Revista brasileira de anestesiologia
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Rev Bras Anestesiol · Mar 2016
[Total knee replacement induces peripheral blood lymphocytes apoptosis and it is not prevented by regional anesthesia - a randomized study].
Among the many changes caused by a surgical insult one of the least studied is postoperative immunosuppression. This phenomenon is an important cause of infectious complications of surgery such as surgical site infection or hospital acquired pneumonia. One of the mechanisms leading to postoperative immunosuppression is the apoptosis of immunological cells. Anesthesia during surgery is intended to minimize harmful changes and maintain perioperative homeostasis. The aim of the study was evaluation the effect of the anesthetic technique used for total knee replacement on postoperative peripheral blood lymphocyte apoptosis. ⋯ Peripheral blood lymphocyte apoptosis is an early event in the postoperative period lasts up to seven days and is not affected by the choice of the anesthetic technique.
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Rev Bras Anestesiol · Mar 2016
[In vitro evaluation of the method effectiveness to limit inflation pressure cuffs of endotracheal tubes].
Cuffs of tracheal tubes protect the lower airway from aspiration of gastric contents and facilitate ventilation, but may cause many complications, especially when the cuff pressure exceeds 30cm H2O. This occurs in over 30% of conventional insufflations, so it is recommended to limit this pressure. In this study we evaluated the in vitro effectiveness of a method of limiting the cuff pressure to a range between 20 and 30cm H2O. ⋯ This method was effective for inflating tracheal tube cuffs of different sizes and manufacturers, limiting its pressure to a range between 20 and 30cm H2O, with a success rate of 99.5% (95% CI: 99.1-99.9%).
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Rev Bras Anestesiol · Mar 2016
[Accidental catheterization of epidural venous plexus: tomographic analysis].
Inadvertent venous catheterizations occur in approximately 9% of lumbar epidural anesthetic procedures with catheter placement and, if not promptly recognized, can result in fatal consequences. The objective of this report is to describe a case of accidental catheterization of epidural venous plexus and its recording by computed tomography with contrast injection through the catheter. ⋯ It is possible to identify the actual placement of the epidural catheter, as well as to register an accidental catheterization of the epidural venous plexus, using computed tomography with contrast injection through the epidural catheter.
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Rev Bras Anestesiol · Mar 2016
[Effectiveness of combined regional-general anesthesia for reducing mortality in coronary artery bypass: meta-analysis.]
Neuraxial anesthesia (NA) has been used in association with general anesthesia (GA) for coronary artery bypass; however, anticoagulation during surgery makes us question the viability of benefits by the risk of epidural hematoma. The aim of this study was to perform a meta-analyzes examining the efficacy of NA associated with GA compared to GA alone for coronary artery bypass on mortality reduction. ⋯ There was no significant difference in mortality. Combined NA and GA showed lower incidence of arrhythmias and lower ICUS.
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Rev Bras Anestesiol · Mar 2016
[Use of a homemade introducer guide (bougie) for intubation in emergency situation in patients who present with difficult airway: a case series].
The incidence of difficult airway reaches 10% of emergency intubations. Although few studies address the use of handmade introducer guides in emergency and intensive care environment, there are descriptions of handmade guides available on the Internet. We describe a case series on the use of a handmade introducer guide (bougie) for emergency intubation in patients with difficult airway. ⋯ The use of the handmade introducer guide can be a useful option for the management of difficult airways.