Browsing by Author "Valladares Pérez, Salvador Rubén"

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    Effects of hypotensive anesthesia compared to normotensive anesthesia in orthognathic surgeryEfectos de la anestesia hipotensora comparada con la anestesia normotensora en cirugía ortognática
    (2024) Dallaserra Albertini, Matías; Vargas Buratovic Juan Pablo; Campolo González, Andrés Francisco; Ríos Espósito, Nicolás; Nazar Jara, Claudio; Valladares Pérez, Salvador Rubén; Ortuño Borroto, Duniel
    Introduction: Orthognathic surgery is widely accepted for correcting dentofacial deformities. Due to the rich blood supply in the head and neck region, considerable bleeding can occur from the incised soft tissues and bone during orthognathic surgery. Hypotensive anesthesia is a method used in surgical practice by which blood pressure is decreased predictably and deliberately to reduce blood loss and improve surgical field. However, there is still uncertainty regarding its effectiveness and safety in orthognathic surgery. Methods: We searched in Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis, and generated a summary of findings table using the GRADE approach. Results and Conclusions: We identified three systematic reviews, including 11 studies overall, which are randomized trials. We concluded that hypotensive anesthesia may reduce intraoperative blood loss and may improve the quality of surgical field, however, the certainty of the evidence has been assessed as low. On the other hand, orthognathic surgery with HA may make little or no difference in surgical time (low certainty evidence). Finally, no studies were found that reported adverse effects or mortality.Introducción: La cirugía ortognática se encuentra ampliamente aceptada para la corrección de anomalías dentofaciales. Debido al importante suministro de sangre en la región de cabeza y cuello, puede ocurrir una considerable pérdida de sangre proveniente de los tejidos duros y blandos intervenidos durante una cirugía ortognática. La anestesia hipotensiva es un método utilizado en la práctica quirúrgica mediante el cual se disminuye de manera predecible y deliberada la presión sanguínea con el fin de reducir la pérdida hemática y mejorar el campo quirúrgico. Sin embargo, aún existe incertidumbre respecto a su efectividad y seguridad en cirugía ortognática. Métodos: Realizamos una búsqueda en Epistemonikos, la mayor base de datos de revisiones sistemáticas en salud, la cual es mantenida mediante el cribado de múltiples fuentes de información, incluyendo MEDLINE, EMBASE, Cochrane, entre otras. Extrajimos los datos desde las revisiones identificadas, analizamos los datos de los estudios primarios, realizamos un metanálisis y preparamos una tabla de resumen de los resultados utilizando el método GRADE. Resultados y Conclusiones: Identificamos tres revisiones sistemáticas, que en conjunto incluyeron 11 estudios primarios, todos ensayos aleatorizados. Concluimos que la anestesia hipotensiva podría reducir la pérdida de sangre intraoperatoria y mejorar la calidad del campo quirúrgico, pero la certeza de la evidencia es baja. Por otro lado, el uso de anestesia hipotensiva podria podría resultar en poca o nula diferencia en el tiempo quirúrgico (certeza de la evidencia baja). Finalmente, no se encontraron estudios que reportaran efectos adversos o mortalidad.
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    Panoramic radiography for detection of bilateral carotid calcified atheroma: An unusual Case Report
    (2020) Bravo Valenzuela, Maximiliano Andrés; Reyes Velásquez, Javiera Grace; Valladares Pérez, Salvador Rubén
    Introduction: Atherosclerosis is a progressive inflammatory disease that can trigger serious medical consequences like acute myocardial infarction or stroke. Case Report: The purpose of this study is to report an unusual case of finding calcified atheromatous plaques in the carotid arteries bilaterally using a panoramic radiography (PR). A 75-year-old female with a morbid history, attends the Teaching Dental Clinic of the Pontifical Catholic University with complementary exams. PR showed well-definedradiopaque structures adjacent to C4. Using a Doppler ultrasound, the presence of calcified atheromas in the right and left carotid arteries were confirmed. The patient was informed of these findings and is currently under medical follow-up. Conclusion: PR is a useful complementary resource in the detection of atherosclerotic plaques of the upper carotid region