Revista brasileira de anestesiologia
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Rev Bras Anestesiol · Oct 2005
[Intraoperative analgesic effect of epidural ketamine, clonidine or dexmedetomidine for upper abdominal surgery.].
Low dose ketamine decreases nociception by blocking NMDA receptor channels. Alpha2-adrenergic receptor activation triggers intense analgesic response. This study aimed at evaluating the effects of epidural ketamine, clonidine and dexmedetomidine, in patients undergoing upper abdominal surgery. ⋯ Epidural ketamine, clonidine or dexmedetomidine decreases alfentanil consumption and isoflurane inspired concentration in the intraoperative period of upper abdominal surgery.
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Rev Bras Anestesiol · Oct 2005
[Effects of intramuscular and perineural clonidine on sciatic nerve block with 0.5% ropivacaine.].
This study evaluated the effects of clonidine on anesthesia onset, quality and duration of analgesia of sciatic nerve block using 0.5% ropivacaine. ⋯ Intramuscular or perineural clonidine has not affected anesthetic onset, quality or the duration of postoperative analgesia of 0.5% ropivacaine-induced sciatic nerve block.
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Myocardial protection defines the set of strategies aiming at attenuating the intensity of myocardial ischemia-reperfusion injury during heart surgery and its harmful consequences on myocardial function. A better understanding of pathophysiological phenomena related to ischemia-reperfusion events and of the anesthetic-induced heart protection has given to the anesthesiologist a major role in intraoperative myocardial protection. The objective of this update was to review the mechanisms of ischemia-reperfusion-induced myocardial injury and myocardial protection modalities focusing on anesthetic techniques. ⋯ The association of adequate anesthetic technique using heart protecting agents to usual myocardial protection modalities performed by the surgeon may contribute to the prevention of cardiac surgery-induced myocardial dysfunction and improve postoperative outcome.
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Rev Bras Anestesiol · Oct 2005
[Postoperative nausea and vomiting: a review of the 'minor-major' problem.].
Notwithstanding continuous investigations and the development of new drugs and techniques, postoperative nausea and vomiting (PONV) are frequent and may contribute to the development of complications, thus increasing hospital and human costs. This article aimed at reviewing physiological mechanisms, risk factors and therapeutic approaches available to manage PONV. ⋯ Although the management of PONV has improved in recent years, it is still common among high-risk patients. Current strategy to prevent and treat PONV is not yet established and Gan guidelines should be adapted to each population and institution.