Revista brasileira de anestesiologia
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Rev Bras Anestesiol · Apr 2002
Influence of dexmedetomidine upon sevoflurane end-expiratory concentration. Evaluation by bispectral index, suppression rate and electroencephalographic power spectral analysis.
Dexmedetomidine, an alpha2-adrenergic agonist, has been described as being able to decrease the demand for both venous and inhalational agents. This study aimed at evaluating the influence of Dexmedetomidine upon sevoflurane end-expiratory concentration (EC) with monitoring the depth of anesthesia. ⋯ Dexmedetomidine was effective in decreasing sevoflurane end-expiratory concentration while maintaining hemodynamic stability without impairing time for hospital discharge, in addition to promoting an earlier emergence.
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Rev Bras Anestesiol · Apr 2002
Postoperative analgesia in pediatric patients: comparative study among local anesthetics, opioids and non-steroidal anti-inflammatory drugs.
The treatment of postoperative pain in children has been given special attention in the last decades. This study aimed at analyzing postoperative analgesia in children, considering analgesia quality and duration, evaluation methods reliability and the incidence of side effects resulting from different analgesia techniques. ⋯ Spinal opioids are safe and effective for postoperative analgesia in children, but when compared to bupivacaine, there have been no significant differences and a higher incidence of side effects. Rectal diclofenac was not effective as a single analgesic as compared to other techniques.
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Rev Bras Anestesiol · Apr 2002
Patient controlled analgesia with fentanyl or sufentanil in the postoperative period of knee ligament reconstruction: comparative study.
Epidural opioids, associated or not to local anesthetics, have been used for postoperative analgesia in continuous infusion and/or patient controlled boluses. The aim of this study was to compare postoperative analgesia provided by epidural fentanyl or sufentanil, in bolus or continuous infusion, in patients submitted to knee ligament reconstruction. ⋯ Epidural fentanyl or sufentanil in continuous epidural infusion and patient-controlled boluses in the doses used in this study have induced excellent postoperative analgesia. However, sufentanil caused more severe side effects than fentanyl.
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Rev Bras Anestesiol · Apr 2002
Fresh-gas flow sequence at the start of low-flow anesthesia: clinical application of Maplesons theoretical study.
In a theoretical study, Mapleson using a multicompartmental pharmacokinetic model in a standard 40-year old and 70 kg man, has shown that with a fresh gas flow (FGF) initially equal to total pulmonary minute ventilation and then decreased to 1 L min(-1), and with fractional anesthetic administration (F(adm)) set to 3 MAC, the end fractional expired also expressed as alveolar (F(E')=F(A)) may reach 1 MAC in few minutes, according to the solubility of the inhaled agent. The purpose of this study was to clinically apply. ⋯ Results obtained confirm the clinical feasibility of Maplesons theoretical model. This way, a fast FA increase of the inhaled agent was achieved, which reached 1 MAC in 1 to 2 minutes and was maintained within this value with minor variations and low anesthetic consumption.