Revista brasileira de anestesiologia
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Physicians has a slightly higher rate of psychoactive substance use when compared to the population in general. Anesthesiology is one of the most affected medicine specialties, especially due to overwork and easier access to drugs. This paper aims to carry out a literature review on the topic. Therefore, research was conducted by searching topic-related keywords on papers from the last 30 years available on MEDLINE. ⋯ Substance abuse by anesthesiologists is an issue that needs to be discussed further, especially due to the possibility of severe consequences for professionals and patients.
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Rev Bras Anestesiol · May 2012
The median effective volume of crystalloid in preventing hypotension in patients undergoing cesarean delivery with spinal anesthesia.
Spinal anesthesia-associated maternal hypotension in Cesarean delivery is the most frequent and troublesome complication, posing serious risks to mothers and compromising neonatal well-being. The effective volume of intravenous crystalloid as the preventive strategy in this context has not been estimated. ⋯ The estimated EV(50) of the preloaded crystalloid required to prevent spinal anesthesia-induced hypotension in a Cesarean section is, approximately, 13mL.kg(-1). However, prophylactic or therapeutic vasoconstrictors should also be prepared and administered at an appropriate time.
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Rev Bras Anestesiol · May 2012
Randomized Controlled Trial Comparative StudyRopivacaine for unilateral spinal anesthesia; hyperbaric or hypobaric?
The aim of this study was to compare the unilaterality of subarachnoid block achieved with hyperbaric and hypobaric ropivacaine. ⋯ Both hyperbaric and hypobaric ropivacaine (11.25mg) provided adequate and dependable anesthesia for total knee replacement surgery, with a high level of patient and surgeon comfort. Hypobaric local anesthetic solutions provide a high level of unilateral anesthesia, with rapid recovery of both sensory and motor block, and therefore may be preferable in outpatient settings.
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Rev Bras Anestesiol · May 2012
Clinical and demographic profile of anesthesiologists using alcohol and other drugs under treatment in a pioneering program in Brazil.
Anesthesiologists are the majority in impaired-physician programs that assist physicians who abuse psychoactive substances. The aim of this paper is to show a descriptive study about the clinical and sociodemographic profile of a sample of chemically dependent anesthesiologists treated in a reference program. In addition, the objective is to cite the psychiatric comorbities, the most frequently used drugs and the psychosocial and professional repercussions of substance abuse. ⋯ Anesthesiologists may present a different profile concerning the risks of opioid use. Opioid abuse usually begins during medical residency or during the first years of clinical practice, which supports the hypothesis that addiction to opioids is an occupational issue among anesthesiologists.
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Rev Bras Anestesiol · May 2012
Assessment of anesthesiologists' rapid sequence induction technique in an university hospital.
The induction of the general anesthesia in patients on "a full stomach" can result in regurgitation of the gastric content and pulmonary aspiration. The function of the rapid sequence induction (RSI) is to minimize the time interval between the loss of the airway protection reflexes and tracheal intubation tube balloon. The objective of this study was to evaluate the rapid sequence induction among the anesthesiologists of the São Paulo Hospital. ⋯ This study showed a broad individual variety of the RSI technique, a fact already reported by different authors. The difficulty in establishing a RSI protocol can be attributed to constant evidence that science provides us, where updating over the years becomes good medical practice.