Sistema Regional de Información
en línea para Revistas Científicas de América Latina,
el Caribe, España y Portugal

Introduction: Suspension of the surgical intervention is a situation that causes inconveniences, goes against optimizing activities, reducing costs, avoiding loss of materials and developing the work with the highest quality.Objective: To describe the main causes for the suspension of elective surgery for eligible patients.Methods: A cross-sectional and descriptive study was carried out at Dr. Juan Bruno Zayas Alfonso General Teaching Hospital in Santiago de Cuba, in the period from September 2017 to September 2018. From a population of 4511 announced surgeries, a sample of 1289 patients was taken, who were interrupted for surgery during the anesthesia consultation and in the immediate preoperative period.Results: The specialty of general surgery presents the highest indicator (26.9%) of the total number of suspensions during consultation; thus, of the 798 suspensions during consultation, 476 (59.6%) were due to patients, and 341 were due to medical causes (42.7%), that is, more than half of the suspensions owed to clinical alterations. The hospital was attributed 386 suspensions, accounting for 29.9% of the total.Conclusions: The incidence of anesthetic-surgical suspensions is high both during anesthesiology consultation and in the immediate preoperative period. These, together with the causes related to the patient, constitute the most relevant medical-assistance practical experience and must be taken into consideration by the acting anesthesiologist, mainly in the presence of patients suffering from cardiovascular comorbidities. 

Introduction: Headache after dura mater puncture is a complication described together with the first neuraxial anesthesia. It is a complex clinical picture that improves rapidly with adequate therapy, but sometimes persists despite the efforts made by the medical team in charge of treating it.Objective: To describe the clinical evolution of case of postdural puncture headache.Discussion: A case is presented of a patient who, following subarachnoid anesthesia for hallux varus surgery, suffered postdural puncture headache that persisted for more than eighteen days, despite the treatments used, both conservative (pharmacological therapy, hydration, rest) and interventionist (peridural hemopatch and water mattress, with dextran 40). The clinical picture disappeared by itself after the time previously discussed.Conclusions: It is concluded that this clinical picture caused by the dura mater puncture is of rapid resolution if treated appropriately, but there are cases in which, despite the indicated therapy, it may persist for a longer time. Keywords: headache; dural puncture; spinal anesthesia; hemopatch.

Introduction: Cranioencephalic trauma corresponds to changes and alterations suffered by the brain, its meningeal envelopes, the cranial vault, or the epicranial soft tissues due to the action of damaging physical agents.Objective: To identify modifiable and nonmodifiable risk factors that determine mortality in the immediate postoperative period among patients with acute head trauma.Methods: A prospective and longitudinal descriptive study was carried out with a sample of 38 patients who received surgery for head trauma, treated at Manuel Ascunce Domenech University Hospital, from 2016 to 2019. We worked with the following variables: age, sex, physical state, classification of cranioencephalic trauma, immediate complications, and mortality in the immediate postoperative period.Results: Surgical head trauma was frequent among young male patients who were evaluated as ASA-III. Patients with mild trauma, according to the Glasgow scale, predominated. Despite not having a significant association with mortality, cerebral edema, hyperglycemia and hypothermia were the most frequently found complications.Conclusions: Surgical head trauma was more frequent among young patients. Despite the complications presented, most of them left the emergency service alive.

Introduction:Anesthesia administration techniques in thoracic surgery have undergone great evolution and greater scientific foundation. Total intravenous anesthesia based on analgesia favors the perioperative period without pain and recovery without complications.Objective:To compare the effectiveness and safety of two techniques of total intravenous anesthesia in elective thoracic surgery with remifentanil as an analgesic base.Methods:Prospective and causiexperimental study carried out at Dr. Salvador Allende Clinical-Surgical Teaching Hospital, in the period from January 2013 to January 2015, with 45 patients scheduled for elective thoracic surgery, who were divided into two groups according to the hypnotic drug used. Group A: propofol/remifentanil, and group B: midazolam/remifentanil. Hemodynamic variables were evaluated at different times during the intraoperative period. Oxygenation variables (PaO2 and SaO2) during unipulmonary ventilation and anesthetic recovery times.Results:Patients older than 60 years predominated in the two groups, with a physical status of ASA III. There were no differences in arterial oxygenation between the groups. There was a decrease in systolic blood pressure in group A without significant differences. The recovery of anesthesia was significantly more delayed in group B.Conclusions:The total intravenous anesthesia technique with remifentanil as an analgesic base associated with propofol was safe and effective in patients undergoing thoracic surgery.Keywords:  intravenous total anesthesia; remifentanil; propofol; midazolam; elective thoracic surgery. 

Introduction:Cancer is the second cause of death worldwide and in Cuba. Its treatment strategy involves oncospecific drugs and surgery. Every day, the number of patients who undergo surgery increases, which leads to a perioperative period and the administration of multiple anesthetic medications.Objective:To describe the main factors related to anesthesia and that, during the perioperative period, influence oncological recurrence.Development:Surgical stress and general anesthesia, with the subsequent neuroendocrine and inflammatory response, by themselves, limit the immune response and alter the balance between the metastatic potential of the tumor and the antimetastatic defense, which represents a plausible mechanism for increased metastasis and oncological relapse.Conclusions:The proliferation of cancer and tumor relapse in the surgical context associated with anesthesia is a relatively new issue and it is therefore necessary to carry out studies with greater scope that validate this phenomenon. However, the immunosuppressive effect produced by perioperative stress, as well as anesthetic drugs such as opioids and halogenated drugs, can be the key to explaining this phenomenon. Total intravenous opioid-free general anesthesia and adequate regional analgesia contribute to diminish this effect. Keywords: cancer; relapse; metastasis; immunosuppression; opioid-free. 

Introduction:The development of computer and communication technologies, together with the need for the computerization of the medical teaching process and the role that electronic textbooks should have in postgraduate training, constitutes a motivation for creating didactic means that support the appropriation of knowledge by future Anesthesiology and Reanimation specialists.Objective:To determine the need to introduce a textbook in electronic format into the teaching of Anesthesiology, as a teaching aid capable of contributing to the training of a specialist with knowledge.Methods:For the justification of the proposal and the determination of its components and characteristics, theoretical and empirical methods were used, such as documentary analysis, the system approach, modeling, the interview, and surveys. These methods allowed the diagnosis of the situation, the preparation of the proposal, and proposal’s implementation.Conclusions:Computerization of the postgraduate teaching process is enhanced and continuously improved through the use of electronic textbooks, which can be a solution to the contradiction manifested in the didactic use of these aids, as well as selective and intentional reading of specific contents, and the pleasant and diverse encounter with the preferred reading or material shared at any time or place.Keywords:   medical teaching; computerization; virtualization; electronic book; pain; postgraduate.

Abstract Introduction: Cerebrovascular accident is one of the commonest causes of mortality in the world.Objective: To determine the association between development of neurological disorders and the need for mechanical ventilation with an increased incidence of mortality in the intensive care unit.Methods: An observational, prospective and cross-sectional study was carried out in the intensive care unit of a secondary care hospital. The study population consisted of 52 patients with cerebrovascular accident who received artificial respiratory support between 2018 and 2020. The final variable of interest was mortality. The neurological factors studied were type of cerebrovascular accident, score according to the Glasgow coma scale, absence of brainstem reflexes, anisocoria, and neurological complications. The level of significance was determined according to P ≤ 0.05, through chi-square of independence.Results: Proportional mortality prevailed in hemorrhagic cerebrovascular accident of nontraumatic intracranial hemorrhage type (P=0.118), absence of brainstem reflexes (P=0.000), anisocoria (P=0.000), score of less than eight points according to the Glasgow coma scale (P=0.000), and neurological complications such as endocranial hypertension (P=0.010).Conclusions: The neurological factors associated with mortality were absence of brainstem reflexes, anisocoria, score of less than eight points according to the Glasgow coma scale, and neurological complications such as endocranial hypertension. Keywords: cerebrovascular accident; neurological complications; neurological factors; intracranial hemorrhage; artificial mechanical ventilation; mortality.  

Introduction: Ischemic heart disease is frequent, has different manifestation forms, and predominates among diseases leading to patient admission into emergency units and hospital admissions in general.Objective: To deepen the knowledge of patients with ischemic heart disease in a municipal intensive care unit.Method: A descriptive and cross-sectional study was carried out of 528 patients who were admitted into the intensive care unit of Orlando Pantoja Tamayo General Teaching Hospital in Contramaestre Municipality, Santiago de Cuba, with a diagnosis of ischemic heart disease, from January 2016 to June of 2019. The variables used were age group, sex, diagnosis at admission, personal pathological history, hospital stay, and status at discharge. We used percentage to summarize the information, as well as the chi-square test to identify statistical association.Results: There was a predominance of males and ages between 60-70 and 36-59 years. Acute myocardial infarction and the combination of three or more risk factors were more frequent. The highest number of deaths occurred in the first three days after admission and among patients with invasive mechanical ventilation.Conclusions: The characteristics of cardiovascular diseases continues to be a major health concern, as long as they are appearing at increasingly earlier ages. In severe cases, mortality can occur in the first seventy-two hours.