Tesis Especializaciones (Ciencias Médicas)

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Alteraciones de la glucemia en anestesia general con halotano vs. fentanyl. Hospital José Carrasco Arteaga [IESS]
(1998) Mera González, Rita del Consuelo; Marín Torres, Esperanza del Carmen; Cañizares Aguilar, Aurelio Ernesto; Barzallo Sacoto, Jorge Eduardo
Alteraciones de la glucemia en anestesia general con halotano vs. fentanyl. Hospital José Carrasco Arteaga [IESS].1997
(Universidad de Cuenca, 1998-11-11) Mera González, Rita del Consuelo; Marín Torres, Esperanza del Carmen; Barzallo Sacoto, Jorge Eduardo; Cañizares Aguilar, Aurelio Ernesto
Circunferencia del cuello como predictor de vía aérea difícil en el paciente obeso sometido a anestesia general, hospitales José Carrasco Arteaga y Vicente Corral Moscoso, Cuenca 2019
(Universidad de Cuenca, 2021-03-29) Mejía Sevilla, Juan Fernando; Bernal Asmal, Angélica Patricia; Morales Sanmartín, Jaime Rodrigo
Background: the difficult airway is prevalent in obese patients, representing one of the main problems for the anesthesiologist; There are multiple methods and factors that determine that a patient will have a difficult airway, however, there is no exact indicator that discriminates between an obese patient who presents this difficulty from those who do not. Research suggests a cervical circumference greater than 40 cm, but no studies have been identified that relate the difficult airway and the size of the cervical circumference in Ecuador. Objective: to determine the relationship between cervical circumference and difficult airway in obese patients under general anesthesia. Methodology: descriptive - observational study in 180 obese patients under general anesthesia at Hospital José Carrasco Arteaga and Vicente Corral Moscoso de Cuenca, selected under inclusion criteria. To classify the participants as obese or not, the WHO classification was used, which considers the body mass index. On the other hand, to determine a difficult airway, the Cormack scale was used. To find the relationship between difficult airway and cervical circumference, the chi-square test was used. Results: the prevalence of difficult airway in obese patients with cervical circumference greater than 40 cm was identified in 27.7%. A dependency relationship was found between cervical circumference and difficult airway. Conclusions: in obese patients, a cervical circumference greater than 40 cm is a potential indicator of a difficult airway.
Comparación del uso de ecografía vs reparos anatómicos en la realización de bloqueo caudal en pacientes de 3-7 años. Hospital Vicente corral moscoso y Hospital José Carrasco Arteaga. Cuenca 2019 a marzo 2020
(Universidad de Cuenca, 2021-05-19) Lucero Samaniego, Andrea Natali; Palacios Reinoso, Carlos Santiago; Morales Sanmartín, Jaime Rodrigo
Background: The techniques advance in the use of regional anesthesia is a motivation to perform local studies that compare the use of ultrasound guidance and anatomical landmarks. Objective: To compare the benefits of caudal block in patients from 3 to 7 years old who had been subjected surgery in the lower hemi body, both with ultrasound-guided caudal block or with anatomical landmarks. Methodology: Observational and descriptive cross-sectional study, 124 children between 3 and 7 years old, subjected to surgery in whom a caudal block was used to alleviate postoperative pain; After intubation or before awakening, a caudal block was performed guided by ultrasound or by anatomical landmarks. The time used for each technique was measured, and in the postoperative period it was observed: vital signs, additional analgesia, the Wong Baker's Faces scale was also applied to determine the benefits of each technique. Results: The mean age was 4.91 years. In 80.6% of the cases were male and 77.4% presenting normal weight. 55.6% of the population belonged to blockage due to anatomical repairs and 44.4% due to ultrasound guidance. Comparing the results of the 2 groups, there were found statistically significant differences, in the variation of the heart rate in favor of the group that uses ultrasound as a guide and in the duration of the procedure in favor of the group that uses anatomical repairs (less time). Conclusions: the ultrasound-guided technique has better results in terms of analgesia than the anatomical landmarks.
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.
Determinación de la línea de tuffier y sus factores asociados en pacientes programadas para cesárea bajo anestesia neuroaxial guiada por ultrasonografía. Hospital Vicente Corral Moscoso. Cuenca 2021
(Universidad de Cuenca, 2023-05-09) Guaillas Gualán, Marcelo de Jesús; Peñafiel Martínez, Nadia Rosalía
Background: The Tuffier line is a reference used daily to guide lumbar puncture, however, it is not entirely reliable as it can be influenced by factors such as age, height, body mass index, pregnancy, among other factors. Objectives: Determine the location of the Tuffier line in patients undergoing cesarean section with neuraxial anesthesia and relate associated factors using ultrasound. Method: The present work is a cross-sectional analytical study, made up of 267 patients undergoing cesarean section under neuraxial anesthesia at the Vicente Corral Moscoso hospital in Cuenca Ecuador, between January and December 2021, the data was collected in a form, the program was used. SPSS version 22 and to analyze descriptive and inferential statistics. Results: Using ultrasound, 94% of the study population had a demarcation of Tuffier's line above L4. It was determined that height and body mass index are factors that influence, women with a height less than 1.52 meters had an association with the demarcation on L3 with the palpation method (OR 153.14 CI = 20.826 - 1126.099 p <0.001), body mass index greater than 25 kg/m2(OR 2.114 CI = 1.180 – 3.787 p = 0.001). Conclusions: The palpation method may not be reliable in pregnant women to determine the space for the application of neuraxial anesthesia, when determining by ultrasound the location above L4 was associated with a smaller height of the pregnant woman.
Determinación de los niveles basales de Co2 espirado mediante capnografía, en pacientes quirúrgicos. Hospital Vicente Corral Moscoso. Cuenca, 2019-2020
(Universidad de Cuenca, 2021-07-09) Tigre Cuenca, Daniela Soledad; Cevallos Sacoto, Francisco Antonio; Morales Sanmartín, Jaime Rodrigo
Introduction: In anesthesiology and in critically ill patients, it is necessary to maintain the levels of carbon dioxide (CO2) in normal parameters, whose alteration influences morbidity and mortality. The pressure values of CO2 and Exhaled CO2 (ETCO2) have been shown to vary depending on atmospheric pressure. In the city of Cuenca at 2560 meters above sea level (masl), there is still no study that establishes normal values. Objective: To determine the basal levels of expired CO2 in surgical patients at the Vicente Corral Moscoso Hospital. Methodology: An observational, descriptive study with 534 patients without comorbidities, who underwent surgery at the Vicente Corral Moscoso Hospital in Cuenca Ecuador. To collect data, a thermometer, barometer, humidity sensor, vital signs monitor and capnograph were used; they were recorded in a form, they were analyzed in the IBM SPSS version 22 software with descriptive statistics. Results: The mean expired ETCO2 was 28.36 ± 1.81 mmHg, 95% CI (28.277 - 28.434). Alveolar pressure was 68,116 ± 3,897 95% CI (28,277 - 28,435). There was a significant difference (p <0.05) in the CO2 means according to respiratory rate, mean arterial pressure and whether it was elective or emergency surgery. Conclusions: There is agreement with other studies that indicate that the higher the ETCO2 levels are lower, the range obtained could be taken into account as a reference for the adequate management of ETCO2 in the inhabitants of this geographical area.
Determinación del nivel cognitivo en pacientes mayores de 60 años sometidos a anestesia general balanceada y total intravenosa en los hospitales José Carrasco Arteaga y Vicente Corral Moscoso, Cuenca 2019
(Universidad de Cuenca, 2021-03-29) Sánchez Correa, María Rosa; Cevallos Sacoto, Francisco Antonio; Morales Sanmartín, Jaime Rodrigo
Introduction: Brain function is affected in the perioperative period, the symptoms manifest during the postoperative period, with depression of the level of consciousness, impaired attention, memory, reaction time, and amnesia, which can last several hours later. General anesthesia, anesthetic drugs, and age are associated factors. Older adults can develop from cognitive deficits and postoperative delirium, which often go unnoticed. Research in recent years seeks solutions to mitigate these pathologies; it is important to determine the associated and aggravating factors such as the type and duration of anesthesia, type of surgery, pathological history, alterations in perioperative homeostasis, among others. Objective: To determine the cognitive alterations that occur in the post-anesthetic of patients undergoing balanced or intravenous general anesthesia. Material and Methods: Analytical and cross-sectional observational study, in 258 patients over 60 years of age, scheduled for elective surgical procedures, from the José Carrasco Arteaga and Vicente Corral Moscoso Hospitals in the city of Cuenca, from January to December of 2019, who were operated with balanced general anesthesia or total intravenous, to whom the minimental test was applied to evaluate the cognitive state.. Descriptive results are shown using absolute and percentage frequency measures, measures of central tendency and dispersion. To determine the degree of association between risk factors and cognitive impairment, the prevalence ratio and confidence intervals were applied. The sample was calculated with a confidence level of 95%, taking into account the prevalence of 20% described in other studies, with a margin of error of 0.05. Results: 258 patients between 60 and 91 years old were studied, with a mean of 70.7, obtaining a prevalence of postoperative cognitive impairment (PDD) of 37.6%, associated with factors such as female sex, age over 80 years, patients classified according to the American Society Anesthesia Physical Status (ASA PS) III and patients who presented complications during surgery. Conclusions: The decrease in cognitive capacity was significantly more notable in: women, long-lived adults, those with an ASA III classification and in patients with complications during the intraoperative period; It is important to identify these factors and take prior measures such as multidisciplinary evaluations that help prevent their appearance or reduce its severity.
Efectividad de la sedación prequirúrgica y su nivel de recuperación postoperatoria en pacientes pediátricos entre 2 y 8 años en el Hospital Vicente Corral Moscoso y Hospital José Carrasco Arteaga. Cuenca 2019
(Universidad de Cuenca, 2021-05-19) Naranjo Proaño, Marcia Isabel; Bravo Briones, Ramón Eduardo
Background: Pre-surgical anxiety is a fear-generating state. Children are more vulnerable and it can be associated with night fears and somatizations. Premedication is key to reducing this state of discomfort. Objective: To observe the effectiveness of presurgical sedation and its level of postoperative recovery in pediatric patients between 2 and 8 years of age, undergoing scheduled surgeries at the Vicente Corral Moscoso Hospital and the José Carrasco Arteaga Hospital. Method and materials: A descriptive observational study was carried out in the period January to December 2019. The sample was representative and random, with 125 patients who received premedication determined by an anesthesiologist. Data were collected during pre-anesthetic, trans and postoperative visits. A questionnaire validated in a pilot plan was used, filled out by previously trained personnel, the analysis was performed using EPI DATA v.3.5 software. With the following criteria, confidence level 95%, percentage of effectiveness 0.08, margin of error 5%. Results: Most of the children presented an adequate level of sedation according to the Richmond Rass Scale. 82.4% presented a level 0; 16.8% presented a level -1; 0.8% presented anxiety. The pharmacological effect was observed in a time greater than 30 minutes in 64% of patients. 68.8% did not present postoperstory pain. 96% had a recovery stay between 30 and 120 minutes, in relation to the level of sedation (p: 0.00). Conclusions: Preoperative sedation has proven to be beneficial as it provides the necessary means for atraumatic care of the child and their families; allows a comfort area that reduces the risk of complications.
Efectividad del videolaringoscopio con y sin canalización en los pacientes bajo anestesia general. Hospitales Vicente Corral Moscoso y José Carrasco Arteaga. Cuenca, 2019.
(Universidad de Cuenca, 2021-05-14) Coronel Aguilar, Tamara Alexandra; Bernal Asmal, Angélica Patricia; Morales Sanmartín, Jaime Rodrigo
Background: Most surgical procedures are performed under general anesthesia, which requires special attention at the time of intubation, a critical step that requires experience and all the appropriate materials, as there are a large number of patients with difficult airways, it is important to perform An analysis of the new tools. Objective: To determine the effectiveness of the use of the video laryngoscope with and without cannulation in relation to the intubation time and number of attempts at the Vicente Corral Moscoso and José Carrasco Arteaga Hospitals from January to December 2019 Materials and Methods: An observational and descriptive study was conducted from January to December 2019. The population consisted of patients undergoing scheduled surgery with general anesthesia who met the inclusion criteria; the sample was representative and random. Results: The mean age of the study population was 32.77 years, the most frequent age group corresponded to 36 to 45 years with 44.3%. 86% of the patients obtained a lemon scale of less than 3, in 33% of the patients a canalization guide was used for intubation. The effectiveness of video laryngoscopy was evidenced by 87.8% of patients who were intubated on the first attempt and 83% who managed to be intubated in less than 30 seconds. 92% of the patients remained with oxygen saturation greater than 90%. There were slightly better results in patients using a channelless video laryngoscope.
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 la satisfacción posanestésica neuroaxial en pacientes programados. Hospital Vicente Corral Moscoso y José Carrasco Arteaga. Cuenca, 2019
(Universidad de Cuenca, 2021-05-19) Reinoso Murillo, Priscila Victoria; Bravo Briones, Ramón Eduardo; Morales Sanmartín, Jaime Rodrigo
Background: The formal evaluation of patient satisfaction after receiving neuraxial anesthesia is one of the least considered aspects in our environment, reducing its importance, this motivated us to carry out this research, to contribute with more information within a comprehensive process of improvement of quality in health. Objective: To decide the degree of satisfaction of patients undergoing elective surgery with neuraxial anesthesia. Methodology: Descriptive observational study, in a sample of 270 patients submitted to planned surgical procedures that required the use of neuraxial anesthesia; To collect the information, an Anesthetic Quality Perception Questionnaire (CPCA) was used; The confidentiality of the information and the signing of the informed consent by the patient were previously guaranteed. Descriptive and inferential statistics with 95% confidence are used for the analysis of the information. Results: The mean age was 47.5 ± 17.8 years, the female sex made up of 54.1% of the patients. After the evaluation using the CPCA, it was determined that 52.6% of the patients were relatively satisfied and 43.7% were satisfied. Regarding the anesthesiologist's care, 54.4% of the patients evaluated it as excellent. Conclusions: The level of satisfaction of patients undergoing neuraxial anesthesia is between relatively satisfied and satisfied.
Factores asociados al despertar intraoperatorio. Revisión sistemática
(Universidad de Cuenca, 2022-03-11) Ordoñez Castro, Amanda Elizabeth; López Torres, Guillermo Teodoro
Introduction: intraoperative awareness during surgery is a rare adverse effect, however, its appearance can cause serious and long-term disabling psychological disorders. Objective: to determine the factors associated with intraoperative awakening in patients undergoing surgical interventions, through a systematic review. Methods: observational study of literature review. Original scientific articles with quality of evidence in category Q1 to Q4 of Scimago Journal and Country Rank during the last 10 years were included. The information was obtained through the search engines: Hinari, Scopus, Redalyc, Scielo, Pubmed, Springer, NJM, BMJ, Cochrane, Latindex and Google Scholar. It consisted of placing keywords with the combination of these through Boolean operators. For data collection, the PICOs strategy was used. The information was consolidated in personalized tables for this purpose. Results: the prevalence of intraoperative awakening ranged from 0.0095% to 8.2%. The risk factors identified with statistical significance were age <60 years, women, obesity, low weight, ASA III-IV, history of prior intraoperative awareness, prolonged interventions, high-risk and emergency surgeries, general anesthesia, and lack of pre medication. Sedation and the application of perioperative analgesia are protective factors. Conclusions: intraoperative awareness is a rare complication during the surgical act, the risk factors were due to determinants related to the patient, the type of surgical intervention and the anesthetic technique.
Grado de satisfacción de pacientes que han recibido anestesia general en los hospitales Vicente Corral Moscoso y José Carrasco Arteaga. Cuenca, 2019
(Universidad de Cuenca, 2021-04-27) Vásquez Espinoza, Lourdes Del Rocío; Peñafiel Martínez, Nadia Rosalía
INTRODUCTION: In medical practice, different scales to measure the quality and satisfaction of the services provided one of the most complete and validated worldwide is the QoR40 scale, which is the one used in the present study. OBJECTIVE: To determine the level of satisfaction of patients who receive general anesthesia in scheduled surgeries at Vicente Corral Moscoso and José Carrasco Arteaga hospitals. METHODS: A descriptive observational study was carried out, the sample consisted of 385 patients who underwent general anesthesia in scheduled surgery in the Vicente Corral Moscoso and José Carrasco Arteaga hospitals, the data were obtained by applying the QoR40 form and they were analyzed with SPSS program version 20(Demo), chi square (X2) was used for the inferential analysis and the p value for statistical significance. RESULTS: The average age was 37, 22 ± 12.05 years, most of them were women with 56.1%. The satisfaction levels found were: dissatisfaction 0.3%, 17.7% partially satisfied and 82.1% satisfied. The levels of satisfaction, using the scores of the QoR40 scale, were statistically different between the hospitals, with an advantage for the Vicente Corral hospital (T-Student and significant p), it was determined that the secondary effects are associated with the satisfaction levels (X2 =6,3 and 0=0,04). CONCLUSIONS: The satisfaction levels found are high, they are related to the adequate control of secondary effects and there is a strong institutional component, probably due to the comprehensiveness of the medical care.
Incidencia de la hipotermia inadvertida en la sala de recuperación post anestésica en pacientes sometidos a cirugía general. Hospital Vicente Corral Moscoso. Cuenca - 2018
(Universidad de Cuenca, 2020-05-05) Astudillo Aguilera, Johanna Catalina; Espinoza Juela, Miguel Ignacio; Morales Sanmartín, Jaime Rodrigo
Introduction: postoperative inadvertent hypothermia is the parameter with the highest incidence. Hypothermia causes myocardial complications, infection, delayed wound healing, coagulopathy, delayed recovery, prolonged hospitalization. Objective: To determine the incidence and characteristics of inadvertent hypothermia in patients who enter the post anesthetic recovery room of the Vicente Corral Moscoso Hospital. Materials and methods: A prospective, descriptive-longitudinal study was performed in patients on APRS after general anesthesia on admission, 60 and 120 minutes. The sample was 400 patients calculated with the random type probabilistic sampling formula, a value of p ≤ 0.05 will be considered statistically significant. Data were analyzed in the SPSS version 22 statistical program. Results: The incidence of hypothermia on admission was 74.5%, average T 35.53 ° C + - 0.67 ° C, at 60 minutes 31.3%, average T 36.1 ° C + - 0, 55 ° C and at 120 minutes 10.5%, average T 36.5 ° C + - 0.46 ° C. There was hypothermia in patients> 60 years (p: 0.000). It was higher in low weight after 60 minutes at 43.8% and remained at 120 minutes at 18.8%. Gynecological surgery presented hypothermia with 83%, 34% and 25%. Patients with ASA III staging plus hypothermia with 84.6%, 53.8% and 19, 2%. Greater hypothermia in surgeries> 3 hours with 93.5%, 63% and 19.6%, (p: 0.000). ASA III patients p: 0.010. Conclusions: The incidence was higher than the reviewed studies, there is a significant relationship between surgical time, age greater than 60 years and ASA III with hypothermia.
Medición de la profundidad anestésica y memoria durante anestesia general mediante el cerebral state monitor (csm x06)
(Universidad de Cuenca, 2007-11-11) Gárate O., Germania; Pacheco B., Juan Pablo; Orellana Cabrera, Iván Eladio; Barzallo Sacoto, Jorge Eduardo
Medición de los niveles y curva de Co2 con el uso de máscara laríngea y tubo endotraqueal en pacientes de 14 a 60 años del Hospital Vicente Corral Moscoso, Cuenca 2018
(Universidad de Cuenca, 2020-11-13) Peñafiel Encalada, Alicia Monserrath; Cevallos Sacoto, Francisco Antonio; Morales Sanmartín, Jaime Rodrigo
Introduction: there are few studies about the variability that exists between capnography and capnometry during the use of the laryngeal mask and endotracheal tube, that’s why it has been considered important to perform this research. Objective: to determine the changes in the levels and curve of expired carbon dioxide (EtCO2) referring to the use of the laryngeal mask (LMA) and the endotracheal tube (ET). Methodological design: a descriptive cross-sectional study was carried out from january to december 2018. The population was made up of a representative sample of patients undergoing balanced general anesthesia procedures. Data from 180 patients were analyzed with the Statistical Package for the Social Sciences (SPSS).Results: in the analysis of the capnography, there was no difference between the two evaluated groups, 2 patterns of bronchospasm were found during the fifth- and thirtieth-minute during surgery with values of p = 0.363 in both cases. Capnometry averages were obtained in the TET group and LMA, with the following results: at minute 5 an average of 36 ± 4 mmHg and 36 ± 3 mmHg with p = 0.324, at minute 30 a value of 35 ± 4 mmHg and 35 ± 3 mmHg with p = 0.517 and at minute 60 a value of 35 ± mmHg and 34 ± 3 mmHg with p = 0.84 respectively. Conclusions: it was concluded that the results of capnography and capnometry do not vary depending on the use of the laryngeal mask and endotracheal tube.
Nivel de conocimiento del consentimiento informado de anestesiología en los pacientes del Hospital José Carrasco Arteaga– periodo enero diciembre 2021
(Universidad de Cuenca, 2023-05-03) Becerra Palacios, Miryam Cristina; Tenezaca Mogrovejo, Janeth Isabel
Background: Informed consent is a legal medical document that needs to be signed prior to any medical procedure. Through it, the risks and benefits of the procedure are known. This is carried out and adapted to medical ethical principles. Objective: To determine the level of knowledge about the anesthetic informed consent that the patients of the José Carrasco Arteaga Hospital have in the period January to December 2021. Materials and method: an analytical cross- sectional study was carried out. The sample was 359. The variables studied were age, sex, origin, residence, educational level, work activity, type of surgery, knowledge of informed consent. Tables and graphs were made with frequency and percentage for qualitative variables and average and standard deviation for the quantitative ones. OR was obtained, with its 95% CI and the p value. Results: the mean age was 52.58 (±) 14.45 years, 61.6% were women and 37% men, 84.7% of Sierra origin, living in rural areas 57.9% with secondary education 37%, work activity on 51.3%. Knowledge of informed consent in the population is 45% and is related to the demographic variables age under 61 years (OR 3.6, p 0.000, IC95% 2.2-6), basic education (OR 0.28,p 0.000, IC95% 0.17-0.44), assets (OR 1.8, p 0.006, CI95% 1.18-2.74), rural residence (OR 2.03, p 0.001, CI95% 1.32-3.3). Conclusions: as in studies carried out in other countries, it is evident that patients do not adequately understand informed consent.
Odinofagia con tubo endotraqueal y máscara laríngea. Hospital Vicente Corral Moscoso. Cuenca, 2018
(Universidad de Cuenca, 2020-03-06) Burbano Siguenza, Diana Alexandra; Bernal Asmal, Angélica Patricia; Morales Sanmartín, Jaime Rodrigo
Introduction: General anesthesia uses devices such as endotracheal tube (TET) and laryngeal mask (ML). Standard gold TET in the airway and is an invasive method compared to ML, although both can cause oropharyngeal lesions. The most cited post-extubación complication by patients is odynophagia. Objective: To determine the incidence of odynophagia with the use of ML and TET in adult patients undergoing elective surgeries under general anesthesia at Vicente Corral Moscoso Hospital in 2018. Method: An observational, descriptive, prospective study was conducted in adult patients undergoing elective surgeries under general anesthesia in 2018, meeting inclusion and exclusion criteria. The sample was simple randomized in 216 patients, whose anesthesiologist established the device according to the patient's needs and surgery. The information was transcribed from anesthesia records and evaluation of respective forms, data analyzed with the SPSS 25.0 free version system. The analysis was performed using frequency, mean, percentage, averages and dispersion measures such as standard deviation and range. Results: Was observed in the following groups: women 41.2%, years range 51-60 in 56.5%, obesity 65.4%, ASA II 51.4%, VAD 85.7%, specialists 53.6%, TET with 60.9%, size 7.5 with 47.1%, the ML Classic in 23.3%, size 4 with 73.7%, attempts is the third with 100%, anesthetic time > 120min 62.5%, laparoscopic surgery 55.6%, intensity range 0-1 in 57.9% and favorable evolution of 94.3%.

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