Revista brasileira de anestesiologia
-
Rev Bras Anestesiol · Nov 2010
Randomized Controlled Trial Comparative StudyComparative study between combined sciatic-femoral nerve block, via a single skin injection, and spinal block anesthesia for unilateral surgery of the lower limb.
Unilateral spinal anesthesia has advantages when used in outpatient basis. The objective of the present study was to compare unilateral spinal anesthesia with combined sciatic-femoral nerve block in unilateral orthopedic surgeries in outpatients. ⋯ This study concluded that combined sciatic-femoral nerve block is technically easy to perform and it can be an alternative for unilateral blockade of the lower limbs. Unilateral spinal anesthesia with low doses of bupivacaine resulted in shorter time to perform it, lower number of attempts, and earlier recovery than combined sciatic-femoral nerve block, but with the same efficacy.
-
Many Intensive Care Unit (ICU) patients present pain. The administration of analgesics and sedatives is crucial for patient comfort and to reduce stress, as well as to prevent delay in recovery and ventilator weaning. The objective of the present study was to conduct a review on analgesia and sedation in the ICU. ⋯ The most commonly employed drugs are morphine, fentanyl, midazolam and propofol. Other medications are less frequently used.
-
Rev Bras Anestesiol · Nov 2010
Influence of central venous oxygen saturation on in-hospital mortality of surgical patients.
Low central venous oxygen saturation (ScvO₂) indicates an imbalance between cellular oxygen supply and consumption and, consequently, worse prognosis for critical patients. However, it is not clear what the value of this marker in surgical patients. The objective of the present study was to evaluate whether low perioperative ScvO₂ determines a worse prognosis. ⋯ Intraoperative ScvO₂ levels are higher than those both in the pre- and postoperative period. However, low preoperative ScvO₂ determines worse prognosis.
-
Rev Bras Anestesiol · Nov 2010
Review Case ReportsIntracranial subdural hematoma post-spinal anesthesia: report of two cases and review of 33 cases in the literature.
Intracranial subdural hematoma is a rare complication of spinal anesthesia. We report two cases of women who developed chronic subdural hematoma post-spinal anesthesia diagnosed after prolonged clinical evolution of post-dural puncture headache (PDPH) and we analyze other 33 cases found on literature review. ⋯ The presence of any of the signs or symptoms mentioned above should alert for the possibility of an intracranial subdural hematoma as a complication of puncture of the dura mater, especially in those patients with PDPH for more than one week, at which time investigation by neuroimaging is necessary.
-
Opioids are commonly used for pain control; however, they can cause hyperalgesia. The reason why this can happen is not known. The objective of this review was to describe the mechanisms, factors implicated, and drug modulation. ⋯ This is a very complex subject, which involves a series of pathophysiological mechanisms that could contribute for OIH and patient discomfort, bringing disastrous consequences.