Revista brasileira de anestesiologia
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Rev Bras Anestesiol · May 2008
Comparative StudyContinuous infusion of remifentanil versus sufentanil in videolaparoscopic surgeries. A comparative study.
Continuous infusion (CI) of remifentanil is common in total intravenous anesthesia. On the other hand, CI of sufentanil for short/medium-term surgeries has not been widely used. The objective of this study was to compare two techniques of total intravenous anesthesia, using CI of remifentanil or sufentanil, regarding their intraoperative behavior and characteristics of recovery of patients undergoing videolaparoscopic surgeries. ⋯ Hemodynamic control was satisfactory in both groups. Continuous infusion of sufentanil promoted better postoperative pain control with decreased consumption of rescue analgesic and, consequently, reduced incidence of PONV and reduced time of stay in the recovery room.
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Rev Bras Anestesiol · May 2008
Randomized Controlled Trial Comparative StudyA comparative study between one and two effective doses (ED95) of rocuronium for tracheal intubation.
Neuromuscular blockers (NMB) are used to induce relaxation of skeletal muscles and facilitate tracheal intubation (TI). According to the literature, two effective doses (ED95) of NMB are ideal for TI. Rocuronium is a steroid-type, synthetic, non-depolarizing neuromuscular blocker of medium duration. The objective of this study was to evaluate and compare the conditions of tracheal intubation with one and two effective doses (ED95) of rocuronium, following the criteria of the Copenhagen Consensus Conference. ⋯ Both doses of rocuronium, 0.3 mg kg(-1) and 0.6 mg kg(-1) ED95, provided clinically satisfactory parameters of TI in elective procedures.
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Rev Bras Anestesiol · May 2008
ReviewBreakage of epidural catheters: etiology, prevention, and management.
The objective of this study was to review published cases of breakage of epidural catheters and, with the data gathered in the literature, to identify predisposing factors for catheter breakage, and list the recommended conducts to prevent and treat this complication. ⋯ The catheter should not be inserted more than five centimeters into de epidural space. Exploratory laminectomy should be undertaken if the patient develops signs or symptoms of neurologic changes, if the catheter is inside the subarachnoid space, or whenever the tip of the catheter is emerging out of the skin. Due to the difficulty to localize retained fragments by imaging exams, catheters should be manufactured with materials that improve their visualization.
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Intravenous lidocaine has been used for several indications since the decade of 1960. Its multimodal mechanism of action was the objective of this review. ⋯ The final analgesic action of intravenous lidocaine is a reflection of its multifactorial action. It has been suggested that its central sensitization is secondary to a peripheral anti-hyperalgic action on somatic pain and central on neuropathic pain, which result on the blockade of central hyperexcitability. The intravenous dose should not exceed the toxic plasma concentration of 5 microg mL(-1); doses smaller than 5 mg kg(-1), administered slowly (30 minutes), under monitoring, are considered safe.
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Rev Bras Anestesiol · May 2008
Review Historical ArticleIntravenous regional anesthesia--first century (1908-2008). Beggining, development, and current status.
Intravenous regional block is celebrating its 10th anniversary in 2008. Since this is a widely used technique, this milestone should be recorded, the date celebrated, Brazilian anesthesiologists should be remembered of its evolutive process, especially in the last 40 years, and we should pay homage to the individual who started it: August Karl Gustav Bier. ⋯ Intravenous regional block is the anesthetic technique created by A. K. G Bier exactly 100 years ago. In the first half of the 20th Centuty, it evolved little and slowly, but in the last several years, it has seen an accentuated improvement, thanks to countless technical, pathophysiological, pharmacological, pharmacokinetic, and clinical developments, for which Brazilian Anesthesiology has contributed considerably. Since it is celebrating its 100th anniversary in 2008, intravenous regional block deserves to have its story told, and the date should not go unnoticed, but should be remembered and celebrated.