Revista brasileira de anestesiologia
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Rev Bras Anestesiol · Mar 2010
Randomized Controlled Trial Comparative StudyHypobaric 0.15% bupivacaine versus hypobaric 0.6% lidocaine for posterior spinal anesthesia in outpatient anorectal surgery.
Low doses of bupivacaine and lidocaine have been used for spinal anesthesia in outpatient surgery. The objective of this study was to compare hypobaric solutions of bupivacaine and lidocaine in outpatient anorectal surgery. ⋯ Hypobaric solution of bupivacaine or lidocaine promotes, predominantly, sensorial blockade after subarachnoid injection in patients in the jackknife position. Hypobaric lidocaine provides analgesia with the same dispersion of that of bupivacaine, but with shorter duration. Hemodynamic stability and the absence of motor blockade represent the major advantages.
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Rev Bras Anestesiol · Mar 2010
Randomized Controlled TrialSpinal block with 10 mg of hyperbaric bupivacaine associated with 5 microg of sufentanil for cesarean section. Study of different volumes.
Several factors affect the cephalad dispersion of the anesthetic solution in the subarachnoid space; among them, physiological changes of pregnancy and the dose and volume of the local anesthetics should be mentioned. The objective of this study was to assess the effectivity and side effects of different volumes of the subarachnoid administration of the association of hyperbaric bupivacaine and sufentanil in cesarean sections. ⋯ Four milliliter of anesthetic solution composed of hyperbaric bupivacaine, 10 mg, associated with 5 microg of sufentanil was more effective than 3 ml of the same solution, providing better intra-and postoperative analgesia without maternal-fetal repercussions.
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Rev Bras Anestesiol · Mar 2010
Review Case ReportsAnesthesia for videolaparoscopic cholecystectomy in a patient with Steinert disease. Case report and review of the literature.
Myotonic dystrophies are autosomal dominant neuromuscular diseases. Among them, myotonic dystrophy type 1 (MD1), or Steinert disease, is the most common in adults, and besides muscular involvement it also has important systemic manifestations. Myotonic dystrophy type 1 poses a challenge to the anesthesiologist. Those patients are more sensitive to anesthetics and prone to cardiac and pulmonary complications. Besides, the possibility of developing malignant hyperthermia and myotonic episodes is also present. ⋯ Myotonic dystrophy type 1 presents several particularities to the anesthesiologist. Detailed knowledge of its systemic involvement along with the differentiated action of anesthetic drugs in those patients will provide safer anesthetic-surgical procedure.
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Rev Bras Anestesiol · Mar 2010
Randomized Controlled TrialInterscalene brachial plexus block. Effects on pulmonary function.
The interscalene is one of the most common approaches used in brachial plexus block. However, the association of this approach with the ipsilateral blockade of the phrenic nerve has been demonstrated. The resulting diaphragmatic dysfunction causes changes in lung mechanics, which can be potentially deleterious in patients with limited respiratory reserve. The objective of the present study was to evaluate the repercussion of interscalene brachial plexus block on pulmonary function by measuring forced vital capacity (FVC). ⋯ Interscalene block reduces FVC in most cases. Changes were more pronounced in the Ropivacaine group.
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Rev Bras Anestesiol · Mar 2010
Comparative StudyA comparative study between the laryngoscope and lighted stylet in tracheal intubation.
Approaching the airways with a laryngoscope can cause different types of injuries. The objective of the present study was to determine whether lighted stylet tracheal intubation can be a less traumatic alternative for patients when compared to direct laryngoscopy. ⋯ The intubation techniques are similar regarding the hemodynamic behavior in both groups. However, hoarseness was more common in group with lighted stylet.