RESUMEN
A case is reported of autoimmune thrombocytopenic purpura in a narcotics addict with antibodies against human immune deficiency virus (HIV). Three points need stressing: 1) HIV is a new viral cause of autoimmune thrombocytopenic purpura, the first report of which dates from 1985; 2) this bleeding diathesis may be seen more often in normal anaesthetic practice because of the frequent association of intravenous toxicomania with anti-HIV antibodies and thrombocytopaenia. Thus, of the thirty cases detected in two years and followed by our Department of haematology, two were operated on in the orthopaedic unit; 3) the use of intravenous human gammaglobulins is of great interest each time the clinical situation requires a rapid increase in the platelet count, such as before surgery. The usual dose is 400 mg . kg-1 . j-1 for five consecutive days. The response to immunoglobulins is seen in two or three days; their efficacy, in the case described, lasted for five to seven days, this including the postoperative time. Booster doses were followed by a quick increase in platelet count.
Asunto(s)
Complejo Relacionado con el SIDA/complicaciones , Enfermedades Autoinmunes/terapia , Fracturas de Cadera/cirugía , Inmunización Pasiva , Púrpura Trombocitopénica/terapia , Adulto , VIH/inmunología , Dependencia de Heroína , Humanos , Masculino , Cuidados Preoperatorios , EsplenectomíaRESUMEN
The properties of propofol in emulsion given by continuous intravenous infusion to spontaneously breathing patients have been well studied. Thirty randomized voluntary premedicated patients undergoing dental extraction were anaesthetized with propofol (2.5 mg X kg-1 IVD, and 9 mg X kg-1 X h-1) or with propanidid (9 mg X kg-1 IVD, and 60 mg X kg-1 X h-1), supplemented with nitrous oxide in oxygen and fentanyl. Induction, maintenance and recovery times had the same characteristics. Highly significant differences occurred between the two groups regarding the increase in heart rate, apnoea and recovery time. This study showed that propofol was an eminently suitable agent for continuous intravenous anaesthesia in spontaneously breathing patients for dental surgery.
Asunto(s)
Anestesia Dental , Anestesia Intravenosa , Anestésicos , Fenoles , Propanidida , Extracción Dental , Adolescente , Adulto , Periodo de Recuperación de la Anestesia , Ensayos Clínicos como Asunto , Femenino , Hemodinámica/efectos de los fármacos , Humanos , Masculino , Persona de Mediana Edad , Propofol , Factores de TiempoAsunto(s)
Cateterismo , Mano/irrigación sanguínea , Anestesia , Aneurisma/etiología , Arterias , Cateterismo/efectos adversos , Cateterismo/métodos , Cuidados Críticos , Embolia/etiología , Humanos , Infecciones/etiología , Periodo Intraoperatorio , Pletismografía , Trombosis/etiología , UltrasonidoRESUMEN
Mönckeberg's sclerosis is characterized by medial arterial calcifications. This disease usually occurs in old people and the lesions are observed in distal lower limb arteries. The evolution is generally asymptomatic. The other arteries are uncommonly affected. This report concerns a patient with exceptionally extensive disease and simultaneous asymptomatic arterial hypertension. Blood pressure measured non invasively represents the force required to compress the brachial artery, and not the real blood pressure. In such patients, blood pressure should be monitored during anaesthesia through arterial cannulation.