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Biomedical subjects

R Bolinches

Publications and source records attributed to R Bolinches.

27 records · Page 2Linked to original sources
PubMedDate not supplied

[Anesthesia with continuous + infusion of propofol for trans-sternal thymectomy in myasthenic patients].

Patients with myasthenia gravis respond unpredictably to muscle relaxants and more often suffer respiratory complications after surgery. We describe the use of total intravenous anesthesia with propofol and alfentanil without muscle relaxants is three myasthenic patients classified as Osserman I-IIB. Mean time since appearance of the disease was 1 year and all were undergoing transsternal thymectomy. Time in surgery ranged from 115 to 170 min and mean total dose of propofol was 1,374 mg. In all cases total intravenous anesthesia afforded good conditions for intubation, maintenance during surgery and rapid recovery from anesthesia, with early extubation.

Adult↗
PubMedDate not supplied

[Comparative study of propofol and midazolam for sedation in regional anesthesia].

OBJECTIVES: To compare the efficacy of propofol and midazolam as sedatives in non-premedicated patients receiving regional anesthesia. MATERIAL AND METHODS: Parameters measured were quality of sedation, intraoperative changes in hemodynamics, respiration and plasma biochemistry as compared with baseline, preinduction and post-anesthetic recovery levels. Forty patients were distributed randomly into two groups. Group P (n = 20) received an infusion of 1% propofol (10 mg/ml) at an initial rate of 6 mg/kg/h for 10 minutes, later decreased to 3 mg/kg/h. Group M (n = 20) received an infusion of 0.3% midazolam with an initial bolus of 0.06 mg/kg along with simultaneous infusion at a rate of 0.05 mg/kg/h. RESULTS: Adequate sedation that was easily controlled during surgery was attained in both groups. The mean doses used were 336.7 +/- 33.7 mg in group P and 10.1 +/- 1.1 mg in group M. No significant changes in hemodynamic and respiratory parameters were observed. Differences between baseline and preinduction levels were found in some analyses, but significant changes during surgery were recorded only for HCO3-. There were no differences in recovery time from the moment infusion ceased until spontaneous eye opening and recall of date of birth. The degree of amnesia was greater in the midazolam group. The lesser amnesia with propofol meant that psychological measures were higher (p < 0.01). No differences in side effects were found. CONCLUSION: Continuous perfusion of propofol and midazolam for sedation in regional anesthesia are equivalent with respect to efficacy and safety.

Adult↗
PubMedDate not supplied

Predictors of patient satisfaction with regional anesthesia.

BACKGROUND AND OBJECTIVES: The practice and success of regional anesthesia (RA) are influenced by a number of factors. The aim of this study was to evaluate patients' attitudes toward RA--perhaps the aspect least evaluated in anesthesia practice--and the factors influencing it. METHODS: A total of 154 patients (59 male, 95 female) aged 13 to 96 years were subjected to different RA techniques for orthopedic and trauma surgery. On the following day, a nurse not belonging to the surgical area and not aware of the anesthesia technique gave a questionnaire to the patient. RESULTS: After application of the study protocol, 110 patients were evaluated (40 male, 70 female), aged 13 to 96 years (mean, 66 +/- 12). Of these, 15.5% had undergone RA previously. Patient attitude toward RA was mostly either favorable (46.4%) or indifferent (45.5%)--only 6.4% showed a negative attitude. Inconveniences of RA were mentioned by 24.6% of patients, and the most common complaint was the needle puncture involved in the technique (18.1%). Advantages of RA were cited by 82.7% of patients (two or more quoted in 75.3%): the possibility of speaking with relatives during the immediate postoperative period (72.7%), staying awake (71.8%), and the absence of pain during the immediate postoperative interval (37.3%). Regression analysis showed the complaint of needle puncture to be the greatest negative factor. CONCLUSION: The performance of RA and consequently the knowledge of it acquired by the patients led to an increase in demand among those individuals who previously had expressed doubts about the technique. Previously positive attitudes remained unchanged. The combination of adequate sedation and the correct anesthetic procedure may favor patient acceptance of RA.

Adolescent↗