Browsing by Author "Pacheco Baculima, Juan Pablo"

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Características de la hiperbilirrubinemia neonatal en recién nacidos del Hospital General de Macas. Período 2013 - 2015
(2017) Montenegro González, Christian Miguel; Siguencia Astudillo, Héctor Fabián; Pacheco Baculima, Juan Pablo
Background: Neonatal hyperbilirubinemia is a frequent pathology in our setting, which might put a risk the life of newborn babies or cause long-term sequels, which is why it is considered a public health issue that must be studied in our region. General objective: To characterize neonatal hyperbilirubinemia in newborn babies at the Hospital General de Macas. 2013 to 2015. Methodology: For data gathering, all the Clinical Charts with Hyperbilirubinemia diagnosis at the Hospital General de Macas were selected (N=104). This was performed with a data gathering instrument. The qualitative variables were presented as absolute and relative frequencies. Results: Prevalence of neonatal hyperbilirubinemia was 51.5%. 56.7% of the mothers were having their firstborn. The rural precedence was 82.7% and urban 17.3%. In regards to sex, the prevailing group was males with 64.4%. Term infants were 86.5% and preterm infants were 13.5%. The most frequent neonatal diagnosis was multifactor hyperbilirubinemia with 62.4%, followed by immunization with 28.8%. Mortality of patients that entered the service due to this pathology was not registered, nor as primary nor as secondary diagnosis. The mean value of total bilirubin was 16.59 ± 4.29 mg/dL, with preponderance of indirect bilirubin. 71.2% was diagnosed after 72 hours of birth. Conclusions: A low frequency of neonatal hyperbilirubinemia was found, mainly due to multifactorial causes, with an absence of mortality probability at the Hospital General de Macas. Therefore, its efficient, protocolar and early management must continue at this health institution in order to continue the safeguarding of the health and wellbeing of the newborns that suffer this condition.
Características del dolor postoperatorio y analgésicos usados en colecistectomía, apendicectomía y hernioplastia laparoscópica en el Hospital Vicente Corral Moscoso, 2018-2019
(2019-06-11) Cajamarca Bermeo, Jorge Geovanny; Feijó Flores, Johanna Estefania; Pacheco Baculima, Juan Pablo
Background: The correct management of postoperative pain is a fundamental pillar throughout the surgery; It is the duty of the anesthesiologist and the surgeon to choose the correct medication to ensure postoperative analgesia. Objective: To determine the characteristics of postoperative pain and the use of analgesics in cholecystectomy, appendectomy and laparoscopic hernioplasty at Hospital Vicente Corral Moscoso 2018-2019. Methodology: In the Hospital Vicente Corral Moscoso, in 2018 and 2019. Pain was evaluated in this regard by applying the Visual Analogue Scale (VAS). The collected data will be analyzed with SPSS 22.0. For categorized qualitative variables frequencies and percentages are used. OR, Chi squared and Tau C were used for the relationship between pain intensity pain postoperative period and the variables that interfere. Results: The average age of the patients was 37.97 years, predominantly women, with secondary education. Emergency surgery generated more pain. When the surgery lasts more than 90 minutes the immediate postoperative pain is greater. In the immediate postoperative period, a combination of analgesics. Conclusions: Mild to moderate pain predominated according to the EVA scale. There was a decrease in pain as the postoperative time elapsed. The intensity of the pain in the postoperative period in its different stages, is conditioned by several factors that influence the combined and not isolated form.
Características y manejo de fracturas de fémur proximal, en pacientes mayores de 60 años, en el Hospital José Carrasco Arteaga enero 2013 – julio 2016
(2017) Perguachi Jaramillo, Christian Andrés; Sinchi Chuqui, Carlos Andrés; Bravo Aguilar, Christian Romeo; Pacheco Baculima, Juan Pablo
Background: The fracture of the Proximal Femur is the main cause of query in the Area Traumatological overcoat in the elderly population; contributing to an increase of the morbidity and mortality and the functional deterioration of these patients. This injury is produced usually by injuries minor as the falls inside and outside of the home. There are different classifications, however, has been considered the capsule articulate as the anatomical boundary to divide them in extracapsular and intracapsular. Currently the conservative or orthopedic medical treatment has no indication, so that surgical treatment is the most used which uses several implants for their realization and whose election depends not only on the type of fracture, but also of the general condition of the patient. General objective. Determine the characteristics and management of proximal femur fractures in patients older than 60 years in the Hospital José Carrasco Arteaga, january 2013 - july 2016. Methodological design. This is a retrospective descriptive quantitative study, which is to determine the characteristics and management of proximal femur fractures in patients older than 60 years with data stolen from medical records, which will be tabulated by using tables and analyzed using software (Epi-info, Spss 15.0). Results. The prevalence found was 9.55%, with predominance of females (22.84%) and an age of 82.1 years ± (9.6 DS); The extracapsular fractures were the most frequent (65.2%) with a superiority of the Intertrochanteric ones (57.78%); The most used surgical treatment was osteosynthesis (53.33%) and arterial hypertension was the most common comorbidity with 60% of the cases
Complicaciones con el uso del videolaringoscopio Hospital José Carrasco Arteaga y Hospital Vicente Corral Moscoso. Cuenca 2019
(Universidad de Cuenca, 2021-05-14) Merchán Peñafiel, Priscila Alejandra; Pacheco Baculima, Juan Pablo; Morales Sanmartín, Jaime Rodrigo
Background: inadequate airway management is the cause of 50% of anesthesia-related surgical complications. Despite medical progress in anticipating difficult airway, the efficacy of preoperative examinations is still limited. Objective: to determine the prevalence of complications with the use of the video laryngoscope in patients undergoing general anesthesia at the “Hospital José Carrasco Arteaga” and “Hospital Vicente Corral Moscoso” Cuenca-Ecuador, year 2019. Methodology: a cross-sectional analytical observational study was carried out; in patients who attended the “José Carrasco Arteaga” and “Vicente Corral Moscoso” Hospitals in the city of Cuenca, to undergo surgery, in which general anesthesia was planned, during 2019. The sample was 246 patients, in which the presence of complications was determined with the use of the video laryngoscope. Using the SPSS 22.0 free version, the data shown in the tables were analyzed. Results: the average age was 42.7; the majority were women (57.7%). The prevalence of immediate complications with the video laryngoscope was 13.8%. A statistical relationship was found between complications with overweight and obesity (p = 0.001); oxygen saturation (p = 0.000); number of attempt (p = 0.000); airway status (p = 0.000). Conclusions: the prevalence of immediate complications was 13.8%, a greater association of complications was found with obese patients with a BMI greater than 30, low oxygen saturation, the greatest number of attempts and a difficult airway according to the Wilson scale.
Complicaciones del uso de la máscara laríngea en pacientes pediátricos. Hospitales Vicente Corral Moscoso y José Carrasco. Cuenca, 2018
(Universidad de Cuenca, 2020-05-07) Ávalos García, José Eduardo; Pacheco Baculima, Juan Pablo; Morales Sanmartín, Jaime Rodrigo
Introduction: The laryngeal mask is the equipment with the aim of increasing quality, safety, care, however despite having universal use and high efficiency for ventilation it is not without complications. Objective: To identify the frequency of complications with the use of laryngeal mask in the Vicente Corral Moscoso and José Carrasco Arteaga hospitals in the city of Cuenca. Methods: It is an observational, descriptive, prospective study in 220 pediatric patients, ASA I, II and III operated in elective and emergent surgeries under general anesthesia in a time interval of 30 to 240 minutes, of all medical specialties of the year 2018, different types of mask were used. The sample was obtained by applying the formula for unknown population (n = (Z2 x p x q) / e2), confidence level (Z): 95%. (1.96) Margin of error (e): 5% Probability of occurrence of the event (p): 15% Probability of non-occurrence of the event (q): 85%. Results: The rate of laryngeal complications is 5.9%, frequent cough and bloody secretion, associated factors such as classic mask, age (2-5 years), time greater than 60 minutes, greater number of attempts, ASA> I, nutritional status overweight , and inserter in training. Conclusion: The laryngeal mask is accepted as a device in pediatric anesthesia for rapid learning, low failure rate and utility in difficult airways. There is insufficient evidence to support the use of a particular device over another.
Composición corporal de los integrantes de las familias del Cantón el Tambo en el año 2016
(2017) Guamán Chalco, Paola Nataly; Mora Fajardo, Enrique Adrián; Quizhpi Merchán, Carmita Victoria; Pacheco Baculima, Juan Pablo
Background: Anthropometry is a useful method to know the body composition and nutritional status of the populations under study. Efficiency is due to fact that this method presents low cost and high accessibility. Objective: Describe the body composition of the members of the families of the Canton El Tambo in the year 2016. Methodology: This is a cross-sectional descriptive study. The universe corresponds to 4.241 people. The sample of 140 inhabitants was randomly calculated with a confidence interval of 95%, expected proportion of 40%, differential error of 8%. The data were collected made in Excel and processed in the IBM SPSS Statistics 23 program. Results: The average age of the study was 39 years ± 14. Female sex represents 70, 7% of the population. The 40% belonged to the Tambo Centro locality. The average weight was 62 kg ± 11 and the average height of 154 cm ± 10. The 88.6% have normal fat percentage (39.3%) or lower (49.2%), overweight is equal to 11, 4%, and obesity does not exist. The 42,1% have decreased bone percentage, 60% increased muscle percentage and 100% normal residual percentage. Conclusions: Due to the high percentages of normal fat, people have a less risk factor for metabolic and cardiovascular diseases. The increased muscle percentage reflects greater physical work for their daily work
Corporación del bloqueo sensitivo con bupivacaina 0,5% 55 MG versus bupivacaina 0,5% 70 MG en igual volumen para anestesia epidural en cesárea. Hospitales Vicente Corral Moscoso y José Carrasco Arteaga, Cuenca 2013
(2014) Ortega Berrezueta, Elizabeth Catalina; Pacheco Baculima, Juan Pablo; Morocho Malla, Manuel Ismael
Objective. Comparation of sensory block produced by 55 mg bupivacaine 0.5 % + fentanylo 150 mcg + saline 3 ml 0.9 % versus 0.5 % bupivacaine 70 mg + 150 mcg fentanylo equal volume in through a catheter in epidural anesthesia for cesarean section. Methodology. This was a randomized controlled design in which two groups of 64 maternal in each, group I received 55 mg bupivacaine 0.5 % + 150 mcg of fentanylo + 3 ml of 0.9 % saline at 17 ml is incluided group II volume and bupivacaine 0.5 % 70 mg + 150 mcg of fentanyl in 17 ml volume epidural catheter, which allowed us to determine the sensory block, metameric level, vital parameters and adverse effects when using different doses equal volume in epidural anesthesia for cesarean on patients attending Vicente Corral Moscoso and José Carrasco Arteaga Hospital in 2013. Results. Full epidural blockade was significantly lower in the group in which lower doses of local anesthetic group 1 ( P = 0.001 ) was used, presenting more frequent pain ( P = 0.000) and tachycardia ( P = 0.041) . In group 2 there was a higher rate of hypotension ( P = 0.000) , nausea (P = 0.003) and vomiting ( P = 0.080 ). Conclusion. The objective was met in this study provided us with results that reverse the trend for dose finding a high percentage of complete blocks in the group in which higher dose was used ( 92.2 % vs 64.1 %, P = 0.001). Concern persist that dose or to find that volume that is suitable for use in obstetric patients. Descriptors. EPIDURAL; VOLUME BUPIVACAINE; DOSE BUPIVACAINE; EPIDURAL CATHETER; FENTANYLO.
Despertar anestésico con remifentanilo versus sin remifentanilo en los pacientes del Hospital Vicente Corral Moscoso. Cuenca, 2013
(2016) Peñafiel Martínez, Nadia Rosalía; Pacheco Baculima, Juan Pablo; Morocho Malla, Manuel Ismael
ABSTRACT OBJECTIVE: To compare the emergence from general anesthesia with remifentanil and without remifentanil in patients undergoing general anesthesia. MATERIALS AND METHODS: This is a randomised controlled trial single-blind study of 140 patients undergoing general balanced anesthesia. They were divided in two equal groups, to group A (n=70) remifentanil was withdrawn 10 minutes before and group B (n=70) received remifentanil in continuous infusion at a dose of 0.05 ug/kg/min until extubation. RESULTS: The variables age, weight, height, basal mean arterial pressure and heart rate between the two groups didn’t have statistically significant differences at p<0.05. In the "A" group during the anesthetic raise mean arterial pressure and 5 minutes after extubation were higher with respect to the group "B" with a statistically significant difference (p=0.009 and p=0.01). Nausea was the adverse effect that presented significant difference in the group receiving remifentanil with p=0.023. The group that presented more frequently and more intensely cough was the "A" group with p=0.047 and p=0.005 respectively. As for the heart rate and the time of awakening haven’t significant difference in the groups. CONCLUSIONS: The group that received remifentanil had a less mean arterial pressure, frequency and intensity of cough, than the group that didn´t receive remifentanil, with equal time in the awakening and few adverse effects
Efecto de la elevación de miembros inferiores en 40 grados y la administración de líquidos intravenoso sobre la presión arterial en pacientes con bloqueo neuroaxial. Hospital Vicente Corral Moscoso. Cuenca, 2019-2020
(Universidad de Cuenca, 2022-02-02) Cajamarca Bermeo, Anabel Gabriela; Pacheco Baculima, Juan Pablo
Background: Spinal anesthesia is a technique used in multiple surgical interventions. The most common adverse effect is a decrease in blood pressure. There are several ways to avoid it such as: drugs, physical or positional means. Objective: To describe the effect of limb elevation below 40 degrees and the administration of parenteral fluids on blood pressure after neuraxial anesthesia. Methods: Descriptive observational study to describe blood pressure after neuroxial blockade at one minute, five and ten minutes, when raising the lower limbs by 40 degrees and when administering fluids. Sample of 331 patients from the Vicente Corral Moscoso Hospital, the data were entered into forms and processed using the SPSS version 15 program with inferential statistics. Results: A mean arterial pressure was obtained after the administration of fluids at one minute of 91.22 ± 6.94 mmHg, with the elevation of the legs of 93.81 ± 8.26 mmHg; at 5 minutes 75.52 ± 12.29 mmHg and 75.51 ± 13.9mmHg and at 10 minutes 74.28 ± 10.58 mmHg and 73.29 ± 11.82 mmHg, respectively. Diastolic blood pressure p = 0.03 and mean p = 0.002 one minute after the block had a significant difference. At 5 and 10 minutes there was no significant difference with p> 0.05. Conclusions: In the present study, the leg elevation and the administration of fluids prevented hypotension and there was no statistically significant difference between the blood pressures of the two methods, suggesting the use of the leg elevation for patients with contraindication to use fluids.
Evaluación de los conocimientos en cuidados paliativos de los internos de Medicina de los hospitales públicos de Cuenca año 2024
(Universidad de Cuenca, 2025-07-24) Gutiérrez Guerrero, Andrea Lizbeth; Vásquez Garzón, María Verónica; Pacheco Baculima, Juan Pablo
Background: Palliative care (PC) as a science that is part of medicine is responsible for alleviating the symptoms of patients in the terminal stage. Previously, palliative care was directed only at patients with oncological disease, currently it covers other diseases including cardiovascular, chronic kidney, chronic respiratory, AIDS, diabetes, among others. Comprehensive and irreplaceable competent care in palliative care requires appropriate training and preparation in the field from classrooms to hospital rooms. Objectives: To evaluate the knowledge about palliative care in medical interns in public hospitals in the city of Cuenca in 2024. Methods: It is a cross-sectional descriptive research in which a questionnaire developed and validated by authors was applied. The sample was made up of 122 students from the rotating internship of the Medicine degree who carry out their internships at the Vicente Corral Moscoso Hospital and the José Carrasco Arteaga Hospital in the city of Cuenca during September 2023-August 2024. For processing and analysis PSPP software (version 29 with academic license) was used for the information. The results were presented in simple and composite tables. Expected results: Determine the level of knowledge in palliative care in Medicine interns who carry out their hospital practices in Cuenca, as well as identify the deficit by area in palliative care according to the questionnaire used.
Frecuencia de resistencia microbiana por β-lactamasas en Enterobacterias en pacientes hospitalizados. Hospital Vicente Corral Moscoso. Cuenca. 2014 -2015
(2017) Bueno Quizhpi, Iván Marcelo; Ochoa Muñoz, Javier Fernando; Pacheco Baculima, Juan Pablo
The frequency of infections caused by bacteria producing B-lactamases has grown steadily over the years, in Latin America have reported higher numbers of 32% and 58% for E. coli and K. pneumoniae , respectively, also in Ecuador in 2009 the percentage of E. coli resistance to third-generation cephalosporins was between 18-20% and K. pneumoniae strains between 42-48%, for this reason and antimicrobial resistance be one of the biggest public health problems worldwide, it is necessary to monitor this problem. Objective: To determine the frequency of bacterial β-lactamases resistance of Enterobacteriaceae in patients hospitalized at the Vicente Corral Moscoso Hospital. Cuenca-Ecuador from 2014-2015. Methodology: A retrospective descriptive study by database area of microbiology Vicente Corral Moscoso Hospital, review of reports of culture and sensitivity of hospitalized patients on July 2014 - July 2015. The information was collected in forms, were processed data using SPSS the V.16, using absolute frequency and percentages, which were represented in tables. Results: 4638 crops were processed, of which 1144 (24.65%) reported Enterobacteriaceae, of which 439 were producing β-lactamases (38.37%). Escherichia coli was the predominant species with 747 cases (65.30) and 269 βlactamases producers (61.28%), followed by Klebsiella pneumoniae with 177 cases (15.47%) and 84 β-lactamases producers (19.13%). Most positive strains come Emergency β-lactamases (37%) and clinical (31%). High resistance to beta-lactams such as ceftriaxone 100%, to quinolones such as ciprofloxacin of 92% and a low resistance to Carbapenems, less than 6% was observed. Conclusions: E. coli has a higher prevalence followed by Klebsiella pneumoniae, the greater percentage of β-lactamases (+) strains were isolated in Emergency, Betalactam antibiotics have a high resistance, carbapenems are still the most active agents against β-lactamases (+) strains
Incidencia de cefalea post punción dural y factores de riesgo asociados en pacientes sometidos a apendicectomía en el Hospital Vicente Corral Moscoso. 2017
(2018) Montenegro Loja, Maritza Fernanda; Tapia Baculima, Erika Ximena; Pacheco Baculima, Juan Pablo
ANTECEDENTES: La CPPD es una complicación de la anestesia raquídea, debido a la pérdida de líquido cefalorraquídeo provocada por la punción dural que lleva a la disminución de la presión intracraneal (1). OBJETIVO GENERAL: Determinar la incidencia de cefalea postpunción dural y factores de riesgo asociados en pacientes sometidos a apendicectomía en el Hospital Vicente Corral Moscoso en el año 2017. MÉTODO Y MATERIALES: Se realizó un estudio analítico y transversal. Muestreo probabilístico aleatorio, con pacientes de 15 a 65 años hospitalizados en el área de cirugía luego de una apendicectomía con anestesia dural. Para la obtención de los datos se utilizó un formulario y se procesó con SPSS. Se calcularon frecuencias y porcentajes, así como medidas de tendencia central y dispersión para la edad. Para evaluar los factores de riesgo y su relación se empleó el Odds ratio y el estadígrafo Chi cuadrado. RESULTADOS: Predominaron los pacientes del sexo masculino entre 20 a 29 años. La frecuencia de CPPD fue de 44,2%. El tratamiento más empleado fueron las medidas Higiénico Dietéticas en más del 56% de los casos, a un 40% se les trató con Medidas Farmacológicas. En ningún caso hubo cambios de técnica anestésica y la aguja empleada siempre fue la #25. No se utilizó el parche como tratamiento debido a que las cefaleas no fueron tan intensas. CONCLUSIONES: Los porcentajes de CPPD son altos y los factores de riesgo muestran que existe una mayor probabilidad de sufrir CPPD si existen antecedentes tanto de CPPD como de migraña.
Medición de la profundidad anestésica y memoria durante anestesia general mediante el cerebral state monitor (csm x06)
(2008) Pacheco Baculima, Juan Pablo; Gárate Osorio, Germania Yolanda; Barzallo Sacoto, Jorge Eduardo; Orellana Cabrera, Iván Eladio
Prevalencia de alteraciones hemodinámicas y ventilatorias intraoperatorias en cirugía laparoscópica y factores de riesgo asociados. Hospitales José Carrasco Arteaga y Vicente Corral Moscoso. Cuenca, 2017-2018
(2019) Abad Regalado, María Fernanda; Bustamante Ojeda, Lenin Humberto; Pacheco Baculima, Juan Pablo; Morales Sanmartín, Jaime Rodrigo
Introduction: Hemodynamic and ventilatory alterations are frequent findings in laparoscopic surgery, being more noticeable in those patients with associated pathology, although they commonly go unnoticed in daily practice. Objective: To determine the intraoperative hemodynamic and ventilatory alterations in laparoscopic surgery and the associated risk factors in the Hospital José Carrasco Arteaga and Vicente Corral Moscoso in the city of Cuenca during 2017-2018. Methodology: An observational, analytical and cross-sectional study was conducted in the year 2017-2018. The population consisted of patients undergoing laparoscopic surgery (cholecystectomy and appendectomy) who met the inclusion criteria; the sample was representative and random, the data were collected directly in the form during the transoperative period and were tabulated and analyzed with SPSS system 22. For the hypothesis test RP, IC95% and p-value <0.05 were applied. Results: We studied 446 cases, observing that the most frequent age group is between 21 and 60 years old (77.6%), with a predominance of females (65.5%), hemodynamic alterations were present in 204 patients (45,7%) and ventilatory in 220 patients (49.3%), the age group older than 60 years had a strong association with hemodynamic variations (69.7%) as well as ventilatory (62.1%), being both statistically significant cases (p: 0,000 and 0,008 ). Among the risk factors, ASA II and III (55.9% and 55.6%), obesity (60%) and arterial hypertension (60.9%) showed significant association with hemodynamic variations; whereas the risk factors that were significantly associated with ventilatory variations are ASA II and III (61.5% and 74.1%), obesity (72.6%), surgical risk class III (75%) and hypertension arterial (64.1%). Conclusion: pneumoperitoneum is responsible for a large part of the hemodynamic and ventilatory alterations, there is a strong association between some variables with these changes, however there are no studies that allow to relate all the parameters analyzed.
Prevalencia y factores de riesgo asociados a hipotensión arterial inducida por anestesia raquídea en la cesárea en los hospitales Vicente Corral Moscoso y José Carrasco Arteaga. Cuenca 2021
(Universidad de Cuenca, 2023-05-03) Siguencia Siguencia, Angélica Gabriela; Pacheco Baculima, Juan Pablo
Background: Spinal anesthesia is the most used neuraxial technique in cesarean section, its frequent adverse effect is hypotension. There are risk factors associated with maternal hypotension such as: non-rupture of the amniotic sac, high sensory blockade, high product weight, overweight and obesity, among others; that by identifying them could be prevented or treated in a timely manner. General Objective: To determine the prevalence and risk factors associated with arterial hypotension induced by spinal anesthesia in cesarean section at the Vicente Corral Moscoso and José Carrasco Arteaga Hospitals. Materials and methods: A cross-sectional study was carried out in 338 pregnant patients at term who underwent cesarean section under spinal anesthesia. The variables studied were: arterial hypotension, age, nutritional status, history of hypertension or hypotension, basal heart rate, amniotic sac rupture, multiple gestation, newborn weight, sensory level. Data were recorded in the form and processed in SPSS version 15. The prevalence ratio was obtained with a 95% CI, x2 with the p value. Results: The prevalence of arterial hypotension induced by spinal anesthesia in cesarean section was 60.40%. Arterial hypotension had a statistically significant association with age >35 years (PR of 1.78 with a CI 95%: 1.03-3.12), non-rupture of the amniotic sac (PR of 2.48 with a CI 95%: 1.09-5.66) and the sensitive level between T1-T4 (PR of 2.77 with a 95% CI of 1.05-5.84). Conclusions: the prevalence of maternal hypotension induced by spinal anesthesia is high, similar to that obtained in other international studies.
Relación de la escala de Han comparada con la de Cormack en el manejo de la vía aérea en anestesia general de pacientes mayores de 18 años en el Hospital Vicente Corral Moscoso, Cuenca 2019
(Universidad de Cuenca, 2021-08-30) Chalco Espinoza, Paúl Sebastián; Pacheco Baculima, Juan Pablo; Morales Sanmartín, Jaime Rodrigo
Background: proper airway management during general anesthesia is vital, even more if there is any difficulty. The scales help to predict a difficult airway. Objective: to determine the relationship of the Han scale with the Cormack scale in the management of the airway of patients older than 18 years, undergoing general anesthesia operated at the Vicente Corral Moscoso Hospital, 2019. Methodology: cross-sectional analytical study developed in the "Hospital Vicente Corral Moscoso" with 160 patients who received general anesthesia and endotracheal intubation. The patients were ventilated with a face mask and evaluated with the Han Scale and during laryngoscopy with the Cormack Lehane Scale. The data were analyzed using descriptive and inferential statistics. Results: the mean age was 41.93 ± 17.12 years with a prevalence of 59.4% of the male sex. 12.5% of the patients presented obesity. 61.8% of the cases were ASA I. 66.2% of the patients were classified as Han grade I, 31.2% as grade II, and 2.5% as grade III. 66.8% of the patients presented Cormack I evaluation. Both scales found 2.5% Difficult Airway. When relating difficult ventilation with difficult laryngoscopy, a Fisher’s exact test was obtained with p = 0.097, Cohen’s kappa coefficient 0.231 (IC95% 0.385-0.075). Conclusions: it is not possible to demonstrate a relationship of the Han scale with the Cormack scale.
Remifentanilo como analgesia complementaria en bloqueo paracervical para aspiración manual endouterina. Hospital Vicente Corral Moscoso. Cuenca, 2013
(2013) Espinoza Juela, Miguel Ignacio; Pacheco Baculima, Juan Pablo; Morocho Malla, Manuel Ismael
Objective. To decrease the pain caused by the the Manual Vacuum Aspiration (MVA) in patients undergoing surgery from paracervical block. Methodology. With a blind randomized controlled trial, eighty patients -two groups of forty- were selected for the treatment of incomplete abortion by Manual Vacuum Aspiration in the Department of Gynecology and Obstretrics in Vicente Corral Moscoso Hospital. Group “B” (n=40) underwent the paracervical block procedure. Besides paracervical block treatment, group “A” (n=40) received 1mcg/kg of intravenous remifentanil as an initial dose followed by 0,5mcg/ kg of bolus every four minutes. Pain intensity was measured using the visual analog scale of 10 points, haemodynamic changes and side effects. Results. There is not a significant difference between the study groups related to age (p=0,118), weight (p = 0,522), height (p = 0,114), IMC (p = 0,668), level of education (p = 0,699). The use of remifentanil decreased the pain according to the visual analog scale (VAS) from 7,58 group “B” to 2,98 in group “A” (p = 0,000). There were not significant changes regarding mean arterial pressure and heart rate (p > 0,05). The side effect that showed a significant difference between the groups was the nausea (p = 0,001) which was higher in group “B” Discussion. The use of remifentanil to paracervical block decresaed the VAS pain by 46% with major changes in hemodynamics and with fewer side effects than the control group having nausea (92.3% with p 0.001) KEY WORDS. INCOMPLETE ABORTION, ANALGESIA, INTERMITTENT BOLUS, REMIFENTANIL, PARACERVICAL BLOCK LIDOCAINE, MVA, VAS PAIN
Videolaringoscopía para intubación pediátrica, en comparación con la intubación orotraqueal clásica. Hospital Vicente Corral Moscoso, Cuenca, 2018
(Universidad de Cuenca, 2020-07-03) Palacios Alvear, Juan Patricio; Pacheco Baculima, Juan Pablo
Introduction: A relevant aspect in pediatric anesthesia is the management of the airway. Anatomical differences in this population makes them more susceptible to devices designed for their management. Video laryngoscopy improves panoramic vision of the glottis. Objective: To compare the use of video laryngoscopy with direct laryngoscopy for orotracheal intubation in pediatric patients. Methods: With an observational descriptive design, 276 cases were studied, patients from 5 to 17 years old, undergoing planned surgery, with general anesthesia plus orotracheal intubation. The specialist decided on the handling device. The data was transcribed from the forms and analyzed with the SPSS 22.0 program. The descriptive analysis was based on median, mode, average, minimum value, maximum value. Standard deviation and range dispersion measurements. A value of p ≤ 0.05 was considered statistically significant. Results: The average age of the study was 9.83 years. With direct laryngoscopy 97.4% intubation was performed at the first attempt and with video laryngoscopy 88.4% (p = 0.003). In 94.2% of cases of direct laryngoscopy, a successful intubation was performed in less than 10 seconds, with video laryngoscopy it was 75.2% (p = 0.000). Complications occurred in 6.6% of intubations with video laryngoscopy versus 2.6% with conventional laryngoscopy (p = 0.103). 56.2% of specialists prefer direct laryngoscopy to manage a pediatric airway without predictors of difficulty. Conclusions: Video laryngoscopy provides additional support in routine airway management, always requiring prior knowledge and skills. The evidence to support one technique over another is insufficient.