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

Introduction:Lip cancer is the most frequent tumor of the oral cavity that affects, above all, the lower lip. Brachytherapy is a unique treatment which is effective in early stages and, as adjuvant therapy to surgery, it is also effective in advanced stages. This technique is a painful process, a reason why deep sedation, intramuscular infiltrations of local anesthetic, and regional anesthesia techniques, among others, have been used.Objective:To present a different and scarcely described anesthetic technique as an alternative to reduce the pain of this intervention.Case presentation:Patient with lip carcinoma scheduled for brachytherapy. Bilateral mental nerve block is performed in the lower lip.Conclusions:This type of block, due to its simplicity and effectiveness, is a useful alternative to deep sedation for brachytherapy in the lower lip.Keywords: lip cancer; lip brachytherapy; mental nerve block. 

Introduction:Malnutrition in patients hospitalized in an intensive care room is high, but it is even higher in the critically-ill elderly patient, with repercussions on the respiratory system, prolonged ventilation, and other complications.Objective:To characterize the nutritional status of geriatric patients under mechanical ventilation in an intensive care unit.Methods:A descriptive, prospective and cross-sectional study was carried out during the period from January 2017 to March 2019, in the intensive care unit of Orlando Pantoja Tamayo General Teaching Hospital. 83 patients aged 60 or older were studied; they required mechanical ventilation for more than 24 hours. The nutritional status was evaluated with the use of the nutritional control score.Results:There was a predominance of the male sex, the age group 60-74 years, and of surgical diseases. Only 9.1% of those who received invasive mechanical ventilation were not undernourished. Those who died had moderate or severe undernutrition.Conclusions:In ventilated geriatric patients hospitalized in the intensive care unit, a high degree of malnutrition was found. Moderate or severe malnutrition predominated in the majority of those who received invasive mechanical ventilation and in the group of the deceased. Keywords:   critically-ill patient; control; mechanic ventilation; nutritional status. 

Introduction: Subarachnoid analgesia is an alternative for labor due to its safety and suitable risk-benefit relationship. Objective: To evaluate the effectiveness of analgesia during labor with the comparison of two analgesic methods. Method: A quasiexperimental, longitudinal and prospective study was carried out in 92 pregnant women who attended Abel Santamaría Cuadrado General Teaching Hospital during the period between January 2014 and January 2017. The patients were divided into two groups of 46 each, randomly assigned, in order of arrival to the surgical unit. Group A was treated with intrathecal administration of bupivacaine 0.5 %, in a dose of 2 mg, and fentanyl in a dose of 25 mcg; and group B was treated with intrathecal administration of pethidine, in a dose of 25 mg. The variables analyzed were mean arterial blood pressure, mean heart rate, partial oxygen saturation, time of onset of analgesia, analgesic quality, adverse effects and level of patient satisfaction. The descriptive analysis and the difference in proportions were used. Results: Group A maintained a mean arterial blood pressure between 84 and 88 mmHg, (Z= 6.0 significant); heart rate averages between 80 and 88 beats per minute, (Z= 1.94 not significant); partial oxygen saturation with an average of 99.2 %. In 46.74 % (43 cases) the time of onset of analgesia was short (Z= 8.47), being good in 100% of the cases (Z= 6.89 significant), with vigorous newborn in 100 % (Z= 10.25 significant). The evolution was satisfactory in 48.19 % of the patients. They presented pruritus 8.69 %. In group B, there was arterial hypertension in 2.17 % of the cases, with less stability of the heart rate, greater times of labor beginning in 12.96 % and it was good in 40.22 %. These patients showed less satisfaction (41.30 %). Conclusions: Subarachnoid administration of fentanyl/bupivacaine was more effective than pethidine for analgesia during labor.

Introduction: Peripheral nerve blocks are an accepted component in medical practice from the surgical area, chronic pain control and the postoperative period. Objective: To evaluate the efficacy of popliteal blockade laterally in patients undergoing surgery for foot and ankle conditions. Methods: A cross-sectional and analytical study was carried out with patients operated on for foot and ankle conditions in the period from September 2015 to September 2018. The study population was made up by 431 patients, and the sample was 209. Results: More than three quarters of the patients operated on for foot and ankle conditions and to which the blockage is applied are above the fifth decade of life. Most of them correspond to the range 51-70 kg, with four to six centimeters of needle depth for the location of the nerve based on the equation of the line. It is 19 times more likely in them the absence of pain at the first six hours of the postoperative period after the blockage and more likely the success of the proposed technique with the determination of the depth in centimeters of the needle based on the equation of the line, with odds ratio of 31. Conclusions: The lateral popliteal block was evaluated as effective in the majority of patients undergoing surgery for foot and ankle conditions.

Introduction:Maintaining adequate oxygenation during single-lung ventilation is a fundamental concern faced by the anesthesiologist during thoracic surgery; therefore, a constant search is maintained for the ideal anesthetic method that helps achieve this goal is maintained.Objectives:To evaluate the outcomes of two total intravenous anesthesia techniques with remifentanil and fentanyl as analgesic base and to identify the onset of complications during surgery.Methods:A prospective and quasi-experimental study was carried out at Dr. Salvador Allende Clinical-Surgical Hospital, between January 2013 and December, with 40 ASA II or III patients who required intrathoracic procedures. These were divided into two groups: A (remifentanil-propofol) and B (fentanyl-propofol). Hemodynamic variables and others of oxygenation during one-lung ventilation were studied, together with anesthetic recovery time (spontaneous ventilation, ocular opening, extubation) and postoperative analgesia.Results:There were no significant variations in the hemodynamics or oxygenation of patients with the use of both anesthetic techniques; however, awakening and short-term postoperative recovery was better in group A. Postoperative pain intensity, based on the analogue-visual scale, was lower in group B.Conclusion:Both techniques are effective for thoracic surgical procedures, with minimal effect in hemodynamics and oxygenation parameters.  Keywords:  intravenous total anesthesia; remifentanil; fentanyl.

Introduction: Post-operative pain in upper thorax and hemiabdomen surgery has a solid neuropathic component; it is therefore associated with evolution towards chronic pain. On this basis, anticonvulsants are applied as part of the multimodal treatment. Objectives: To evaluate analgesic effectiveness and safety of gabapentin for management of pain after thorax and upper abdomen surgery. Method: A quasiexperimental, comparative and prospective study was conducted with the patients announced for surgery of the upper abdomen and thorax, in the period from 2015 to 2017. Thirty patients divided into 2 groups were included. The Group G (n=14) received treatment with gabapentin 100 mg orally the day before the intervention and every 12 h in the postoperative period until 24 h. The Group C (n=16) received the conventional analgesia prescribed for this type of intervention. Results: The sample was homogeneous regarding age and sex. Pain intensity levels were lower in the gabapentin group and this difference becomes more significant 24 hours after surgery. This corresponds to a lower need for rescue analgesia (71% vs. 100%). Associated complications were more frequent in the study group at the expense of nausea, although there were no significant differences. Conclusions: The use of gabapentin in the perioperative period guarantees better pain control with few complications.