Complications during repeated tracheal intubation in the Intensive Care Unit. A prospective, observational study comparing the first intubation and the reintubation.

Background And Goal Of The Study: The goal of the study was to compare the incidence of complications, technical difficulty of intubation and physiologic pre-intubation status between the first intubation and reintubation performed on the same patient in an ICU.

Materials And Methods: The study was approved by the ethics committee of Galicia (Santiago-Lugo, code No. 2015-012).

Critically ill COVID-19 patients attended by anesthesiologists in northwestern Spain: a multicenter prospective observational study.

Background And Objectives: There are limited information on outcome, complications and treatments of critically ill COVID-19 patients requiring admission to an intensive care unit (ICU). The aim of this study is to describe the clinical ICU course, treatments used, complications and outcomes, of critically ill COVID-19 patients admitted in seven ICU in Galicia region during the 2020 March-April pandemic peak.

Methods: Between March 21 and April 19, 2020, we evaluated critically ill COVID-19 patients admitted to the ICU of Anesthesia of seven hospitals in Galicia, northwestern Spain.

Reintubation in the ICU following cardiac surgery: is it more difficult than first-time intubation in the operating room?: A prospective observational study.

Background: After cardiac surgery, a patient's trachea is usually extubated; however, 2 to 13% of cardiac surgery patients require reintubation in the ICU.

Objective: The objective of this study was to compare the initial intubation in the cardiac operating room with reintubation (if required) in the ICU following cardiac surgery.

Design: A prospective, observational study.

[Intravenous regional anesthesia with long-acting local anesthetics. An update].

Intravenous regional anesthesia is a widely used technique for brief surgical interventions, primarily on the upper limbs and less frequently, on the lower limbs. It began being used at the beginning of the 20th century, when Bier injected procaine as a local anesthetic. The technique to accomplish anesthesia has not changed much since then, although different drugs, particularly long-acting local anesthetics, such as ropivacaine and levobupivacaine in low concentrations, were introduced.

A national survey on current practice of preanaesthetic assessment in elective surgery patients in Spain.

Objective: To analyse the preanaesthetic assessment prior to elective surgery in hospitals of the Spanish National Health Care System.

Methods: A prospective cross-sectional descriptive observational survey was performed. Primary variables were patient characteristics, type of preanaesthetic evaluation and the evaluator, as well as type of support the evaluator received during patient assessment.

Paravertebral cervical nerve block in a patient suffering from a Pancoast tumor.

In patients with aggressive tumors resistant to conventional pain treatment, regional anaesthesia frequently becomes an alternative therapy. Cervical paravertebral nerve block among several access options to the brachial plexus is barely ever used. We present a case with severe shoulder and upper extremity pain owing to an expanding Pancoast tumor exhibiting compression upon the brachial plexus.

[Ruptured sinus of Valsalva aneurysm and pregnancy: what anesthetic technique should be preferred for a scheduled cesarean section?].

Sinus of Valsalva aneurysm is a rare cardiac abnormality rupture the right sinus and if ruptured open into the right ventricle or atrium. Usually silent, may cause significant hemodynamic changes. Few cases of ruptured Valsalva sinus aneurysm have been reported in the literature, and the course of this condition during pregnancy and anesthetic management have scarcely been mentioned.

Is ultrasound guidance superior to conventional nerve stimulation for coracoid infraclavicular brachial plexus block?

Background And Objectives: In different peripheral nerve blocks, it has been speculated that needle guidance by ultrasound improves onset time and success rate compared with the more frequently used nerve stimulation-guided technique. In the present study, we tested the hypothesis that ultrasound guidance improves onset time of coracoid infraclavicular brachial plexus block (IBPB) when compared with a nerve stimulation-guided technique.

Methods: Seventy patients scheduled for hand or forearm surgery were randomly assigned to receive coracoid IBPB using either ultrasound guidance (group U, n = 35), or nerve stimulation (group S, n = 35).

Two unusual cases of urinary incontinence during continuous sciatic nerve block with stimulating catheters.

One of the advantages of lower extremity peripheral nerve blocks compared with neuroaxial Neuraxial techniques is the lack of effect on urinary function. We report two cases of urinary incontinence during continuous sciatic nerve block with stimulating catheters placed using the posterior gluteal Labat approach. The two patients were able to control micturition 6 h after the catheter was removed.

Comparison of continuous infusion versus automated bolus for postoperative patient-controlled analgesia with popliteal sciatic nerve catheters.

Background: This investigation was designed to compare a new methodology of automated regular bolus with a continuous infusion of local anesthetic for continuous popliteal sciatic block; both regimens were combined with patient-controlled analgesia (PCA).

Methods: Fifty patients undergoing hallux valgus repair were randomly allocated to receive an infusion of 0.125% levobupivacaine administered through a popliteal catheter as an automated regular bolus (n = 25) or as a continuous infusion (n = 25), both combined with PCA.

Low volume and high concentration of local anesthetic is more efficacious than high volume and low concentration in Labat's sciatic nerve block: a prospective, randomized comparison.

Background: Various factors markedly affect the onset time and success rate, of peripheral nerve blockade. This prospective, randomized, double-blind study, compared a dose of mepivacaine 300 mg, in a 20 or 30 mL injection volume for sciatic nerve blockade using Labat's posterior approach.

Methods: A total of 90 patients undergoing foot surgery were randomly allocated to receive sciatic nerve block with 20 mL of 1.

A "new" automated bolus technique for continuous popliteal block: a prospective, randomized comparison with a continuous infusion technique.

Background: We designed the present, prospective, randomized, double-blind study to compare the administration of an automated intermittent bolus dose with a conventional technique of continuous infusion of local anesthetic for postoperative analgesia in continuous popliteal sciatic nerve blockade.

Methods: Forty-four patients undergoing hallux valgus repair were randomly assigned to receive either a continuous infusion of 0.125% levobupivacaine with an infusion rate of 5 mL/h (continuous infusion group, n=22) or automated bolus doses of 5 mL every hour of the same local anesthetic (automated bolus group, n=22) for 24 h.

Lower extremity nerve blocks.

Purpose Of Review: The purpose of this review is to present the most important recent studies into the clinical use of peripheral nerve blocks for anesthesia and postoperative analgesia of the lower limb surgery.

Recent Findings: There is increasing interest in lower extremity peripheral nerve blocks because of their potential advantages and concerns over interactions of centroneuraxis blocks and anticoagulants. Several authors have studied different approaches to the blockade of peripheral nerves with their advantages or disadvantages.

A prospective, randomized comparison between the popliteal and subgluteal approaches for continuous sciatic nerve block with stimulating catheters.

In this prospective, blinded study, we randomized 56 patients undergoing hallux valgus repair to receive continuous sciatic nerve block using a subgluteal (n = 28) or a posterior popliteal approach (n = 28) with a perineural stimulating catheter. Postoperatively, the stimulating catheter was connected to a patient-controlled analgesia pump with 0.0625% levobupivacaine (basal infusion rate of 3 mL/h, patient-controlled bolus dose of 3 mL, and lockout time of 20 min).

High thoracic epidural anesthesia and coronary artery disease in surgical and non-surgical patients.

Purpose Of Review: Even though high thoracic epidural anesthesia has been shown to be highly efficacious in the control of symptoms in refractory angina, its general use is still restricted. In patients who undergo coronary revascularization, however, the technique is becoming more and more popular. The present review outlines the use of high thoracic epidural anesthesia in patients with ischemic heart disease who underwent coronary revascularization in order to further reveal high thoracic epidural anesthesia's low complication rate and to analyze why physicians still refrain from using it more frequently.

What is the minimum effective volume of local anesthetic required for sciatic nerve blockade? A prospective, randomized comparison between a popliteal and a subgluteal approach.

For sciatic nerve blockade, no study has defined the optimal volume of local anesthetic required to block the nerve. The current, prospective, randomized investigation was designed to find a minimum volume of 1.5% mepivacaine required to block the sciatic nerve using the subgluteal and posterior popliteal approaches.

Does the site of injection distal to the greater trochanter make a difference in lateral sciatic nerve blockade?

Unlabelled: The two components of the sciatic nerve become more distant from one another in their course down the lower limb. This may have clinical implications if a small volume of local anesthetic is used with a single injection technique. In this prospective, randomized, double-blind study, we compared two different injection sites, 20 cm and 30 cm distal to the greater trochanter, in terms of onset time and success rate of sciatic nerve blockade after a single injection of 20 mL of 1.

Plantar flexion seems more reliable than dorsiflexion with Labat's sciatic nerve block: a prospective, randomized comparison.

Labat's classic approach to the sciatic nerve has not been able to show which motor response of the foot provides a more frequent rate of complete sensory and motor block. In this prospective, randomized, double-blind study, we compared plantar flexion with dorsiflexion with regard to onset time and efficacy of sciatic nerve block using the classic posterior approach. A total of 80 patients undergoing hallux valgus repair were randomly allocated to receive sciatic nerve block after evoked plantar flexion (n=40) or dorsiflexion (n=40).

Is a double-injection technique superior to a single injection in posterior subgluteal sciatic nerve block?

Background And Objectives: Currently, no information is available on the effects of a double-injection technique on onset time and efficacy following subgluteal sciatic nerve blockade. We hypothesized that the success rate and time to onset of subgluteal nerve block following a double-injection technique would be superior to that after a single injection.

Methods: Fifty ASA I or II patients undergoing foot or ankle surgery randomly received a single or double injection subgluteal sciatic nerve block.

Sciatic nerve block via posterior Labat approach is more efficient than lateral popliteal approach using a double-injection technique: a prospective, randomized comparison.

Background: For peripheral nerve blockade, the double-injection technique proved to be superior to a single injection in previous investigations. The current study was designed to compare onset time and efficacy of two different double-injection approaches for sciatic nerve block with 0.75% ropivacaine.

Sedation after spinal anesthesia in elderly patients: a preliminary observational study with the PSA-4000.

Purpose: Neuraxial blockade is known to have a sedative effect, decreasing the need for inhalational and iv anesthetic agents. The purpose of the present study was to quantify the sedative effect of spinal anesthesia and to determine the time of maximum sedation.

Methods: This is an observational study in which 20 unsedated patients were scheduled to undergo urologic and orthopedic surgeries under spinal anesthesia.

[Peripheral nerve block for surgical anesthesia and postoperative analgesia of the legs].

Even though peripheral nerve blocks (PNB) on the lower limb offer advantages over neuroaxial blockades and general anesthesia, their use has not been fully established. The infrequency with which PNBs are used may be due to inadequate learning, the need to make several injections, the time until onset of block, or anesthesiologists' and surgeons' lack of familiarity with the benefits of regional blocks. Interest seems to have increased in recent years, as numerous publications have focused on lower limb PNBs for surgery and postoperative analgesia.