Revista brasileira de anestesiologia
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Rev Bras Anestesiol · Aug 2006
[The interaction between labor analgesia and its results: assessment using the newborn s weight and Apgar score.].
There are controversies regarding whether labor analgesia can interfere with labor and the vitality of the newborn. The objective of this study was the interaction between labor analgesia, using the continuous epidural and combined spinal-epidural techniques with a small dose of local anesthetic, and the type of delivery analyzing the newborn's weight and Apgar score. ⋯ If the analysis focuses the newborn's weight and Apgar score, the techniques of analgesia, continuous epidural and combined spinal-epidural with small doses of local anesthetic, do not interfere with the result of the delivery.
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Rev Bras Anestesiol · Aug 2006
[Postoperative analgesia for cesarean section: does the addiction of clonidine to subarachnoid morphine improve the quality of the analgesia?].
The mechanism of action of alpha2-adrenergic analgesia has been explored for more than one hundred years. The increased duration of the sensitive and motor blockades caused by clonidine is dose-dependent and has antinociceptive properties. The objective of this study was to evaluate whether the addition of 15 to 30 microg of clonidine to spinal anesthesia for cesarean sections with 0.5% hyperbaric bupivacaine (12.5 mg) and morphine (100 microg) improves the quality of postoperative analgesia. ⋯ The addition of clonidine to spinal anesthesia with 0.5% hyperbaric bupivacaine (12.5 mg) and morphine (100 microg) for cesarean section improved the quality of the postoperative analgesia without increasing the incidence of side effects. We suggest that the dose of 15 microg of clonidine should be used.
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Rev Bras Anestesiol · Aug 2006
[Dexmedetomidine for neurocognitive testing in awake craniotomy: case report.].
Tumor resections in the speech areas of the brain are more safely done using cognitive tests to determine their exact location. Patients must be awake, comfortable, and cooperative for the precise identification of the areas to be preserved. The objective of this report is to present a surgical procedure done with the patient awake, without endotracheal intubation, using sevofluorane initially, followed by dexmedetomidine. This technique allowed the realization of motor and speech evaluation tests. ⋯ Awake craniotomy with the proper mapping of speech and motor cortical areas was successfully done with the continuous infusion of dexmedetomidine. Both the patient and the surgical team were pleased with the technique.
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Rev Bras Anestesiol · Aug 2006
[Catheters and anesthetic solutions in regional peripheral anesthesia: Quo Vadis? Case Reports.].
The clinical results of regional peripheral blockades are not always what we hope for. Sometimes the results are short of our intent and sometimes are exaggerated. To understand and learn those phenomena, radioimaging techniques are very helpful. The objective of this study is to demonstrate the different trajectories and distribution of catheters and anesthetics (local anesthetic with contrast), respectively, used in regional blockades of the upper and lower limbs. ⋯ Contrast X-rays are very useful to verify the position of catheters and solve unexpected anesthetic effects, because they are able to relate the unpredictable dispersion of anesthetics to the signs and symptoms of peripheral blockades.