Revista brasileira de anestesiologia
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Rev Bras Anestesiol · Jul 2011
Case ReportsRetrograde orotracheal intubation with a double-lumen tube.
Difficult airway management in thoracic surgeries is a peculiar subject due to the demands of monopulmonary ventilation with double-lumen tubes. Flexible bronchoscopy guidance is extremely important, but it is not always available. The objective of this report was to describe a case of retrograde selective orotracheal intubation in the absence of specific endoscopy equipment for the procedure. ⋯ Retrograde selective orotracheal intubation is a minimally invasive technique, low cost, safe, and extremely useful whenever flexible bronchoscopy is not available.
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Rev Bras Anestesiol · Jul 2011
Case ReportsAnaesthesia for caesarean section in a patient with lumbar syringomyelia.
Syringomyelia is a rare neurological condition characterized by the presence of an expansive cystic cavity in the spinal cord, resulting in several neurologic manifestations. The objective of the present report was to address the safety of general anesthesia in this group of patients. ⋯ General anesthesia can be safely used in patients with syringomyelia. Care should be taken to prevent increase in intracranial pressure and neuromuscular blockade should be monitored.
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Rev Bras Anestesiol · Jul 2011
ReviewIntraoperative monitoring with transesophageal echocardiography in cardiac surgery.
Since its clinical introduction in the 80s, intraoperative transesophageal echocardiography (TEE) has represented one of the greatest advances in modern cardiac anesthesia. It is a semi-invasive technique that allows direct and fast visualization of structural anatomy of the heart and great vessels as well as contributes to hemodynamic and functional evaluation of the cardiovascular system. Thus, it has become an important monitor in aiding the diagnosis of cardiac pathologies and anesthesia and surgical interventions. The objective of this report was to perform a comprehensive review on the use of intraoperative TEE in cardiac surgery. ⋯ Intraoperative TEE is a safe method of cardiovascular monitoring, which is useful in the formulation of a surgical strategy, orientation of hemodynamic interventions, and immediate assessment of surgical outcomes. Once qualified to use the method, the anesthesiologist expands its role in perioperative medicine, providing clinical information necessary to the anesthetic-surgical procedure in cardiac surgery.
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Rev Bras Anestesiol · Jul 2011
Randomized Controlled Trial Comparative StudyComparison between the hemodynamic parameters of rigid laryngoscopy and lighted stylet in patients with coronariopathies.
Anesthesiologists are responsible for airway management whenever they assume the anesthesia of a patient. In this study, we compare the hemodynamic parameters of rigid laryngoscopy and lighted stylet in patients with coronariopathies. ⋯ It was possible to observe that both techniques are safe for tracheal intubation in patients with coronariopathies. However, lighted stylet has fewer repercussions on mean arterial pressure.
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Rev Bras Anestesiol · Jul 2011
Randomized Controlled TrialIncidence of regional pain syndrome after carpal tunnel release. Is there a correlation with the anesthetic technique?
Complex regional pain syndrome (CRPS) previously known as reflex sympathetic dystrophy refers to a set of signs and symptoms that include pain, increased sweating, and vasomotor instability. Pain is usually triggered by a noxious stimulus in a peripheral nerve, which is disproportionate to the triggering stimulus. Its development after surgery is not uncommon varying with the type of intervention. An incidence of 2.1 to 5% has been reported after carpal tunnel release (CTR). Sympathetic blockade may prevent the onset of CRPS. However, there is no study validating this technique to prevent CRPS after CTR. The objective of the present study was to define the incidence of CRPS after CTR and its relationship with four anesthetic techniques. ⋯ Complex regional pain syndrome has an incidence of 8.3% after CTR surgery without association with the anesthetic techniques investigated.