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Biomedical subjects

R García Guasch

Publications and source records attributed to R García Guasch.

At least 19 recordsLinked to original sources
PubMed2005

[Initial experience with Arndt-type bronchial blockers in thoracic surgery].

OBJECTIVES: The aim of the present study was to consider the feasibility of Arndt-type bronchial blockers in thoracic surgery. PATIENTS AND METHODS: We enrolled the first 11 patients undergoing uncomplicated thoracic surgery expected to be of short duration. The following variables were recorded: age, weight, height, diagnosis, type of surgery, side where the blocker was used, time needed for positioning, the number of times the blocker was malpositioned according to fiberoptic bronchoscopy, time of lung isolation, duration of surgery, and effectiveness of lung collapse. RESULTS: Eleven blockers were placed in 5 women and 6 men aged between 25 and 81 years old (mean +/- SD, 52.73 +/- 22.12 years). Weight ranged from 45 to 88 Kg (mean 65.82 +/- 11.86 Kg). Height ranged from 157 to 175 cm (mean 166 +/- 5.76 cm). Time needed for positioning the blocker ranged from 2 to 30 minutes (median 5 minutes, interquartile range 1-12). According to fiberoptic bronchoscopy, the bronchial cuff was malpositioned, with herniation into the carina, in 1 case. Duration of surgery ranged from 30 minutes to 4 hours (median 70 minutes, interquartile range 50-210 minutes). Lung collapse was excellent in 9 cases and acceptable in 2 according to the surgeon. CONCLUSIONS: Our initial experience with bronchial blockers in elective surgery has shown that time for initial positioning is acceptably short and that surgical conditions are excellent in most cases.

Adult↗
PubMed1989

[Biliary peritonitis after hepatic biopsy: favorable course with conservative medical treatment].

In a 53-year-old woman a percutaneous liver biopsy was performed with tru-cut to study persistent hypertransaminasemia. The patient did not present extrahepatic cholestasis. Immediately after biopsy the patient had a picture of biliary peritonitis that evolved favorably with conservative medical treatment, including hemodynamic resuscitation, antibiotic therapy, analgesic treatment and monitoring by the resuscitation service. A review is made of the literature on this complication of liver biopsy and treatment is discussed.

Bile Ducts, Intrahepatic↗
PubMedDate not supplied

[Problem-based learning in an undergraduate medical school course on anesthesiology, recovery care, and pain management].

INTRODUCTION: We describe our experience with problem-based learning (PBL) in an undergraduate course in anesthesiology and recovery care. MATERIAL AND METHODS: The study was carried out over 5 consecutive academic years from 2000 through 2005. In total, 168 students took part. PBL was started in seminars in the first 3 years the course was given. In the last 2 years, PBL was used throughout the entire course, which consisted of 12 seminars. At the end, each student evaluated the activities overall, the tutor's intervention, the student's own participation, and the time invested in searching for information and preparing for discussions. RESULTS: In the first 3 years, most students considered they had better assimilated the knowledge presented and that they had participated more. In the last 2 years, assessment of the course overall reached a score of 8.47 (SD, 1.24); of the instructor, 8.84 (0.98); and of student participation, 7.38 (1.29). The students used 2.11 (1.43) hours to search for information and 1.74 (1.14) hours to prepare for discussion. CONCLUSIONS: The medical students' level of satisfaction with and acceptance of PBL in this anesthesiology course were high. The instructor's intervention and student participation were assessed highly. A large amount of time was used for study.

Adult↗
PubMedDate not supplied

[Spinal cord ischemia in the postoperative period of aortic surgery].

Paraplegia is a fearful and not uncommon complication of aortic clamping in surgical procedures involving thoracic and abdominal aorta. We report a case of transient spinal cord ischemia during the early postoperative period of aortobifemoral bypass in a 69-year-old male with arteriosclerosis obliterans, hypertension, type II diabetes mellitus and COLD. The anesthetic procedure was combined (peridural + intubation and mechanical ventilation + isofluorane). Two hypotensive episodes of about 80 mmHg developed, one after induction and another in the Reanimation area. The first one had a short duration, whereas the second one required the administration of colloids, crystalloids and blood. The infrarenal aortic clamping time was 35 minutes. In the early postoperative period the patient had clinical features consistent with spinal ischemia, which progressively recovered. To prevent spinal ischemia during surgery a shorter duration than 30 minutes of aortic clamping, a higher distal perfusion pressures higher than 60 mmHg during clamping, and the attempt to exclude the least possible number of intercostal and/or lumbar vessels are recommended. Drugs (corticosteroids, naloxone) and hypothermia can be useful.

Aged↗
PubMedDate not supplied

[Periorbital hematoma as a complication of posterior peribulbar anesthesia].

We report a case of a large periorbital hematoma which furtherly extended to the ipsilateral orbit and appeared after posterior peribulbar blockade in a 70-year-old woman undergoing cataract extraction and intraocular implant. Peribulbar blockade was carried out with a 23-gauge blunt bevel Atkinson's needle introduced at the level of nasal or internal angle of the upper lid without loosing contact with the ceiling of the orbit. Anesthetic solution was bupicavaine at 0.75% with 10 U/ml of hyaluronidase, 3 ml. Usual blockade of lower lid was not carried out as with the first blockade, an almost complete paresis of extraocular muscles together with discrete conjunctival ecchymosis occurred. Ocular compression was conducted with Homan's balloon at 30 mmHg gor 30 minutes. Then, the eyeball was decompressed and a progressive increase of edema with conjunctival hemorrhage becoming bilateral was observed. Coagulation tests were normal. The incidence of conjunctival ecchymosis and palpebral hematoma with such technique ranges from 2% to 9%; it does not represent any intraoperative problem but may difficult surgery.

Aged↗