrach and I.O.T. 94% where 54% was the first attempt, 32% the second and 4% the third attempt. The complications presented were minimal and reached 2%. Conclusion: The use of the laryngeal mask for intubation (Fastrach) as an alternative to direct laryngoscopy for orotracheal intubation in patients with easy airway is feasible and has been shown to be useful, safe and effective.
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