Browsing by Author "Lacassie, Hector J."

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    Behavioural testing and histological assessments of rabbit spinal cord following intrathecal administration of ondansetron
    (WILEY, 2006) Lacassie, Hector J.; Schultz, John R.; Cummings, Thomas J.; Morris, Richard; Trasti, Scott L.; Reynolds, James D.
    Intrathecal injection of ondansetron has the potential to reduce opioid-related side-effects. The aim of the present study was to determine whether this route of administration produces neuraxial injury.
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    Dexamethasone for postoperative nausea and vomiting prophylaxis: effect on glycaemia in obese patients with impaired glucose tolerance
    (LIPPINCOTT WILLIAMS & WILKINS, 2009) Nazar, Claudio E.; Lacassie, Hector J.; Lopez, Rodrigo A.; Munoz, Hernan R.
    Background and objective Dexamethasone given to prevent postoperative nausea and vomiting may produce significant hyperglycaemia in the perioperative period. effect of dexamethasone on patients with impaired tolerance is unknown.
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    Intraoperative Fascial Plane Blocks Facilitate Earlier Tracheal Extubation and Intensive Care Unit Discharge After Cardiac Surgery: A Retrospective Cohort Analysis
    (2023) Revollo, Shirley O.; Echevarria, Ghislaine C.; Fullerton, Demian; Ramirez, Ignacio; Farias, Jorge; Lagos, Rodrigo; Lacassie, Hector J.
    Objectives: Novel fascial plane blocks may allow early tracheal extubation and discharge from the intensive care unit (ICU). The present study primarily aimed to determine whether fascial plane blocks, in comparison with intravenous analgesia alone, significantly shortened tracheal extu-bation times in patients undergoing cardiac surgery. The secondary objectives were to compare each block's performance with that of intrave-nous analgesia alone in terms of the individual tracheal extubation time and length of ICU stay.Design: Retrospective observational study.Setting: Single-center study.Participants: Patients who underwent cardiac surgery between 2018 and 2019 were identified from a prospective clinical registry. After obtain-ing ethics approval, the clinical and electronic records of patients undergoing cardiac surgery in 2018 were analyzed. Data of patients receiving fascial plane blocks (erector spinae plane [ESP], pectoral plane I and II [PECs], and serratus anterior plane [SAP] blocks) with intravenous anal-gesia were compared with those of patients receiving only intravenous analgesia. A propensity score (PS) model was used to control for differen-ces in the baseline characteristics. Adjusted p < 0.05 was considered statistically significant.Measurements and Main Results: Of the 589 patients screened, 532 met the inclusion criteria; 404 received a fascial plane block. After PS matching, weighted linear regression revealed that by receiving a block, the predicted extubation time difference was 9.29 hours (b coefficient; 95% CI:-11.98,-6.60; p = 0.022). Similar results were obtained using PS weighting, with a reduction of 7.82 hours (b coefficient; 95% CI:-11.89,-3.75; p < 0.001) in favor of the block. In the fascial-plane-block group, ESP block achieved the best performance. The length of ICU stay decreased by 1.1 days (b coefficient; 95% CI:-1.43,-0.79; p = 0.0001) in the block group. No complications were reported.Conclusions: Fascial plane block is associated with reduced extubation times and lengths of ICU stay. ESP block achieved the best performance, followed by PECs and SAP blocks. After PS matching, only ESP block reduced the extubation time.(c) 2022 Elsevier Inc. All rights reserved.
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    Motor blocking minimum local anesthetic concentrations of bupivacaine, levobupivacaine, and ropivacaine in Labor
    (W B SAUNDERS CO-ELSEVIER INC, 2007) Lacassie, Hector J.; Habib, Ashraf S.; Lacassie, Hector P.; Columb, Malachy O.
    Background and objectives: Adequate comparison of blocking capabilities of local anesthetics should be done with some knowledge of their relative potencies. The objective of this clinical trial was to simultaneously determine the motor blocking minimum local anesthetic concentrations (MMLAC) and the relative potency ratios for racemic bupivacaine, levobupivacaine, and ropivacame during labor.
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    Vasoactive drugs for the management of maternal arterial hypotension after spinal anesthesia for cesarean section. An updated integrative narrative review
    (2024) Astete, Martin; Lorena Basso, V; Lacassie, Hector J.
    Spinal neuraxial anesthesia remains the technique of choice due to its large number of maternal-fetal advantages over general anesthesia. However, its adverse effects, such as hypotension, nausea and vomiting continue to represent an important source of morbimortality and a challenge for anesthesiologists. Currently, there are different strategies for its prevention and management, vasoactive drugs being one of the mainstay treatments. In recent years different pharmacological alternatives and administration schemes have emerged in hopes of finding the ideal one and ending this dilemma. The objective of this integrative narrative review is to provide an update on vasoactive drugs used in cesarean section with the latest available evidence. To date, norepinephrine seems to achieve hemodynamic stability with a lower rate of maternal-fetal complications in patients without other associated complications.