Bibloc 2 5 Mg

[Apolonio Hicks]

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Methods: Obstructive sleep apnea (OSA) subjects treated with a monobloc or bibloc during two different time periods were identified from medical records and data were extracted. Subjects treated with either of the appliances passed the same primary examination, follow-up visits, and follow-up polygraphic examination. A 1-year clinical follow-up was made on the bibloc group.

Conclusions: The results indicate that the monobloc and bibloc appliances are equally effective but the cost of treatment over 1 year was higher with the bibloc. However, prospective randomized controlled trials are needed to adequately test the assumption that the two treatment modalities are equally effective.

Background: The clinical benefit of bibloc over monobloc appliances in treating obstructive sleep apnoea (OSA) has not been evaluated in randomized trials. We hypothesized that the two types of appliances are equally effective in treating OSA.

Patients and methods: In this multicentre, randomized, blinded, controlled, parallel-group equivalence trial, patients with OSA were randomly assigned to use either a bibloc or a monobloc appliance. One-night respiratory polygraphy without respiratory support was performed at baseline, and participants were re-examined with the appliance in place at short-term follow-up. The primary outcome was the change in the apnoea-hypopnea index (AHI). An independent person prepared a randomization list and sealed envelopes. Evaluating dentist and the biomedical analysts who evaluated the polygraphy were blinded to the choice of therapy.

Limitations: The study shows short-term results with a median time from commencing treatment to the evaluation visit of 56 days and long-term data on efficacy and harm are needed to be fully conclusive.

Introduction: lanesthsie pour la chirurgie urgente de la fracture pertrochantrienne (FPT) chez les patients haut risque anesthsique reprsente souvent un vritable challenge pour les praticiens en vue du risque periopratoire majeur. Nous rapportons notre exprience avec le bibloc ou bloc combin lombaire et sciatique plexique (BCLS) comme technique anesthsique alternative face ce type de situation.

Mthodes: une tude transversale, descriptive, monocentrique, a t mene sur une priode de 3 ans, incluant les patients haut risque anesthsique prsentant une FPT rcente. Les deux blocs nerveux taient raliss au niveau plexique selon la technique classique de neurostimulation. Un mlange de 20ml de lidocaine 2% et de bupivacaine 0,5% (50/50) a t inject au niveau de chaque bloc. Le critre dvaluation principal tait lefficacit du BCLS apprci par l'incidence dchecs de la technique anesthsique, dfinie par la ncessit de convertir en anesthsie gnrale (AG). Les critres dvaluation secondaires taient: 1) les donnes techniques de la procdure anesthsique, 2) les retentissements hmodynamiques, respiratoires et neurologiques periopratoires, et 3) les rsultats et les complications ventuelles en postopratoire.

Rsultats: trente patients ont t colligs. L'ge moyen tait de 74 10 ans. Le dlai moyen d'admission aux urgences-intervention tait de 12(5-36) heures. La dure moyenne pour la ralisation de la procdure tait de 15,20 3,45 minutes. Aucune conversion en AG na t ncessaire. Il ny avait pas de diffrences statistiquement significatives entre les diffrentes valeurs enregistres des paramtres hmodynamiques et respiratoires periopratoires (PAM, FC, SpO2) (p > 0,05). La dure de lintervention tait de 46 5 minutes. La satisfaction des chirurgiens tait de 9,7 0,1. La premire demande en antalgiques postopratoires tait aprs 8(1-24) heures. Tous les patients avaient une rcupration sensitivomotrice complte.

Conclusion: le BCLS est une alternative anesthsique pour les interventions urgentes de FPT chez les patients haut risque anesthsique: dlais opratoires rduits, efficacit anesthsique, stabilit hmodynamique et respiratoire periopratoire, absence de complications inhrentes aux autres techniques anesthsiques, passage rapide en salle de surveillance post-interventionnelle (SSPI), et analgsie postopratoire de qualit.

Introduction: emergency surgery for pertrochanteric femoral fractures (PFF) in patients at high risk of anaesthetic complications is a real challenge for surgeons due to the increased intraoperative risk. We report our experience with combined lumbar plexus-sciatic nerve block as an alternative anesthetic technique for these fractures. Methods: we conducted a three-year descriptive, single-center, cross-sectional study including patients with a history of recent pertrochanteric femoral fractures (PFF) at high risk anaesthetic complications. Combined lumbar plexus-sciatic nerve block was performed using the common neurostimulation technique. A mixture of 20ml of lidocaine 2% and bupivacaine 0.5% (50/50) was injected into each block. The primary endpoint was the effectiveness of lumbar plexus-sciatic nerve block assessed through the rates from anesthesia-related failures defined as need for conversion into general anaesthesia (GA). The secondary endpoints were: 1) anesthetic technique, 2) intraoperative hemodynamic, respiratory and neurological impairment, and 3) outcomes and potential postoperative complications.Results: the study included 30 patients. The average age of patients was 74 10 years. The average admission time in the Department of Emergency Surgery was 12(5-36) hours. The average duration of the procedure was 15.20 3.45 minutes. No conversion into GA was necessary. There were no statistically significant differences between the various recorded intraoperative hemodynamic and respiratory parameters (MAP, HR, SpO2) (p > 0,05). Surgical procedure duration was 46 5 minutes. Surgical satisfaction was 9.7 0.1. The first post-operative analgesic treatment was started after 8(1-24) hours. All patients had complete sensorimotor recovery.Conclusion: combined lumbar plexus-sciatic nerve block is an anesthetic alternative for urgent PFF surgery in patients at high risk of anaesthetic complications: reduced operative delays, anesthetic efficiency, hemodynamic and intraoperative respiratory stability, absence of complications due to other anesthetic techniques, rapid admission to recovery room, and good postoperative analgesia.

Les fractures pertrochantriennes sont trs frquentes et constituent lun des principaux problmes de sant travers le monde du fait de leur morbi-mortalit trs leve; Lanesthsie pour la chirurgie urgente de ces fractures chez les patients haut risque anesthsique reprsente souvent un vritable challenge pour les praticiens en vue du risque periopratoire majeur; La rachianesthsie a t depuis longtemps privilgie par la plupart des oprateurs comme technique anesthsique de choix pour ces interventions car elle concilie les impratifs chirurgicaux et anesthsiques.

Entre des mains exprimentes le bibloc lombaire et sciatique plexique constitue une alternative anesthsique prometteuse pour les interventions urgentes de fracture pertrochantrienne chez les patients haut risque anesthsique.

The contents of this site is intended to professionals in the field or medicine, public health, and other professionals in the biomedical field. The PAMJ and associated products are from the Pan African Medical Center for Public Health Research and Information, a Non-governmental Organization (NGO) registered with the Kenya NGO Board.

Desde septiembre de 2020 el nuevo Cdigo Tcnico de Edificacin (CTE) exige que el 50% de la energa consumida en edificios nuevos de uso residencial privado provenga de fuentes renovables. En esta situacin, los sistemas de aerotermia se convierten en una de las alternativas ms interesantes para dotar de climatizacin y ACS a una vivienda mediante una fuente de energa renovable.

Si optamos por un sistema de aerotermia, una de las primeras decisiones que tenemos que tomar es si apostamos por una bomba bibloc con lnea frigorfica o por una bomba monobloc con conexiones hidrulicas. En este artculo te contamos las diferencias entre sistemas monobloc y bibloc y te detallamos las ventajas e inconvenientes de cada uno de ellos.

En primer lugar, debes saber que ambas soluciones pueden ser adecuadas y funcionarn correctamente en cualquier situacin. Sin embargo, dependiendo del clima, el espacio del que dispongamos, la distancia que existira entre la unidad interior y exterior o las necesidades que tengamos, resultar ms apropiada una opcin o la otra.

La principal diferencia entre monobloc y bibloc es el nmero de unidades de cada uno de estos sistemas. Los sistemas bibloc se caracterizan por contar con una unidad exterior y otra interior dentro de la vivienda, mientras que en la instalacin monobloc todos los elementos se integran en un nico bloque que debe instalarse en el exterior.

Una instalacin de aerotermia con sistema monobloc se compone de una nica unidad para su instalacin en el exterior, por lo que son muy adecuadas para unifamiliares en los que el espacio no es un tema tan crtico o para situaciones que requeriran salvar grandes distancias entre la unidad interior y la exterior.

Dispone de un circuito frigorfico hermtico y solo se necesita conectar los tubos de agua de entrada y salida a las instalaciones de ACS y climatizacin de la vivienda. Por tanto, se necesita ms espacio, pero la instalacin es ms sencilla.

No es necesaria la habilitacin por parte del instalador al no haber manipulacin de gases. Igualmente, no hay riesgo de fugas, no son necesarias las revisiones para controlarlas y son sistemas ms respetuosos con el medio ambiente.

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