Revista brasileira de anestesiologia
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Rev Bras Anestesiol · Oct 2004
[Unilateral spinal anesthesia with low 0.5% hyperbaric bupivacaine dose.].
Unilateral spinal anesthesia may be advantageous, especially for outpatient procedures. Low anesthetic doses, pencil point or cutting point needles, slow injection rate and the lateral position have been reported as helping unilateral spinal anesthesia technique. This longitudinal study aimed at investigating the depth of unilateral spinal anesthesia with 5 mg of 0.5% hyperbaric bupivacaine injected with 27G Quincke needle with patients in the lateral position and limb to be operated on facing downward. ⋯ In the conditions of our study, 0.5% hyperbaric bupivacaine (5 mg) has provided predominantly unilateral block. Twenty minutes were enough for blockade installation. Major unilateral spinal anesthesia advantages are hemodynamic stability, patients satisfaction and faster anesthetic recovery.
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Preoperative pediatric anxiety is characterized by stress, worry, nervosism and concern and may be expressed in different ways. Postoperative behavior changes, such as nocturnal enuresis, dietary problems, apathy, insomnia, nightmares and agitated sleep may be results of this anxiety. In some children, these changes persist for one year. This study aimed at evaluating anxiety-related aspects affecting children and parents in the preoperative period, as well as pharmacological or non-pharmacological interventions to minimize them. ⋯ The preoperative period is accompanied of an emotional overload for the whole family, especially the child. For many children, a turbulent preoperative period may translate into several behavior changes lasting for long periods of time. The presence of parents during anesthetic induction and the preoperative preparation of children and parents may be useful for selected cases, taking into account age, temperament and previous hospital experience. Preanesthetic medication with benzodiazepines, especially midazolam, is clearly the most effective method to decrease postoperative anxiety in children and their related behavior changes.
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Rev Bras Anestesiol · Oct 2004
[Correlation between end-tidal carbon dioxide levels and cardiac output during cardiac surgery with cardiopulmonary bypass.].
End-tidal carbon dioxide (P ET CO2) not only reflects pulmonary ventilation but also carbon dioxide production (metabolism) and pulmonary blood supply (circulation). During constant metabolism and ventilation, P ET CO2 reflects pulmonary blood perfusion, thus cardiac output (CO). This study aimed at evaluating the correlation between P ET CO2 levels and CO during cardiac surgery with cardiopulmonary bypass (CPB). ⋯ In this study, where patients submitted to cardiac surgery with CPB were evaluated, ventilation/perfusion changes throughout the procedure might have been the factors determining decreased correlation between cardiac output and end tidal CO2.