F. Gilsanz

Hospital Universitario La Paz

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E. Guasch

Hospital Universitario La Paz

N. Brogly

Hospital Universitario La Paz

E. Alsina

Hospital Universitario de La Princesa

R. Schiraldi

Hospital Universitario La Paz

Emilio Maseda

Hospital Universitario Quirónsalud Madrid

G. Maggi

Sapienza University of Rome

E. Gredilla

Hospital Universitario La Paz

Alejandro Suárez-de-la-Rica

Hospital Universitario de La Princesa

Eduardo Torres Alonso

Universidad Nacional Autónoma de México

E. Canser

Hospital Universitario La Paz

Cooperative Institutions

Hospital Universitario La Paz

184

Universidad Autónoma de Madrid

Hospital Universitario de La Princesa

Hospital Clínico Universitario de Valencia

Instituto de Salud Carlos III

Universidad Complutense de Madrid

Hospital Clínic de Barcelona

Hospital General Universitario Gregorio Marañón

Hospital Universitari i Politècnic La Fe

Hospital Universitario Puerta de Hierro Majadahonda

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Anesthetic management of a patient with MERRF syndrome

Pediatric Anesthesia (2005)

H. Vilela F. Fernandez Elba M Parodi F. Reinoso‐Barbero Pilar Durán

There are several specific considerations regarding anesthesia in patients with mitochondrial disease. We describe the successful administration of a combined general and epidural anesthesia with sevoflurane maintenance in a patient with myoclonic epilepsy with ragged red fibers (MERRF syndrome) scheduled for surgical treatment of bilateral clubfoot.

10.1111/j.1460-9592.2005.01384.x

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Citations (28)

Effective volumes of 1.5% mepivacaine with different sodium concentration for ultrasound guided popliteal block

Journal of Clinical Anesthesia (2017)

María Mercedes López M J Roca Calvo Azahara Sancho N. Brogly E. Guasch

Mepivacaine

10.1016/j.jclinane.2016.12.009

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Ventilación jet para la extracción de un cuerpo extraño endobronquial en un paciente con neumotórax drenado: informe de caso

Colombian Journal of Anesthesiology (2017)

Julieta Latorre N. Brogly G. Maggi Fabiola Quinteros Natalia Peña del Ser

Aunque la aspiración de cuerpos extraños es rara en adultos, requiere en algunas ocasiones la realización de una broncoscopia rígida para su extracción. El modo ventilatorio para este procedimiento es un reto, especialmente en pacientes con enfermedad pulmonar. Describimos aquí el caso de un paciente de 71 años con aspiración de un cuerpo extraño enclavado a nivel del lóbulo superior izquierdo asociado a un neumotórax contralateral. Después de insertar un tubo de tórax se extrajo el cuerpo extraño utilizando broncoscopia rígida bajo anestesia general y ventilación jet de alto flujo sin complicaciones hemodinámicas o pulmonares adicionales, sugiriendo que esta técnica es segura en pacientes con fugas pulmonares. En el presente caso clínico, la broncoscopia rígida minimizó el riesgo de aspiración de sangre y detritus gracias a la inyección de un flujo continuo de gas ascendente, y evitó así el incremento de la fuga a través del neumotórax por las presiones limitadas en la vía aérea, constituyendo una indicación clara de esta técnica. Even though foreign body aspiration (FBA) is rare in adult patients, they sometimes require the performance of rigid bronchoscopy for its extraction. Ventilation for this procedure is challenging, especially in patients with pulmonary disease. We described the case of a 71-year old man who presented with a FBA in the left upper lobe associated with a controlateral pneumothorax. After the placement of a pleural drainage, the foreign body was extracted, using rigid bronchoscopy under general anaesthesia and high flow jet ventilation with no further haemodynamic or pulmonary complications, suggesting that this technique is safe in patients with pulmonary leaks. In the case described, rigid bronchoscopy minimized the risk of aspiration of blood and detritus due to continuous flow of gas upward, and avoided the increase of the air leak through the pneumothorax thank to limited airway pressures, making it a clear indication.

10.1016/j.rca.2016.11.006

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Reasons to choose anaesthesiology: A survey among the residents of anaesthesia in Madrid (Spain)

European Journal of Anaesthesiology (2010)

E. Guasch J. C. Sanchez-Gil N. Brogly Jesús Díez‐Manglano F. Gilsanz

Regional anaesthesia

10.1097/00003643-201006121-00737

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Síndrome de Horner y bloqueo del plexo braquial ipsilateral en un caso de analgesia epidural para el trabajo del parto

Revista de la Sociedad Española del Dolor (2006)

J. Avellanosa Juan Luis Avila Vera Pedro Morillas E. Gredilla F. Gilsanz

espanolEl Sindrome de Horner es una complicacion de la anestesia epidural que aparece mas frecuentemente en pacientes obstetricas debido a los cambios fisiologicos y anatomicos propios del embarazo; sin embargo, su incidencia es baja, y solo se han descrito dos casos previos asociando un bloqueo del plexo braquial. Presentamos el caso de una gestante de 23 anos que preciso analgesia epidural para el trabajo de parto. Tras comprobar la correcta colocacion del cateter se administro una dosis inicial en bolo de 8 ml de ropivacaina 0,2% y 50 μgr de fentanilo, y se iniciσ una perfusion de ropivacaina a 0,125% y fentanilo a 1,2 μg/ml a 10 mg/h. Tras cuatro horas de perfusion, la paciente alcanza dilatacion completa y pasa a quirofano para realizar prueba de parto. Alli se administro una dosis de refuerzo por via epidural con 10 ml de ropivacaina 0,5% y 50 μg de fentanilo. A los 15 minutos, la paciente comenzo a manifestar un cuadro de disestesias en hemicara derecha y miembro superior derecho. A continuacion, estando ya la paciente en la zona de recuperacion la paciente refirio bloqueo motor y sensitivo de miembros inferiores asociado a perdida de fuerza de miembro superior derecho y ptosis palpebral, miosis con ligero enrojecimiento de ojo derecho, siendo diagnosticado como sindrome de Horner con bloqueo del plexo braquial ipsilateral, desapareciendo espontaneamente en las tres horas siguientes. EnglishHorner´s syndrome is an uncommon side effect after epidural analgesia which occurs more frecuently in pregnant women due to physiological and anatomical changes; however, it has a low incidence, and the association with ipsilateral brachial plexus block has only been published twice before. We report the case of a 23-year-old woman who required epidural analgesia for labor. After verifying correct placement of the catheter, an initial dose of 8 ml of ropivacaine 0,2% with 50 μg of fentanyl was injected. A continuous infusion of ropivacaine 0,125% with fentanyl 1,2 μg/ml was started at 10 mg/h. Four hours after the initial dose, the patient achieves complete cervical dilation and goes on to the operating room for a delivery test, receiving a new dose of 10 ml of ropivacaine 0,5% with 50 μg of fentanyl. Fifteen minutes later, the patient reported right-sided arm, chest and hemiface numbness with paresthesias. Later on, the physical examination revealed a sensory and motor blockade in the lower extremities associating right-sided ptosis, miosis, facial flush, dry skin and loss of strength on the upper right-sided extremity. The diagnose was a unilateral Horner´s syndrome with ipsilateral brachial plexus block. It spontaneously resolved over the next three hours.

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Citations (3)

Regional blocks for breast surgery: is it enough?

PubMed (2016)

Iván Huercio Alfredo Abad‐Gurumeta F. Gilsanz

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Haemodynamic changes during inhalational induction with sevoflurane in cardiac surgery

European Journal of Anaesthesiology (2000)

M. A. Santos M.J. Orts T. Carnero Luis Quecedo F. Gilsanz

European Society of Anaesthesiologists; 8th Annual Meeting with the Austrian International Congress; Vienna, Austria, 1-4 April 2000

10.1097/00003643-200000002-00191

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Conventional stepwise vs. vital capacity rapid inhalation induction at two concentrations of sevoflurane

European Journal of Anaesthesiology (2004)

R. Martín-Larrauri F. Gilsanz Juan P. Rodrigo P. Vila M. Ledesma

Background and objective: A multicentre study was conducted to compare three methods of inhalation induction with sevoflurane in adult premedicated patients. Methods: One-hundred-and-twenty-five adult patients of ASA I-II were scheduled for short elective surgical procedures (<90 min) under general anaesthesia with spontaneous ventilation of the lungs via a laryngeal mask airway. Patients were randomly assigned to one of three groups: conventional stepwise inhalation induction group (Group C) or vital capacity rapid inhalation induction groups at 4.5% (Group VC4.5) or at 8% sevoflurane (Group VC8). Before anaesthetic induction, fentanyl 1 μg kg−1 was given and the face mask applied with the anaesthetic breathing system primed with sevoflurane 4.5% or 8% in the respective vital capacity groups. Loss of eyelash reflex, time to cessation of finger tapping, laryngeal mask insertion, side-effects and adequacy of induction were recorded. Results: The time to loss of eyelash reflex was significantly shorter in both vital capacity groups vs. the control group: VC8: 68 ± 7 s; and VC4.5: 94 ± 6.5 s vs. C: 118 ± 6.4 s (P < 0.0001). Significant differences were found in all pairwise comparisons for time to cessation of tapping: Group VC8 (62 ± 7 s), Group VC4.5 (85 ± 6 s) and Group C (116 ± 6 s; P < 0.0001). The time to laryngeal mask insertion was significantly shorter in the Group VC8 (176 ± 13 s) compared with the other two groups, Group VC4.5 (219 ± 13 s) and Group C (216 ± 9 s). There were no significant differences in the incidence of side-effects between the three groups. Conclusions: Inhalation induction of anaesthesia with sevoflurane with the three techniques tested is safe, reliable and well accepted by the patients. The vital capacity rapid inhalation group primed with sevoflurane 8% was the fastest method with no relevant side-effects.

10.1097/00003643-200404000-00003

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Citations (11)

Burnout syndrome in anesthesia trainees, our experience in a tertiary university hospital

European Journal of Anaesthesiology (2014)

Juan Manuel Urbano Gálvez Kollmann A. Camaiora R. Schiraldi E. Guasch N. Brogly

Urbano, J.; Camaiora, Kollmann A.; Schiraldi, R.; Guasch, E.; Brogly, N.; Gilsanz, F. Author Information

10.1097/00003643-201406001-00736

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Trans-oesophageal Doppler-guided fluid management in massive obstetric haemorrhage

International Journal of Obstetric Anesthesia (2014)

R. Schiraldi L Calderón G. Maggi N. Brogly E. Guasch

10.1016/j.ijoa.2014.06.007

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