Revista brasileira de anestesiologia
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Rev Bras Anestesiol · Jul 2012
Case ReportsCase of anaphylaxis induced by rocuronium treated with sugammadex.
Anaphylaxis during anesthesia is a rare event that may occur in up to 1:20,000 cases and approximately 60% to 70% of these cases are secondary to the use of muscle relaxants, particularly succinylcholine and rocuronium. The aim of this report is to describe the treatment of a case of rocuronium-induced anaphylaxis with inadequate response to traditional therapy, and the case resolution after using sugammadex. ⋯ In this case, sugammadex was used to reverse the hemodynamic picture caused by rocuronium-induced anaphylaxis. However, it was not possible to identify the exact mechanism for the reversal.
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To assess the accuracy of the ultrasound (US) to predict the depth to reach lumbar intrathecal and epidural spaces in order to decrease the number of puncture attempts. ⋯ This study supports the idea that the US transversal plane allows the identification of axial anatomical structures and provides physicians with efficient information to perform spinal anesthesia.
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Prolonged use of opioids is a possibility for chronic pain treatment. Opioids are effective for virtually all chronic noncancer pain syndromes, but may cause dependence. The aim of this paper is to review the use and rotation of opioids in chronic non-oncologic pain. ⋯ Opioids are drugs with proven efficacy for chronic non-oncologic pain, but its prescription should meet certain criteria in order to reduce the incidence of adverse effects and addiction.
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Although there is extensive discussion on the subject in medical literature, most of the questions still unanswered due to the lack of clear definitions and guidelines, in addition to a large number of contradictions in literature. The aim of this review is to try to determine the best form of sedation for patients with cancer. ⋯ Although in recent years palliative sedation is being considered a normal medical practice, there are still many gaps in our current understanding. There is no consensus about which are the standard drugs, maintenance or not of food, fluid intake, and hydration. Moreover, there is no ethical clarification on possible life-shortening effects and decision-making process.