Revista brasileira de anestesiologia
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Rev Bras Anestesiol · Sep 2008
Case ReportsUltrasound-guided sciatic-femoral block for revision of the amputation stump. Case report.
The use of ultrasound in regional blocks has become increasingly used because its role as facilitator and its efficacy. Direct ultrasound visualization allows the identification of peripheral nerves, independently of the ability of obtaining sensitive or motor stimulation. ⋯ Ultrasound assistance is capable of amplifying the spectrum of uses of peripheral nerve blocks in surgical interventions on amputated limbs in situations neurostimulation cannot be used.
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Rev Bras Anestesiol · Sep 2008
Influence of tracheal gas insufflation during capnography in anesthetized patients.
Tracheal gas insufflation (TGI) consists in injecting gas in the trachea (usually oxygen). is used in patients with acute respiratory distress syndrome (ARDS) to reduce capnometry. In Anesthesiology, the reduction in capnometry can be useful, but there are no studies on the reduction in capnometry using TGI. The objective of this study was to evaluate the changes caused by TGI on capnometry in anesthetized patients. ⋯ The use of TGI did not result in a reduction in PaCO2 or P(ET)CO2 but it altered the morphology of the capnography curve.
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Rev Bras Anestesiol · Sep 2008
ReviewThe role of peripheral opiate antagonists in pain medicine and perioperative care.
Pre-clinical and clinical trials of peripheral opiate antagonists have shed new light on the effects of exogenous and endogenous opioids. ⋯ If approved these drugs may offer potential solutions to important clinical problems in pain management.
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Rev Bras Anestesiol · Sep 2008
Randomized Controlled Trial Comparative StudyComparative study for the postoperative analgesic efficacy of 20 mL at 0.5, 0.75, and 1% ropivacaine in posterior brachial plexus block.
Arthroscopic shoulder surgeries are associated with severe postoperative pain. Among the analgesic techniques available, brachial plexus block has the best results. The objective of this study was to determine which concentration of local analgesic used in the posterior brachial plexus block provides longer postoperative analgesia. ⋯ This study demonstrated that posterior brachial plexus block provides effective analgesia for shoulder surgeries. Twenty milliliters of ropivacaine in the different concentrations used in this study promoted similar analgesia.
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Rev Bras Anestesiol · Sep 2008
ReviewMyocardial protection by pre- and post-anesthetic conditioning.
Perioperative myocardial ischemia is commonly observed, and it can increase significantly postoperative morbidity and mortality. The cardioprotective properties of volatile anesthetics and opioids have been studied during several decades and currently constitute powerful tools in the management of patients with ischemic coronariopathy. The objective of this review was to provide the fundaments of myocardial protection by preconditioning. ⋯ Phenomena known as myocardial ischemic preconditioning and anesthetic preconditioning are well known, and the mechanism of protection is similar in both situations; however, not every step that leads to this protection has been fully explained. Further studies are necessary to increase the clinical applicability of the cardioprotective properties of anesthetics.