Revista brasileira de anestesiologia
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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.
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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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The intraoperative awareness is an adverse event in the general anesthesia, and may occur in approximately 20,000 cases per year, which justifies the study of the risk factors for this event. The objective of this study was to review this subject in order to reduce the incidence of intraoperative awareness and psychological sequelae incurring from this incident, which may result in post-traumatic stress disorder with negative repercussions on the surgical patient social, psychic and functional development. ⋯ The reduction of awareness incidence during anesthesia is related to the anesthesiologist improved scientific and technical performance, involving issues such as monitoring, comprehension of the anesthesia activity components, hypnotic and analgesic drugs, neuromuscular blocking agents, autonomic and motor reflex control, in addition to the risk factors involved in this event.
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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.