Tesis Especializaciones (Ciencias Médicas)

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Browsing Tesis Especializaciones (Ciencias Médicas) by Subject "Anestesia Epidural"

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    Analgesia epidural con bupivacaína en el trabajo de parto en multíparas del Hospital Vicente Corral Mosoco 1995-1996
    (1997) Washco Castro, Wilson Fabián; Auquilla Tacuri, Martha Cecilia; Andrade Iglesias, Luis Bolívar; Cárdenas Herrera, Oswaldo José; Barzallo Sacoto, Jorge Eduardo; Morales Sanmartín, Jaime Rodrigo
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    Anestesia espinal en cesárea con bupivacaína 0.5 por ciento: estudio comparativo entre la solución isobárica e hiperbárica
    (Universidad de Cuenca, 1997-11-11) Salcedo, Claus; Lema, Luis; Barzallo Sacoto, Jorge Eduardo; Morales Sanmartín, Jaime Rodrigo
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    Anestesia espinal en cesárea con bupivacaína 0.5 por ciento: estudio comparativo entre la solución isobárica e hiperbárica
    (1997) Salcedo Serrano, Claus Augusta; Lema, Luis; Barzallo Sacoto, Jorge Eduardo; Morales Sanmartín, Jaime Rodrigo
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    Bicarbonato de sodio 8,4% vs fentanilo para disminuir la latencia del bloqueo epidural con bupivacaína 0.5% en cesáreas. Hospital Vicente Corral Moscoso. 2014 - 2015
    (2016) Palacios Pérez, Galo Adrián; Araujo Astudillo,Juan Diego; Arévalo Peláez, Carlos Eduardo
    Introduction: Epidural anesthesia is a widely used technique because of its favorable operating conditions, mild respiratory depressionand gives a calmer postoperative recovery. As main disadvantage long latency time, for which the use of additives or alkalinization is recommended. Objetive: To determine the efficacy of sodium bicarbonate 8.4% vs fentanyl to decrease latency Epidural Block with Bupivacaine 0.5% in caesarean sections Materials and methods: Clinical single-blind randomized controlled trial. We randomly selected 180 patients, pregnant women, between 18 to 45 years, ASA II - III, without contraindications to epidural anesthesia for emergency cesarean section. Group A (Bupivacaine), Group B (bupivacaine / fentanyl) and Group C (Bupivacaine / Sodium Bicarbonate): Three groups were studied. Latency, sensory block, motor, and adverse hemodynamic changes were studied. Results: There were statistically significant p = 0.000 latency differences. Thus, latency for group A (Bupivacaine), average 20.42 minutes (SD: 1.29), group B (bupivacaine / fentanyl) 15.08 minutes (SD: 0.89) and group C (Bupivacaine / Sodium Bicarbonate) 8.68 minutes (DS: 0.83). Statistically significant differences in mean arterial pressure and heart rate, at 15, 30, 45 and 60 minutes but that did not compromise the life of the mother or baby; a greater number of adverse effects on the group B 88.33%, following the 31.7% group C and group A smaller proportion 3.3% Conclusions: Bupivacaine plus sodiumbicarbonate produces a shorterlatency time and fewersideeffects
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    Bloqueo motor y sensitivo en anestesia epidural con l-bupivacaína vs Bupivacaína en cesáreas. Hospital Vicente Corral Moscoso. Cuenca 2013
    (2016) Cabrera Córdova, Patricia Eugenia; Morales García, Henry Paúl; Arévalo Peláez, Carlos Eduardo
    ABSTRACT Introduction: When considering the use of a local anesthetic, it is important to think about the physiological effects, indications and contraindications of various anesthetic techniques for cesarean section. Whatever the technical and drug used, it must strive to preserve the maternal-fetal homeostasis. Objective: To compare the intensity of motor block and the duration of sensory block produced by L-bupivacaine + fentanyl vs bupivacaine + fentanyl in epidural anesthesia for cesarean sections. Material and methods: We conducted a controlled clinical study randomized single-blind study with 236 maternal divided into two equal groups. Group A (n = 118) received L-bupivacaine + 150 µg of fentanyl, group B (n = 118) received bupivacaine + 150 µg of fentanyl. Was compared in both groups immediately after surgery, the intensity of motor block with the Bromage scale in the recovery room until discharge of patients to the floor of gynecology for about two hours and duration of sensory block every ten minutes until this absence. The incidence of nausea, vomiting, hypotension and hemodynamic changes that occurred in the two groups was quantified. Expected Results: The motor block according to Bromage scale is lower with L-bupivacaine, p = 0.000; no cases of motor block 2 or 3, which was observed when 3.4% bupivacaine. A sensitive lock 5.5 hours in the group of l-bupivacaine compared with 3.8 hours in the bupivacaine group, p = 0.000 was obtained. No major differences in the two groups regarding the heart rate and side effects were observed p = 0.624. The percentage of patients who achieved a level of sensitive blockade with L-T4 bupivacaine is 72.9% compared to 54.2% in the bupivacaine group. (p = 0.011). The frequency of hypotension in the group with l-bupivacaine is 34.7% compared to 63.6% of bupivacaine group (p = 0.028). Conclusions: the use of l-bupivacaine presents better clinical indicators compared with bupivacaine for cesarean section
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    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.
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    Dosis vs volumen de 75 mb de L-bupivacaina + 100 mcg de fentanil en anestesia epidural para cesárea. Hospitales José Carrasco y Vicente Corral, Cuenca 2009
    (2010) Morocho Malla, Rosa Balbina; Vega Crespo, Bernardo José; Orellana Cabrera, Iván Eladio
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    Localización del espacio epidural mediante una variante del signo de Gutiérrez, Hospitales Vicente Corral Moscoso y José Carrasco Arteaga Cuenca, 2012
    (2013) Oleas Vivar, Lilian Eliana; Gárate Osorio, Germania Yolanda; Morocho Malla, Manuel Ismael
    Background. In regional anesthesia epidural space identification is a procedure that requires refined skills. Some devices have attempted to facilitate the approach, but the main difficulty has been the widespread use. Recently it has been reported the usefulness of a stopcock which placed in the drum of the Tuohy needle becomes a variation of the pendant drop. Objective. To determine the usefulness of a variant of the technique of hanging drop Gutierrez to identify the epidural space. Material and methods. With simple random sampling 155 patients scheduled for lower body surgery under epidural anesthesia were included . A variant of the hanging drop was used Gutierrez through a stopcock attached to the drum of the Tuohy needle 18G to identify the epidural space. Was considered as a sign of correct identification of the epidural space to absorption of anesthetic vertical branch of the device and the percentage of success was measured. Results. The age of the sample was 33.9 ± 14.6 years old (18-75 years). The weight was 33.9 ± 14.6 kg (50-98 kg) and height 1.59 ± 0.6 m. Normal weight was found in 40%, overweight in 39.4% and obesity in 20.6 %. Space was located correctly in 98.1% of cases with an error of 1.9%. Compared to 18% error reported with classical technique Gutiérrez the difference was highly significant (P = 0.0004) Discussion. The correct localization of the epidural space with a simple and easy device management is emerging as getting a fully valid alternative especially for anesthesiologist in training. KEYWORDS. EPIDURAL ANESTHESIA, PENDANT DROP GUTIERREZ, VICENTE CORRAL MOSCOSA HOSPITAL: JOSE CARRASCO ARTEAGA HOSPITAL; CUENCA – ECUADOR
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