Rotational thromboelastometry assessment of ballanced crystalloid, hydroxyethyl starch and gelatin effects on coagulation: a randomized trial
Publication date: Available online 22 May 2019Source: Brazilian Journal of Anesthesiology (English Edition)Author(s): Silvie Sevcikova, Miroslav Durila, Tomas VymazalAbstractBackground and objectivesModern crystalloid and colloid solutions are balanced solutions which are increasingly used in perioperative period. However, studies investigating their negative effect on whole blood coagulation are missing, and vivid debate is going on about which solution has the minimal coagulopathy effect. The aim of our study was to assess the effect of modern fluid solutions on whole blood coagulation using rotational thromboelastometry...
Source: Brazilian Journal of Anesthesiology - May 23, 2019 Category: Anesthesiology Source Type: research

Sufentanil during anesthetic induction of remifentanil-based total intravenous anesthesia: a randomized controlled trial
Publication date: Available online 23 May 2019Source: Brazilian Journal of Anesthesiology (English Edition)Author(s): Daniel C. Menezes, Edison I.O. Vidal, Cesar M. Costa, Glenio B. Mizubuti, Anthony M.H. Ho, Guilherme A.M. Barros, Fernanda B. FukushimaAbstractBackgroundPostoperative pain represents an important concern when remifentanil is used for total intravenous anesthesia because of its ultrashort half-life. Longer acting opioids, such as sufentanil, have been used during induction of remifentanil-based total intravenous anesthesia as a means to overcome this shortcoming. However, the effectiveness and safety of such...
Source: Brazilian Journal of Anesthesiology - May 23, 2019 Category: Anesthesiology Source Type: research

Analgesia Nociception Index: assessment of acute postoperative pain
In this study we aimed to investigate the effectiveness of analgesia nociception index as a tool for acute postoperative pain assessment. Our hypothesis was that analgesia nociception index may have good correlation with Numerical Rating Scale values.MethodA total of 120 patients of American Society of Anesthesiologists (ASA) physical status I and II undergoing any surgical procedure under halogenated-based anesthesia with fentanyl or remifentanil were enrolled for the study. At the 15th minute of arrival to the Postoperative Care Unit the patients’ pain was rated on a 0–10 point Numerical Rating Scale. The pat...
Source: Brazilian Journal of Anesthesiology - May 22, 2019 Category: Anesthesiology Source Type: research

Comparison of fentanyl and dexmedetomidine as an adjuvant to bupivacaine for unilateral spinal anesthesia in lower limb surgery: a randomized trial
ConclusionsThe addition of fentanyl and dexmedetomidine to bupivacaine in unilateral spinal anesthesia can increase the duration of the motor and sensory block in dependent limb and prolong the duration of postoperative pain. However, fentanyl is more effective than dexmedetomidine.ResumoJustificativa e objetivosUma das desvantagens da raquianestesia unilateral é a curta duração da analgesia pós-operatória, que pode ser abordada pela adição de adjuvantes aos anestésicos locais. O objetivo deste estudo foi comparar os efeitos da adição de dexmedetomidina,...
Source: Brazilian Journal of Anesthesiology - May 22, 2019 Category: Anesthesiology Source Type: research

Preemptive nebulized ketamine for pain control after tonsillectomy in children: randomized controlled trial
Publication date: Available online 22 May 2019Source: Brazilian Journal of Anesthesiology (English Edition)Author(s): Hala S. Abdel-Ghaffar, Amani H. Abdel-Wahab, Mohammed M. Roushdy, Amira M.M. OsmanAbstractObjectivesThe administration of ketamine as nebulized inhalation is relatively new and studies on nebulized ketamine are scarce. We aimed to investigate the analgesic efficacy of nebulized ketamine (1 and 2 mg.kg−1) administered 30 min before general anesthesia in children undergoing elective tonsillectomy in comparison with intravenous ketamine (0.5 mg.kg−1) and saline placebo.MethodsOne hun...
Source: Brazilian Journal of Anesthesiology - May 22, 2019 Category: Anesthesiology Source Type: research

Evaluation of the neurotoxic effects of intrathecal administration of (S)-(+)-Ketoprofen on rat spinal cords: a randomized controlled experimental study
ConclusionIntrathecal (S)-(+)-Ketoprofen caused dose-dependent neurohistopathological changes in rats on days 3 and 7 after injection, suggesting that (S)-(+)-Ketoprofen should not be intrathecally administered.ResumoJustificativa e objetivosA administração intratecal de anti-inflamatórios não esteroides é mais eficaz no tratamento da dor pós-operatória. A Anti-inflamatórios não esteroides, como o (S)-(+)-cetoprofeno, pode ser eficaz em doses intratecais inferiores às parenterais; a segurança pré-clínica relativa à possí...
Source: Brazilian Journal of Anesthesiology - May 21, 2019 Category: Anesthesiology Source Type: research

Wide-Awake Local Anesthesia and No Tourniquet (WALANT) in open thumb fracture under antithrombotic therapy: overcoming an impasse
Publication date: Available online 21 May 2019Source: Brazilian Journal of Anesthesiology (English Edition)Author(s): Laurent Becuwe, Jean-Christian Sleth, Yann-Erwan Favennec, Gilles Candelier (Source: Brazilian Journal of Anesthesiology)
Source: Brazilian Journal of Anesthesiology - May 21, 2019 Category: Anesthesiology Source Type: research

Ultrasound assessment of gastric antrum in term pregnant women before elective cesarean section
Publication date: Available online 17 May 2019Source: Brazilian Journal of Anesthesiology (English Edition)Author(s): Caio Klippel Amaral, Márcio Luiz Benevides, Marília Marquioreto Benevides, Diogo Leite Sampaio, Cor Jesus Fernandes FontesAbstractBackground and objectivesPregnant women are considered patients at risk for pulmonary aspiration of gastric contents. The study aim was to evaluate the gastric antral cross-sectional area using ultrasound.MethodIn this prospective study, 85 scheduled term pregnant women underwent gastric ultrasound. The outcomes were the measurement of the gastric antral cross-secti...
Source: Brazilian Journal of Anesthesiology - May 18, 2019 Category: Anesthesiology Source Type: research

Evaluation of Bispectral Index time delay in response to anesthesia induction: an observational study
ConclusionOur results may be another indication that the delay in BIS processing may be much longer than stated by the manufacture, a fact with clinical implications.ResumoJustificativa e objetivosDe acordo com o fabricante, o índice bispectral (BIS) tem um tempo de processamento de cinco a dez segundos. Estudos que avaliaram esse tempo de processamento sugeriram atrasos mais longos. Nós avaliamos o tempo de atraso na resposta do BIS.MétodosCom base em dados clínicos de 45 pacientes, calculamos a diferença entre o tempo de atraso previsto e real do índice bispectral durante um per&...
Source: Brazilian Journal of Anesthesiology - May 17, 2019 Category: Anesthesiology Source Type: research

Airway management in Ludwig's angina: what is necessary and what is sufficient condition?
Publication date: Available online 14 May 2019Source: Brazilian Journal of Anesthesiology (English Edition)Author(s): Reza Aminnejad (Source: Brazilian Journal of Anesthesiology)
Source: Brazilian Journal of Anesthesiology - May 15, 2019 Category: Anesthesiology Source Type: research

Simulation of difficult airway management for residents: prospective comparative study
ConclusionsA 3 h procedural simulation training for difficult airway management did not improve the frequency of use of devices at 6 months by residents. However, other positive effects suggest exploring the best ratio of time/acquisition efficiency with difficult airway management simulation.ClinicalTrials.gov IdentifierNCT02470195.ResumoJustificativa e objetivosO treinamento em simulação de procedimentos para o manejo de via aérea difícil oferece oportunidades de aprendizagem. A hipótese foi que um treinamento em simulação de procedimentos de três horas, para o ...
Source: Brazilian Journal of Anesthesiology - May 15, 2019 Category: Anesthesiology Source Type: research

Development of a multivariable predictive model for postoperative nausea and vomiting after cancer surgery in adults
Publication date: Available online 13 May 2019Source: Brazilian Journal of Anesthesiology (English Edition)Author(s): Léia Alessandra Pinto Yamada, Gabriel Magalhães Nunes Guimarães, Magda Aparecida Santos Silva, Angela Maria Sousa, Hazem Adel AshmawiAbstractBackgroundPredicting postoperative nausea and vomiting risk is the cornerstone for deciding prophylaxis. Apfel's score does not define how long a person must be abstinent from smoking to be considered a non-smoker, and the use of intraoperative spinal opioids as a risk factor for predicting postoperative nausea and vomiting is also not addressed. T...
Source: Brazilian Journal of Anesthesiology - May 14, 2019 Category: Anesthesiology Source Type: research

Bilateral lower thoracic erector spinae plane block in open abdominal gynecologic oncology surgery: a case series
ConclusionsErector spinae plane block provided effective analgesia in our case series. While its true mechanism of action remains obscure, the available case reports show encouraging analgesic results with no adverse events recorded. Formal prospective randomized trials are underway to provide further evidence on its efficacy, failure rate and safety.ResumoJustificativa e objetivoO bloqueio do plano do músculo eretor da espinha é um novo bloqueio troncular analgésico que foi popularizado devido à sua facilidade de realização e segurança percebida. O bloqueio do plano do m&ua...
Source: Brazilian Journal of Anesthesiology - May 12, 2019 Category: Anesthesiology Source Type: research

Pharmacogenomics of sevoflurane: role in emergence delirium
Publication date: Available online 10 May 2019Source: Brazilian Journal of Anesthesiology (English Edition)Author(s): Abhijit Nair (Source: Brazilian Journal of Anesthesiology)
Source: Brazilian Journal of Anesthesiology - May 12, 2019 Category: Anesthesiology Source Type: research

Emergence delirium following sevoflurane anesthesia in adults: prospective observational study
ConclusionsThe incidence of emergence delirium in adults after general anesthesia using sevoflurane is significant and has not been adequately reported. Modifiable risk factors need to be addressed to further reduce its incidence.ResumoJustificativa e objetivosO delírio ao despertar após a anestesia geral com sevoflurano não tem sido relatado com frequência em adultos como nas crianças. Este estudo teve como objetivo determinar a incidência de delírio ao despertar em pacientes adultos submetidos à anestesia com sevoflurano como agente volátil e os provávei...
Source: Brazilian Journal of Anesthesiology - May 3, 2019 Category: Anesthesiology Source Type: research

Tutorial for performing systematic review and meta-analysis with interventional anesthesia studies
ConclusionThe evidence generated through a systematic review can provide the clinician with greater confidence in decision making at the moment of clinical practice and optimize the benefits to his patients, serving as a tool to assist managers in making decisions regarding the implementation of new strategies for the health of the population.ResumoJustificativa e objetivoA revisão sistemática de ensaios clínicos randomizados é crucial para avaliar a segurança e a efetividade das intervenções médicas. O objetivo deste artigo é apresentar um tutorial para o plan...
Source: Brazilian Journal of Anesthesiology - May 3, 2019 Category: Anesthesiology Source Type: research

Neuraxial labor analgesia: a literature review
Publication date: Available online 1 May 2019Source: Brazilian Journal of Anesthesiology (English Edition)Author(s): Fábio Farias de Aragão, Pedro Wanderley de Aragão, Carlos Alberto Martins, Karlla Fernanda Custódia Silva Leal, Alexandro Ferraz TobiasAbstractThe use of analgesia techniques for labor has become increasingly frequent, with neuraxial techniques being the most commonly used and most effective. Labor pain entails a number of physiological consequences that may be negative for the mother and fetus, and therefore must be treated. This literature review was performed through a search i...
Source: Brazilian Journal of Anesthesiology - May 3, 2019 Category: Anesthesiology Source Type: research

Delayed trigeminocardiac reflex after maxillofacial surgery: case report
ConclusionTrigeminocardiac reflex may be a protective neurogenic, oxygen-conserving response with low morbidity, however, very severe in certain situations. The interaction between surgeon and anesthesiologist, together with a careful monitoring of blood pressure and heart rate are fundamental for diagnosis and treatment.ResumoJustificativaO reflexo trigêmino-cardíaco é um fenômeno fisiológico passível de ocorrer em cirurgias da cabeça e pescoço, e normalmenteé benigno. Contudo, pode apresentar respostas exageradas, com grave morbidade.Relato de casoPaciente masc...
Source: Brazilian Journal of Anesthesiology - May 1, 2019 Category: Anesthesiology Source Type: research

Relevance of single-lumen endotracheal tube diameter and type of bronchial blocker for lung isolation in an emergent case
Publication date: Available online 30 April 2019Source: Brazilian Journal of Anesthesiology (English Edition)Author(s): Carlos Almeida (Source: Brazilian Journal of Anesthesiology)
Source: Brazilian Journal of Anesthesiology - May 1, 2019 Category: Anesthesiology Source Type: research

Do we still need central blocks while we have erector spinae plane block? Case of 2.5 month old infant
Publication date: Available online 30 April 2019Source: Brazilian Journal of Anesthesiology (English Edition)Author(s): Can Aksu, Yavuz GürkanAbstractErector spinae plane block is gaining popularity both for its ease of application and as its comparable effect on postoperative analgesia with central regional techniques like paravertebral block or epidural anesthesia. Its use for many indications has been reported in the literature for pediatric patients. We would like to share our experiences in a 2.5-month infant scheduled for thoracotomy for a giant congenital cyst. Single shot erector spinae plane block was done at...
Source: Brazilian Journal of Anesthesiology - May 1, 2019 Category: Anesthesiology Source Type: research

Analgesia Nociception Index (ANI): assessment of acute postoperative pain
In this study we aimed to investigate the effectiveness of analgesia nociception index as a tool for acute postoperative pain assessment. Our hypothesis was that analgesia nociception index may have good correlation with Numerical Rating Scale values.MethodA total of 120 patients of American Society of Anesthesiologists (ASA) physical status I and II undergoing any surgical procedure under halogenated-based anesthesia with fentanyl or remifentanil were enrolled for the study. At the 15th minute of arrival to the Postoperative Care Unit the patients’ pain was rated on a 0–10 point Numerical Rating Scale. The pat...
Source: Brazilian Journal of Anesthesiology - May 1, 2019 Category: Anesthesiology Source Type: research

Implementing a chronic pain ambulatory care: preliminary results
ConclusionThe prevalence of chronic pain was associated with females in 50–59 years old and severe mixed pain. Pain was located mainly in lower limbs and lumbar region. The most frequent diagnosis was low back pain followed by fibromyalgia. The patients were informed about their disease and treatment.ResumoJustificativa e objetivosA dor é um dos motivos mais comuns para procurar atendimento médico. Este estudo teve como objetivo analisar pacientes com dor crônica atendidos em Maricá, no estado do Rio de Janeiro, Brasil.MétodosEstudo transversal retrospectivo com 200 pacientes, atendi...
Source: Brazilian Journal of Anesthesiology - April 27, 2019 Category: Anesthesiology Source Type: research

Predictive value of plasma cytokines for acute kidney injury following lung resection surgery: Prospective observational study
ConclusionsIncreased postoperative plasma cytokine levels are associated with acute kidney injury after lung resection surgery in our study, which worsens the prognosis. Plasma interleukin-6 may be used as an early indicator for patients at risk of developing acute kidney injury after lung resection surgery.ResumoJustificativa e objetivosos pacientes submetidos à cirurgia de ressecção pulmonar apresentam risco de desenvolver lesão renal aguda pós-operatória. A determinação dos níveis de citocinas permite detectar uma resposta inflamatória precoce. Invest...
Source: Brazilian Journal of Anesthesiology - April 24, 2019 Category: Anesthesiology Source Type: research

Continuous lumbar erector spinae plane block for postoperative pain management in revision hip surgery: a report of two cases
Publication date: Available online 23 April 2019Source: Brazilian Journal of Anesthesiology (English Edition)Author(s): Sakura Kinjo, Alison SchultzAbstractThe number of total hip arthroplasty cases performed each year continues to increase; accordingly, so does the number of revision total hip arthroplasty procedures. While our traditional method of analgesia for these patients has involved multimodal medications and a continuous lumbar plexus block, we report two cases of patients who received continuous lumbar erector spinae plane blocks. Both patients exhibited excellent pain control postoperatively and were able to di...
Source: Brazilian Journal of Anesthesiology - April 24, 2019 Category: Anesthesiology Source Type: research

Endovascular repair of subclavian artery injury secondary to internal jugular vein catheterization in a patient under general anesthesia
ConclusionUnder general anesthesia several factors such as hypotension can mask the signs of subclavian artery injury. This case indicates that clinicians should be aware of the complications of central venous catheterization and take prompt action.ResumoJustificativa e objetivosA cateterização da veia jugular interna guiada por ultrassom é um procedimento comum e geralmente seguro em sala de cirurgia. No entanto, a punção inadvertida de uma artéria não compressível, como a artéria subclávia, embora rara, pode estar associada a sequelas com risco para vi...
Source: Brazilian Journal of Anesthesiology - April 23, 2019 Category: Anesthesiology Source Type: research

Negative pressure pulmonary edema: report of case series and review of the literature
ConclusionsThe anesthesiologists should prevent the patient from perform a forced inspiration against closed glottis, in addition to being able to recognize and treat cases of negative pressure pulmonary edema.ResumoJustificativa e objetivosO edema pulmonar por pressão negativa ocorre por aumento da pressão negativa intratorácica após inspiração contra via aérea superior obstruída. A pressão gerada é transmitida aos capilares pulmonares e supera a pressão de equilíbrio hidrostático, o que causa extravasamento de líquido para o...
Source: Brazilian Journal of Anesthesiology - March 29, 2019 Category: Anesthesiology Source Type: research

Severe bradycardia and asystole associated with sugammadex: case report
ConclusionsDocumented bradycardia and asystole were attributed to the administration of sugammadex. This case shows that, although rare, cardiac arrest is a possible adverse effect of this drug, and that the knowledge of this situation can be determinant for the patient's evolution.ResumoJustificativa e objetivosO sugamadex é uma gama ciclodextrina modificada, o primeiro agente seletivo para reversão do bloqueio neuromuscular induzido pelos relaxantes musculares não despolarizantes do tipo esteroide, com maior afinidade para o rocurônio. Neste artigo apresentamos um caso de bradicardia grave e as...
Source: Brazilian Journal of Anesthesiology - March 29, 2019 Category: Anesthesiology Source Type: research

Aortic dissection after mitral valve replacement: the role of intraoperative echocardiography in this diagnosis
Publication date: March–April 2019Source: Brazilian Journal of Anesthesiology (English Edition), Volume 69, Issue 2Author(s): José Mateus Costa, Fábio de Vasconcelos Papa, Kamila Fernanda StaszkoAbstractAccording to the most recent guidelines, the use of intraoperative transesophageal echocardiography in valvular surgeries is well established, as well as its use in the diagnosis, management, and rescue of perioperative complications. The aim of this case report is to illustrate a condition in which its intraoperative use had a positive influence on the outcome.ResumoO uso da ecocardiografia transesof&aa...
Source: Brazilian Journal of Anesthesiology - March 29, 2019 Category: Anesthesiology Source Type: research

Looking for the reason of hemodynamic instability: a case report of the role of intraoperative ultrasound
ConclusionEvery anesthesiologist should be able to use the intraoperative echocardiography as an effective tool in order to establish the appropriate measures to promote the survival of patients suffering severe trauma.ResumoJustificativa e objetivosO atendimento rápido e eficaz do paciente de trauma é necessário. O objetivo deste relato de caso foi destacar a importância do ecocardiograma intraoperatório como uma ferramenta útil em pacientes que sofrem de instabilidade hemodinâmica refratária sem explicação aparente.Relato de casoUma mulher de 41 anos sof...
Source: Brazilian Journal of Anesthesiology - March 29, 2019 Category: Anesthesiology Source Type: research

Importance of preoperative guided ultrasound in patients with femoral fracture: case report
ConclusionsThe use of ultrasound guidance by the anesthesiologist can provide relevant information for individualizing the anesthetic technique, without postponing the surgical intervention, which usually occurs when the patient is referred for complete examination by the specialist.ResumoObjetivoExemplificar o papel do emprego da ultrassonografia à beira do leito pelo anestesiologista e oferecer uma abordagem individualizada para a condição específica do paciente, sem que haja postergação desnecessária de correções cirúrgicas de fraturas de fêmur ...
Source: Brazilian Journal of Anesthesiology - March 29, 2019 Category: Anesthesiology Source Type: research

Anesthesia for surgical repair of the pentalogy of Cantrell: case report
In this report our objective was to describe a surgical case of a female patient and make some anesthetic considerations about this rare congenital malformation.ResumoA pentalogia de Cantrell é uma anomalia congênita associada a defeitos na formação da parede abdominal, do esterno, diafragma e pericárdio diafragmático, além do desenvolvimento de anomalias cardíacas. É uma doença rara, com incidência estimada em um caso para cada 65.000 nascimentos, mais comum no sexo masculino (60% dos casos). Apresenta prognóstico reservado com mortalidade e...
Source: Brazilian Journal of Anesthesiology - March 14, 2019 Category: Anesthesiology Source Type: research

Single needle versus double needle celiac trunk neurolysis in abdominal malignancy pain management: a randomized controlled trial
ConclusionSingle needle celiac neurolysis with changing patients’ position has less failure block rate, less procedure time, shorter duration of patient positioning than double needles celiac neurolysis in abdominal malignancy.ResumoIntroduçãoA neurólise do plexo celíaco guiada por tomografia computadorizada tornou-se uma técnica relativamente segura para aliviar a dor abdominal maligna. Comparamos a técnica de agulha única mudando o posicionamento do paciente e a técnica de agulha dupla usando a abordagem anterocrural posterior.MétodosNo grupo designado ...
Source: Brazilian Journal of Anesthesiology - February 28, 2019 Category: Anesthesiology Source Type: research

Validation of APACHE IV score in postoperative liver transplantation in southern Brazil: a cohort study
This study evaluated the calibration and discrimination of APACHE IV in the postoperative period of elective liver transplantation in the southern Brazil.MethodsThis was a clinical prospective and unicentric cohort study included 371 adult patients in the immediate postoperative period of elective liver transplantation from January 1, 2012 to December 31, 2016.ResultsIn this study, liver transplant patients who evolved to hospital death had a significantly higher APACHE IV score (82.7 ± 5.1 vs. 51.0 ± 15.8; p 
Source: Brazilian Journal of Anesthesiology - February 16, 2019 Category: Anesthesiology Source Type: research

Unilateral mydriasis: a complication of spine surgery in prone position
Publication date: Available online 23 January 2019Source: Brazilian Journal of Anesthesiology (English Edition)Author(s): Priyanka Gupta, Vijay B. Adabala, Amiya K. BarikAbstractProne position though a commonly used position for better access to surgical site but may be associated with a variety of complications. Perioperative Visual Disturbances/Loss is rare but devastating complication that is primarily associated with spine surgeries in prone position. In this case we report a 42 year old ASA-II patient who developed anisocoria with left pupillary dilatation following lumbar microdiscectomy in prone position. Following ...
Source: Brazilian Journal of Anesthesiology - January 23, 2019 Category: Anesthesiology Source Type: research

Comparison of adductor canal block for analgesia in arthroscopic surgery with ropivacaine alone and ropivacaine and clonidine
ConclusionAddition of clonidine to ropivacaine in USG guided adductor canal block led to significant prolongation of pain free period though pain score at rest and movement and rescue analgesic requirement did not differ.ResumoJustificativa e objetivosO alívio inadequado da dor após a reconstrução do ligamento cruzado anterior afeta a mobilidade, levando ao desenvolvimento de aderências, fraca Inserção do ligamento e atrofia muscular. O bloqueio do canal adutor para analgesia pós-operatória preserva a força do quadríceps. O presente estudo foi real...
Source: Brazilian Journal of Anesthesiology - January 22, 2019 Category: Anesthesiology Source Type: research

Emergence delirium following sevoflurane anesthesia in adults – a prospective observational study
ConclusionsThe incidence of emergence delirium in adults after general anesthesia using sevoflurane is significant and has not been adequately reported. Modifiable risk factors need to be addressed to further reduce its incidence.ResumoJustificativa e objetivosO delírio ao despertar após a anestesia geral com sevoflurano não tem sido relatado com frequência em adultos como nas crianças. Este estudo teve como objetivo determinar a incidência de delírio ao despertar em pacientes adultos submetidos à anestesia com sevoflurano como agente volátil e os provávei...
Source: Brazilian Journal of Anesthesiology - January 15, 2019 Category: Anesthesiology Source Type: research

Severe bradycardia and asystole associated with sugammadex: clinical case report
ConclusionsDocumented bradycardia and asystole were attributed to the administration of sugammadex. This case shows that, although rare, cardiac arrest is a possible adverse effect of this drug, and that the knowledge of this situation can be determinant for the patient's evolution.ResumoJustificativa e objetivosO sugamadex é uma gama ciclodextrina modificada, o primeiro agente seletivo para reversão do bloqueio neuromuscular induzido pelos relaxantes musculares não despolarizantes do tipo esteroide, com maior afinidade para o rocurônio. Neste artigo apresentamos um caso de bradicardia grave e as...
Source: Brazilian Journal of Anesthesiology - January 15, 2019 Category: Anesthesiology Source Type: research

Profile of malignant hyperthermia susceptibility reports confirmed with muscular contracture test in Brazil
ConclusionThe crises of malignant hyperthermia resembled those described in other countries, but with frequency lower than that estimated in the country.ResumoJustificativa e objetivoHipertermia maligna é síndrome farmacogenética hipermetabólica, autossômica dominante, com mortalidade 10%-20%, desencadeada por uso de anestésico inalatório halogenado ou relaxante muscular succinilcolina. O padrão-ouro para pesquisa de suscetibilidade à hipertermia maligna é o teste de contratura muscular in vitro em resposta ao halotano e à cafeína. A determi...
Source: Brazilian Journal of Anesthesiology - January 15, 2019 Category: Anesthesiology Source Type: research

Negative pressure pulmonary edema: report of four cases and review of the literature
ConclusionsThe anesthesiologists should prevent the patient from perform a forced inspiration against closed glottis, in addition to being able to recognize and treat cases of negative pressure pulmonary edema.ResumoJustificativa e objetivosO edema pulmonar por pressão negativa ocorre por aumento da pressão negativa intratorácica após inspiração contra via aérea superior obstruída. A pressão gerada é transmitida aos capilares pulmonares e supera a pressão de equilíbrio hidrostático, causa extravasamento de líquido para o par&e...
Source: Brazilian Journal of Anesthesiology - January 12, 2019 Category: Anesthesiology Source Type: research

Comparative ultrasound study of gastric emptying between an isotonic solution and a nutritional supplement
Publication date: Available online 12 January 2019Source: Brazilian Journal of Anesthesiology (English Edition)Author(s): Flora Margarida Barra Bisinotto, Luciano Alves Matias da Silveira, Tiago Caneu Rossi, Laura Bisinotto Martins, Gustavo Palis Zago, Mariana Andrade Lopes MendonçaAbstractBackground and objectivesPreoperative fasting may lead to undesirable effects in the surgical patient in whom there is a stimulus to ingesting liquids clear liquids until 2 h before anesthesia. The aim of this study was to evaluate the gastric emptying of two different solutions using ultrasound.MethodsIn a prospective, rando...
Source: Brazilian Journal of Anesthesiology - January 12, 2019 Category: Anesthesiology Source Type: research

Importance of preoperative guided ultrasound in patients with femoral fracture – case report
ConclusionsThe use of ultrasound guidance by the anesthesiologist can provide relevant information for individualizing the anesthetic technique, without postponing the surgical intervention, which usually occurs when the patient is referred for complete examination by the specialist.ResumoObjetivoExemplificar o papel do emprego da ultrassonografia à beira do leito pelo anestesiologista e oferecer uma abordagem individualizada para a condição específica do paciente, sem que haja postergação desnecessária de correções cirúrgicas de fraturas de fêmur ...
Source: Brazilian Journal of Anesthesiology - January 12, 2019 Category: Anesthesiology Source Type: research

Ultrasound guided erector spinae plane block for postoperative analgesia after augmentation mammoplasty: case series
Publication date: Available online 3 January 2019Source: Brazilian Journal of Anesthesiology (English Edition)Author(s): Başak Altıparmak, Melike Korkmaz Toker, Ali İhsan Uysal, Semra Gümüş DemirbilekAbstractAugmentation mammoplasty is the third most frequently performed esthetic surgicalprocedure worldwide. Breast augmentation with prosthetic implants requires the insertion ofan implant under breast tissue, which causes severe pain due to tissue extension and surgicaltrauma to separated tissues. In this case series, we present the successful pain management of 6 patients with ultrasound-guided Erector Spinae...
Source: Brazilian Journal of Anesthesiology - January 4, 2019 Category: Anesthesiology Source Type: research

Should maternal anesthesia delay breastfeeding? A systematic review of the literature
ConclusionsMost of the anesthetic drugs are safe for nursing mothers and offer low risk to the breastfed neonates when administered in single-dose. However, high-dose and repeated administration of drugs significantly increase the risk of adverse effects on neonates. Moreover, diazepam and meperidine should be avoided in nursing women. Finally, anesthesiologists and pediatricians should consider individual risk/benefit, with special attention to premature neonates or babies with concurrent diseases since they are more susceptible to adverse effects.ResumoIntroduçãoA importância e os benefícios do...
Source: Brazilian Journal of Anesthesiology - December 27, 2018 Category: Anesthesiology Source Type: research

Minimum effective volume of bupivacaine 0.5% for ultrasound-guided retroclavicular approach to infraclavicular brachial plexus block
ConclusionsThe MEV50 of bupivacaine 0.5% for US-guided retroclavicular approach to infraclavicular brachial plexus block was 9.6 mL and the calculated MEV95 was 23.2 mL. Future studies are required for infraclavicular brachial plexus block with different approaches, other LA agents and different concentrations of bupivacaine.ResumoJustificativa e objetivosO presente estudo teve como objetivo determinar o volume mínimo efetivo (VE) de bupivacaína a 0,5% em 50% dos pacientes para uma abordagem retroclavicular guiada por ultrassom no bloqueio do plexo braquial por via infraclavicular.MétodosUm t...
Source: Brazilian Journal of Anesthesiology - December 27, 2018 Category: Anesthesiology Source Type: research

Addition of dexmedetomidine to bupivacaine in ultrasonography-guided paravertebral blockade potentiates postoperative pain relief among patients undergoing thoracotomy
The objective of this study was to investigate the effects of bupivacaine and bupivacaine plus dexmedetomidine on postoperative pain score and analgesic consumption in thoracotomy patients who had undergone ultrasonography-guided paravertebral blockade.Material and method93 ASA I–II patients aged 18–65 years were included in the study and scheduled for thoracic surgery. Prior to anesthesia induction, the paravertebral blockade procedure was performed by an anesthetist with ultrasonography. Cases were randomly stratified into three groups. The paravertebral blockade procedure was performed with 20 mL 0.5% b...
Source: Brazilian Journal of Anesthesiology - December 22, 2018 Category: Anesthesiology Source Type: research

YouTube as an informational source for brachial plexus blocks: evaluation of content and educational value
ConclusionsThe majority of the videos examined for this study lack the comprehensive approach necessary to safely guide someone seeking information about brachial plexus nerve blocks.ResumoJustificativa e objetivosO YouTube, site de compartilhamento de vídeos mais popular, contém um número significativo de vídeos médicos, incluindo bloqueios do plexo braquial. Apesar do uso generalizado dessa plataforma como fonte de informação médica, não há regulamentação para a qualidade ou o conteúdo dos vídeos. O objetivo deste estudo foi...
Source: Brazilian Journal of Anesthesiology - December 22, 2018 Category: Anesthesiology Source Type: research

Reversible cerebral vasoconstriction syndrome a rare cause of post-partum headache – an anesthetic overview
We report a rare case of a patient with chief complain of postpartum headache, was later diagnosed as a case of reversible cerebral vasoconstriction syndrome. A young full term primigravida with good uterine contraction admitted to labour room. Later she complained of leaking per vagina and on examination meconium stained liquor was noted. Caesarean delivery under spinal anesthesia was done and intra-operative period was uneventful. Both mother and baby were normal and shifted to postoperative ward and nursery respectively. In postoperative ward, mother complained of severe headache after 1 h and later developed seizu...
Source: Brazilian Journal of Anesthesiology - December 22, 2018 Category: Anesthesiology Source Type: research

Trends in hospital consumption of analgesics after the implementation of a pain performance improvement plan
ConclusionOpioid consumption showed an increasing trend during the 5 year period, with fentanyl replacing morphine as the most used opioid. In general, analgesics diminished use due to the decreasing trend of anti-inflammatory and antirheumatic products non-steroids consumptions.ResumoJustificativaA Comissão para o controle da dor estabeleceu um plano de melhora no comportamento da dor em 2012.ObjetivosO objetivo do estudo foi avaliar as tendências do consumo de analgésicos em um hospital de ensino terciário e o impacto econômico associado.MétodosEstudo descritivo, retrospectivo, rea...
Source: Brazilian Journal of Anesthesiology - December 22, 2018 Category: Anesthesiology Source Type: research

Risk factors for postoperative hypothermia in the post-anesthetic care unit: a prospective prognostic pilot study
Publication date: Available online 19 December 2018Source: Brazilian Journal of Anesthesiology (English Edition)Author(s): Fabrício Tavares Mendonça, Marcelo Cabral de Lucena, Raul Silva Quirino, Catia Sousa Govêia, Gabriel Magalhaes Nunes GuimarãesAbstractBackgroundHypothermia occurs in up to 20% of perioperative patients. Systematic postoperative temperature monitoring is not a standard of care in Brazil and there are few publications about temperature recovery in the postoperative care unit.Design and settingMulticenter, observational, cross-sectional study, at Hospital de Base do Distrito Fed...
Source: Brazilian Journal of Anesthesiology - December 19, 2018 Category: Anesthesiology Source Type: research

Knowledge retention after focused cardiac ultrasound training: a prospective cohort pilot study
ConclusionFour weeks of intensive FoCUS training results in adequate knowledge acquisition and 6-month knowledge retention.ResumoJustificativa e objetivosA ultrassonografia cardíaca focalizada (USCF) provou ser importante para orientar o processo de tomada de decisão clínica dos anestesiologistas. Treinar os residentes para fazer e interpretar uma USCF é viável e eficaz. No entanto, o grau de retenção do conhecimento após o treinamento permanece um assunto de debate. Procuramos fornecer uma descrição do currículo de quatro semanas do treinamento d...
Source: Brazilian Journal of Anesthesiology - December 7, 2018 Category: Anesthesiology Source Type: research