<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1137-6627</journal-id>
<journal-title><![CDATA[Anales del Sistema Sanitario de Navarra]]></journal-title>
<abbrev-journal-title><![CDATA[Anales Sis San Navarra]]></abbrev-journal-title>
<issn>1137-6627</issn>
<publisher>
<publisher-name><![CDATA[Gobierno de Navarra. Departamento de Salud]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1137-66272019000100013</article-id>
<article-id pub-id-type="doi">10.23938/assn.0585</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Anestesia espinal hipobara en hernia supraumbilical de gran tamaño]]></article-title>
<article-title xml:lang="en"><![CDATA[Hypobaric spinal anesthesia in a large ventral hernia]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Armendáriz-Buil]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gil-Caballero]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Guibert-Bayona]]></surname>
<given-names><![CDATA[MA]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Martín-Rubio]]></surname>
<given-names><![CDATA[AM]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Vicente de Vera-Floristán]]></surname>
<given-names><![CDATA[JM]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Río-Manterola]]></surname>
<given-names><![CDATA[J Del]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Reina Sofía Servicio de Anestesiología y Reanimación ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Spain</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital García Orcoyen Servicio de Anestesiología y Reanimación ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Spain</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>04</month>
<year>2019</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>04</month>
<year>2019</year>
</pub-date>
<volume>42</volume>
<numero>1</numero>
<fpage>93</fpage>
<lpage>96</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_arttext&amp;pid=S1137-66272019000100013&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_abstract&amp;pid=S1137-66272019000100013&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_pdf&amp;pid=S1137-66272019000100013&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen La cirugía de pared abdominal alta puede requerir anestesia general pero en los pacientes con alto riesgo de vía aérea difícil y de complicaciones respiratorias es de elección la anestesia local o regional. La anestesia espinal usada habitualmente (isobara o hiperbara) puede comprometer la función respiratoria al bloquear la metámera T6 o superiores. La anestesia espinal hipobara (AEH) a dosis bajas (3,6 cc de bupivacaína hipobara al 0,1% y 0,2 cc de fentanilo al 0,005%) consigue una analgesia suficiente con mínimo bloqueo motor. Exponemos el caso de un paciente con una hernia supraumbilical de gran tamaño, con alto riesgo de vía aérea difícil y de complicaciones respiratorias, al que se le aplicó AEH. El paciente no refirió dolor ni disnea durante la intervención, por lo que la AEH a dosis bajas es una opción a tener en cuenta en la cirugía de pared abdominal alta, pese a no haber sido descrita para este uso.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract High abdominal wall surgery may require general anesthesia but, in patients with high risk of difficult airway and respiratory complications, local or regional anesthesia is the choice whenever possible. Spinal anesthesia usually used (both isobaric and hyperbaric) could compromise the respiratory function due to blockade of the T6 metamere or higher. Hypobaric spinal anesthesia (HSA) at low doses (3.6 cc of 0.1% hypobaric bupivacaine plus 0.2 cc of 0.005% fentanyl) achieves sufficient analgesia with minimal motor blockade. We present the case of a patient with a large supraumbilical hernia with high risk of difficult airway and respiratory complications, who went through HSA. The patient did not report pain or dyspnea during the surgical procedure thus, HSA at low doses is an option to be taken into account in high abdominal wall surgery despite not having been described for this use.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Anestesia espinal]]></kwd>
<kwd lng="es"><![CDATA[Bupivacaína]]></kwd>
<kwd lng="es"><![CDATA[Hernia umbilical]]></kwd>
<kwd lng="es"><![CDATA[Hernia ventral]]></kwd>
<kwd lng="es"><![CDATA[Vía aérea]]></kwd>
<kwd lng="en"><![CDATA[Spinal anesthesia]]></kwd>
<kwd lng="en"><![CDATA[Bupivacaine]]></kwd>
<kwd lng="en"><![CDATA[Umbilical hernia]]></kwd>
<kwd lng="en"><![CDATA[Ventral hernia]]></kwd>
<kwd lng="en"><![CDATA[Airway management]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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