Citas bibligráficas
Castillejo, J., (2004). Evaluación de secuencia inversa con vecuronio en pacientes sometidos a anestesia general [Tesis de segunda especialidad, Universidad Nacional Mayor de San Marcos]. https://hdl.handle.net/20.500.12672/1777
Castillejo, J., Evaluación de secuencia inversa con vecuronio en pacientes sometidos a anestesia general [Tesis de segunda especialidad]. PE: Universidad Nacional Mayor de San Marcos; 2004. https://hdl.handle.net/20.500.12672/1777
@misc{renati/473106,
title = "Evaluación de secuencia inversa con vecuronio en pacientes sometidos a anestesia general",
author = "Castillejo Correa, Julio César",
publisher = "Universidad Nacional Mayor de San Marcos",
year = "2004"
}
-- EVALUATION OF THE INVERSE SEQUENCE WITH VECURONIO IN PATIENTS SUBMITED TO GENERAL ANESTHESIA IN THE GUILLERMO ALMENARA IRIGOYEN´S HOSPITAL. Julio César Castillejo Correa Hospital NacionalGuillermo Almenara Irigoyen. UNMSM Objective: Determine how the administration sequence of Vecuronio influences in time, to reach suitable conditions for intubation in patients that receive general anesthesia. Methodology: A experimental study (clinical rehearsal), prospective, analític, longitudinal, Cohort type. The sample include 200 patients, that obeyed the inclusion criteria and they were divided at random in two groups: Group 1: normal- sequence Induction (Propofol - Vecuronio) Group 2: inverse- sequence Induction (Vecuronio - Propofol) With an observer's help that was registering the monitorization's data and another one (the same one in all cases) perform the intubation. The intubation conditions were evaluated with the Damoal's - Mehta scale modified. The endotraqueal intubation were realize according to the clinical conditions of the patient and in correlation to a peripheric- nerve stimulator with accelerometer (TOF - GUARD). We use Epi - Info 2000 program. Results: Both study groups were comparable for age, sex, physical state (ASA) and intubation conditions. The induction technique with inverse sequence (Vecuronio 0.15 mg/Kg during 20 sec, 20 sec after, Propofol applied 2 mg/Kg during 20 sec), is able to produce suitable intubation conditions in less time (28 sec average), as compared with the normal induction sequence (Propofol 2 mg/Kg during 20 sec, 20 sec after, Vecuronio applied 0.15 mg/Kg during 20 sec) that obtain suitable intubation conditions in 101sec average. A time reduction of 73% was appreciated when both sequences were compared. We obtain the less time in produce suitable intubation conditions (18 sec) in a patient of female sex, of 21 years, ASA I, that was induced with inverse sequence. We checked that with the inverse-sequence technique appears minimal hemodinamics variations (cardiac frequency, blood pressure sistolic and diastolic). The measure of the muscular relaxation by neuroestimulator (TOF), corroborated that the study's patients submit to induction with inverse sequence (56.043%) and normal sequence (58.86%), presented similar relaxation percentages, achieving the inverse-sequence group less time to reach these values. The intubation conditions not shows significant differences among both groups. All of the patients had good and excellent conditions at the moment of the intubation.. Conclusion: The inverse- sequence induction produces suitable conditions of intubation in a less time, than the induction with normal sequence, resulting this technique efficient in shortening the period among the administration of the agent of induction and the intubation (start of the relaxant's action), observing that when we administrate the complete intubation dose of the muscular relaxant before the inductor, the patient wins some seconds in the period whereon remain unconscious and without isolating airway. Key words: Inverse Sequence, normal sequence, TFIT
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