Revista brasileira de anestesiologia
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Rev Bras Anestesiol · Jan 2011
Effects of 2 mg.kg⁻¹ of intravenous lidocaine on the latency of two different doses of rocuronium and on the hemodynamic response to orotracheal intubation.
Lidocaine potentiates the effects of neuromuscular blockers and attenuates the hemodynamic response to orotracheal intubation. The objective of the present study was to test the effects of lidocaine on the latency of two different doses of rocuronium and on the hemodynamic response to intubation. ⋯ Intravenous lidocaine before anesthetic induction was capable of attenuating the hemodynamic response associated to OI maneuvers, but it did not reduce the latency of the neuromuscular blockade produced by two different doses of rocuronium.
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Rev Bras Anestesiol · Jan 2011
Regional anesthesia for cesarean section in obese pregnant women: a retrospective study.
The objective of the data gathering was to identify anesthetic techniques, and their difficulties and complications in patients with BMI ≥ 30 kg.m(-2) undergoing cesarean sections. The study intends to support the development of new protocols and more adequate conducts for this population of pregnant women. ⋯ Technical difficulties as well as hypotension, bleeding, and surgical time were more frequent in patients with higher degrees of obesity.
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Rev Bras Anestesiol · Jan 2011
Comparative StudyPreanesthesia evaluation and reduction of preoperative care costs.
Preanesthesia evaluation (PAE) is fundamental in the preparation of a surgical patient. Among its advantages is the reduction of preoperative care costs. Although prior studies had observed this benefit, it is not clear whether it can be taken into consideration among us. The objective of the present study was to compare the costs of preoperative care performed by the surgeon with estimated costs based on PAE. In parallel, we compared the American Society of Anesthesiologists (ASA) physical status classification determined by the anesthesiologist with that estimated by other specialists. ⋯ Preoperative care based on judicious preanesthesia evaluation can result in significant reduction in costs when compared to that oriented by the surgeon. Good concordance in ASA classification was observed.
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Rev Bras Anestesiol · Jan 2011
Intraosseous anesthesia in hemodynamic studies in children with cardiopathy.
Intraosseous (IO) access has been used with good results in emergency situations, when venous access is not available for fluids and drugs infusion. The objective of this study was to evaluate IO a useful technique for anesthesia and fluids infusion during hemodynamic studies and when peripheral intravascular access is unobtainable. The setting was an university hospital hemodynamics unit, and the subjects were twenty one infants with congenital heart disease enrolled for elective hemodynamic study diagnosis. ⋯ Results showed superiority for IO infusion when considering the puncture time of the procedure. Due to its easy manipulation and efficiency, hydration and anesthesia by IO access was satisfactory for hemodynamic studies without the necessity of other infusion access.
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Rev Bras Anestesiol · Jan 2011
ReviewCaudal epidural anesthesia: an anesthetic technique exclusive for pediatric use? Is it possible to use it in adults? What is the role of the ultrasound in this context?
Caudal epidural anesthesia is the most popular regional anesthesia technique used in children. With advanced age, only the relative difficulty in localizing the sacral hiatus limits its use. However, in adults this technique has been widely used to control chronic pain by adjuvant use of fluoroscopy. Thus, the ability to locate the hiatus and define anatomical variations is the main determinant of the success and safety of caudal epidural anesthesia. In this context, the use of the ultrasound in caudal epidural anesthesia has been increasing. The objective of this review was to determine the role of the ultrasound in caudal epidural anesthesia and to demonstrate that this technique, widely used in children, is also useful and can be used in adults. ⋯ Despite its limitations, the ultrasound can be a useful tool to position the needle in the caudal space. It allows prompt identification of the sacral anatomy and real-time visualization of the injection. Considering it is portable, non-invasive, and free of radiation exposure, it is an attractive technique in the operating room especially in difficult cases. However, since its use in neuroaxis anesthesia is very primitive, more studies are necessary to make it a routine technique in anesthetic practice.