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[Resumen] Introducción y Objetivo. La cantidad de procedimientos mínimamente invasivos realizados fuera del quirófano ha crecido en las últimas décadas. La sedación, la analgesia o ambas, pueden ser nece- sarias para muchos de estos procedimientos de intervención o diagnóstico. Sin embargo, y hasta donde hemos podido conocer, no hay experiencia en el uso de sedoanalgesia para procedimientos (SAP) en pacientes con quemaduras faciales que necesitan desbridamiento enzimático El objetivo de este trabajo es evaluar la eficacia y la seguridad de la SAP para el control del dolor en pacientes con quemaduras faciales sometidos a tratamiento con desbridamiento enzimático. Material y Método. Describimos 16 casos de pacientes adultos con quemaduras en cara y cuello que necesitaron desbridamiento enzimático. Cuatro pacientes sin ventilación mecánica fueron tratados con SAP. Resultados. La SAP generalmente requiere combinación de múltiples agentes para alcanzar los efectos deseados de analgesia más ansiolisis. El procedimiento fue bien tolerado y los pacientes no sufrieron complicaciones. Conclusiones. Presentamos la SAP como opción para el desbridamiento enzimático de quemaduras faciales en pacientes adultos sin ventilación mecánica. [Abstract] Background and Objective. The number of minimally invasive procedures performed outside of the operating room has grown exponentially over the last several decades. Sedation, analgesia, or both may be needed for many of these interventional or diagnostic procedures. However, to our knowledge, there is no experience on the use of procedural sedation analgesia (PSA) in patients with facial burns who need enzymatic debridement. The aim of this study is to assess the effectiveness and safety of PSA for pain relief in patients with facial burns undergoing enzymatic debridement. Methods. We describe 16 cases of adult patients with burns on the face and neck who needed enzymatic debridement. Four patients without mechanical ventilation were treated with PSA. The procedure was well tolerated and the patients did not suffer complications Results. PSA usually requires combinations of multiple agents to reach desired effects of analgesia plus anxiolysis. The procedure was well tolerated and the patients did not suffer complications. Conclusions. PSA can be an option for enzymatic debridement of facial burns in adults patients without mechanical ventilation.

Spinal cord injuries (SCIs) often lead to impairment of the respiratory system and, consequently, restrictive respiratory changes. Paresis or paralysis of the respiratory muscles can lead to respiratory insufficiency, which is dependent on the level and completeness of the injury. Respiratory complications include hypoventilation, a reduction in surfactant production, mucus plugging, atelectasis, and pneumonia. Vital capacity (VC) is an indicator of overall pulmonary function; patients with severely impaired VC may require assisted ventilation. It is best to proceed with intubation under controlled circumstances rather than waiting until the condition becomes an emergency. Mechanical ventilation can adversely affect the structure and function of the diaphragm. Early tracheostomy following short orotracheal intubation is probably beneficial in selected patients. Weaning should start as soon as possible, and the best modality is progressive ventilator-free breathing (PVFB). Appropriate candidates can sometimes be freed from mechanical ventilation by electrical stimulation. Respiratory muscle training regimens may improve patients’ inspiratory function following a SCI.