Fentanyl and 0,5 % bupivacaine in elderly patients with hip fracture operated on under subarachnoid anesthetic

Background: the elderly patient is at a greater risk of hemodynamic instability and anesthetic complications during the perioperative period.Objective: to describe the hemodynamic stability in the elderly operated on for hip fracture using subarachnoid anesthetic, at the Ernesto Guevara de la Serna Hospital from January through December 2015.Methods: a prospective longitudinal study was carried out at the place and during the period herein mentioned. The study universe consisted of all the elderly patients with hip fracture, who underwent surgery to correct it. The sample was made up of 47 patients with ASA 2 and 3 physical statuses, who were operated on using subarachnoid anesthetic with doses of bupivacaine, 0,5 % 8 mg plus fentanyl, 25 mcg. Descriptive statistics was used by means of percentage analysis.Results: female patients prevailed in 70,21 %; 63,82 % belonged to the 76 to 85 age group; patients with ASA 2 physical status were more frequent with 68,1 %; 87,23 % showed stability of blood pressure; heart rate remained normal in 83 %; the most common side effect was mild pruritus, which occurred in 100 % of the cases, followed by drowsiness in 74,4 %.Conclusions: most of the elderly patients who were operated on for hip fracture under subarachnoid anesthetic using the combination of fentanyl, 25 mcg plus 0,5 % bupivacaine, 8 mg showed hemodynamic stability in terms of blood pressure and heart rate. All cases reported mild facial pruritus as an adverse effect.</p

The use of ketamine-propofol in therapeutic diagnostic ambulatory colonoscopy

Background: there is no consensus among specialists as to determine the best type of sedation/analgesia for endoscopic gastrointestinal procedures.Objective: to describe the use of the combination of ketamine and propofol as inducing agents in patients who underwent therapeutic diagnostic ambulatory colonoscopy at the "Dr. Ernesto Guevara de la Serna" General Teaching Hospital of Las Tunas, between September 2016 and March 2017.Methods: a longitudinal, prospective study was carried out at the aforementioned hospital and during the period herein declared. The sample consisted of 123 patients of the 18 to 70 age group, with ASA 1 and 2 physical statuses, who underwent colonoscopy using ketofol (ketamine 0,4 mg / kg and propofol 1 mg / Kg).Results: there was prevalence of female patients in 58,53 % and of the 50 to 60 age group (35,2 %). The ASA 2 physical status was the most frequent one (55,4 %). In all patients heart rate values were within normal limits. A slight increase was observed in stage II with respect to stage I, as well as a decrease in stages III and IV, and an increase in stage V. Variation in the mean arterial pressure kept stable in stages I and II, with lower values in stages III, IV and V, without decreasing to pathological figures. At none of the studied moments oxygen desaturation occurred. Rapid anesthetic recovery predominated (79,67 %). 78,86 % of the patients did not report pain. Only sleepiness and nausea were identified as complications.Conclusions: most of the patients to whom ketamine and propofol were applied as induction agents showed hemodynamic stability in terms of blood pressure, heart rate and oxygen saturation. Only sleepiness and nausea were identified as complications.</p

Propofol-ketamine and propofol-fentanyl as anesthetic combinations in ambulatory colonoscopy

Background: the best type of sedation/analgesia for gastrointestinal endoscopic procedures is yet to be defined. Among the combinations used are ketamine at subclinical dose with propofol and propofol with fentanyl.Objective: to characterize the use of propofol-ketamine and propofol-fentanyl as inducing agents during ambulatory colonoscopy, in patients treated at the “Dr. Ernesto Guevara de la Serna” Hospital of Las Tunas, between September 2016 and December 2018.Methods: a prospective longitudinal study was carried out with patients undergoing ambulatory colonoscopy, in the aforementioned institution and during the period herein declared. The sample consisted of 300 patients of the 18 to 70 age group with ASA 1 and ASA 2 physical status. They were divided into two groups of 150, one group with anesthetic combination, randomly selected.Results: male patients predominated. The average age was 60.4 years for women and 58.6 years for men; the highest number of cases were classified as ASA 2. With propofol-fentanyl the results were: 40,67 % of patients with bradycardia, 57 % were normotensive, 23 patients (15,33 %) presented less than 94 % of oxygen saturation. With propofol-ketamine the results were: 45,33 % kept a normal heart rate, 65,3 % normotensive, 64 % with complete oxygen saturation and shorter recovery time (at 20 minutes 36 % of the patients recovered). Both anesthetic techniques caused some manifestations such as nausea, vomiting and drowsiness, to a greater extent with propofol-fentanyl.Conclusions: the use of the two anesthetic combinations was characterized in the patients who underwent colonoscopy.</p

Cell therapy in myocardial infarction

Myocardial infarction is a morbid process that initially affects the coronary arteries and results in the necrosis of a part of the heart muscle. This was the second cause of death in Cuba in 2014, and cell therapy has become a promising alternative for the treatment of this condition. Therefore, a literature review was carried out to describe the modalities of cardiac and extracardiac stem cells that allow the regeneration of this tissue in patients with myocardial infarction, by reviewing 24 bibliographical references. Although cell therapy is applied with good results, the persistence of its long-term effects are not yet fully achieved in infarcted patients. Umbilical cord cells appear to have a greater ability to repair cardiac damage than stromal stem cells, due to multiple advantages