Fredy Ariza Cadena

Estrategias para disminuir los eventos adversos más frecuentes relacionados con bloqueadores neuromusculares

Neuromuscular blocking agents are without doubt the drugs most frequently associated with perioperative adverse events in anesthesia. Acknowledging and treating those patients at high risk of developing unexpected events caused by the administration of these agents should become a routine for the perioperative medicine specialist. This article is a reflection on simple pharmacokinetics and pharmacodynamics for improved safety in the administration of NMBs by the anesthesiologist. Preserving internal homeostasis, thermoprotection and securing microcirculation are key strategies for reducing events such as postoperative residual curarization. Furthermore, a right clinical approach to patients at high risk of developing NMBrelated hypersensitivity reactions enables a safe and comprehensive management of the patient, avoiding subsequent and more severe or even fatal events.

Anestesia espinal con levobupivacaína hiperbárica al 0,75 % para artroscopia ambulatoria de rodilla: estudio aleatorio doble ciego que compara tres dosis diferentes

Metodos. 180 pacientes ASA I-II entre 18 y 60 anos programados para artroscopia unilateral de rodilla fueron aleatorizados prospectivamente a recibir 7,5 mg (n = 59), 9,37 mg (n = 61) y 11,25 mg (n = 60) de LBPH al 0,75 %, a traves de una aguja Whitacre 27-gauge, y fueron dejados en decubito lateral por cinco minutos. Un observador independiente evaluo el nivel de bloqueo motor y sensitivo luego del retorno a la posicion supina, al final de la cirugia y cada diez minutos en UCPA hasta el alta.