Natalia Bello-Caraballo, Joaquín Cogo-Pagella, O. Iodice, Claudio Cervino
{"title":"Efectos de la combinación de melatonina con clorhidrato de ketamina sobre regímenes estándar de anestesia en ratas","authors":"Natalia Bello-Caraballo, Joaquín Cogo-Pagella, O. Iodice, Claudio Cervino","doi":"10.24875/RAA.18000022","DOIUrl":"https://doi.org/10.24875/RAA.18000022","url":null,"abstract":"Aim: Assess melatonin administration as an anaesthetic agent and establish whether combining this drug can decrease the required dosage of ketamine and/or enhance its effects. Materials and methods: Single and combined doses of melatonin (15 to 100 mg/kg) and ketamine (35, 50 and 70 mg/kg) are tested in 54 rats. Duration and depth of anaesthesia are assessed through recording righting and withdrawal reflexes. Four intervals of anaesthesia are defined (induction, general, surgical and full recovery). Results: Nine treatments are tested: (a) control and doses of 15 mg/kg melatonin and 35 mg/kg ketamine do not produce anaesthetic effects; (b) doses of 50 and 70 mg/kg ketamine and combination melatonin-ketamine 15 + 50 mg/kg effects of melatonin are verified. These effects are enhanced when combined with ketamine. Our results are compared with those obtained with combinations of ketamine and other anaesthetic drugs. The possible effect of the ketamine-melatonin combination on the GABAergic system and the NMDA receptors for glutamate is discussed. Conclusion: The melatonin-ketamine combination causes a rapid onset of anaesthesia and prolongs the effect of ketamine alone in rats. So, this study suggests that melatonin modulates mechanisms involved in the induction of anaesthesia by ketamine.","PeriodicalId":351025,"journal":{"name":"Revista Argentina de Anestesiologia","volume":"188 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121849576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Burnout (síndrome de desgaste profesional) en médicos residentes de anestesiología y su relación con la percepción del clima educacional","authors":"L. Neculpán, M. Bruno","doi":"10.24875/RAA.18000021","DOIUrl":"https://doi.org/10.24875/RAA.18000021","url":null,"abstract":"Introducción: El clima educacional (CE) influye en la motivación de los estudiantes, en la disposición hacia el estudio y en el rendimiento académico. El burnout es una respuesta prolongada a factores estresantes emocionales e interpersonales crónicos en las organizaciones de trabajo. Los médicos residentes son una población de riesgo para el desarrollo de burnout. Objetivos: Evaluar el CE y su relación con el burnout en médicos residentes de anestesiología. Materiales y métodos: El estudio se realizó durante el 2.o Encuentro Internacional de Residentes de Anestesiología, organizado por la Federación Argentina de Asociaciones de Analgesia, Anestesia y Reanimación. Se diseñó un estudio analítico de corte transversal. Las variables a analizar fueron: sexo, año de residencia, percepción del CE (cuestionario Postgraduate Hospital Education Environment Measure) y el burnout (cuestionario Maslach Burnout Inventory). Resultados: Respondieron 80 residentes (10% del total del país). La media del CE fue de 95.5/160 (clima más positivo que negativo, con aspectos a mejorar). Hubo una prevalencia de burnout del 20%. Existe una asociación estadísticamente significativa entre burnout y una peor percepción del CE (T: 3.51; p=0.0025). Los varones son el grupo más afectado por el burnout (x2:4.88; p = 0.027). Discusión: Los trabajos acerca del CE y el burnout realizados con el mismo instrumento arrojan resultados similares en otras especialidades. Se requieren trabajos prospectivos para evaluar intervenciones que mejoren el CE y el burnout. Conclusiones: Existe una asociación significativa entre el burnout y una peor percepción del CE en los médicos residentes de anestesiología participantes del estudio.","PeriodicalId":351025,"journal":{"name":"Revista Argentina de Anestesiologia","volume":"107 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133196740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cristina Monteserín-Matesanz, J. Gonzalez-Cantero, Francisco Gonzalez-Moraga, G. Sánchez-Pedrosa, M. Lema-Tome, Francisco J. Sanz-Fernández, I. Garutti-Martínez
{"title":"Guidelines for perioperative management of apixaban. Can we trust them?","authors":"Cristina Monteserín-Matesanz, J. Gonzalez-Cantero, Francisco Gonzalez-Moraga, G. Sánchez-Pedrosa, M. Lema-Tome, Francisco J. Sanz-Fernández, I. Garutti-Martínez","doi":"10.24875/RAA.18000009","DOIUrl":"https://doi.org/10.24875/RAA.18000009","url":null,"abstract":"","PeriodicalId":351025,"journal":{"name":"Revista Argentina de Anestesiologia","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116250013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Carlos Andrés Cortés-Samacá, Héctor Julio Meléndez-Flórez, Saúl Álvarez-Robles, Sonia M. Vivas-García, Andrea J. Castillo-Niño
{"title":"Trauma vascular y depuración de lactato como predictor determinante de mortalidad. Reporte de caso","authors":"Carlos Andrés Cortés-Samacá, Héctor Julio Meléndez-Flórez, Saúl Álvarez-Robles, Sonia M. Vivas-García, Andrea J. Castillo-Niño","doi":"10.24875/RAA.19000003","DOIUrl":"https://doi.org/10.24875/RAA.19000003","url":null,"abstract":"lesión vascular, una medición de lactato sérico, control de y Poste-riormente se diagnosticó una lesión vascular, y fue llevado a exploración vascular de vasos subclavios más arteriotomía por hallazgo de vasoespasmo en la arteria axilar con trombo in situ y rafia de la arteria subclavia. Conclusiones: La medición seriada del lactato sérico y su rápida depuración en las primeras horas del evento predice exitosamente una baja probabilidad de morbimortalidad a pesar de las características y la gravedad del trauma. Palabras clave: Trauma. Depuración de lactato. Lactato. Lesión vascular. Abstract Introduction: The serial measurement of serum lactate is essential for monitoring the therapeutic response of initial resuscitation and damage control in patients with vascular trauma, as well as a predictor of morbidity and mortality. Case report: We present a 25-year-old male patient who suffers trauma due to knife wound in the thorax with vascular injury, in whom a serial measurement of serum lactate, damage control and resuscitation was performed; subsequently, a vascular lesion was diag-nosed, and vascular exploration of the subclavian vessels + arteriotomy was carried out due to the finding of vasospasm in the axillary artery with in situ thrombus and subclavian artery raffia. Conclusions: The serial measurement of serum lactate and its rapid clearance in the first hours of the event successfully predicts a low probability of morbidity and mortality despite the characteristics and severity of the trauma.","PeriodicalId":351025,"journal":{"name":"Revista Argentina de Anestesiologia","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125226497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}