Revista brasileira de anestesiologia
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Rev Bras Anestesiol · Aug 2004
[Epidural clonidine or dexmedetomidine for post-cholecystectomy analgesia and sedation.].
Clonidine and dexmedetomidine are alpha2-adrenergic agonists with analgesic proprieties which potentiate local anesthetic effects when epidurally administered. The goal of this study was to evaluate the analgesia and sedation promoted by clonidine or dexmedetomidine associated to epidural ropivacaine, in the postoperative period of subcostal cholecystectomy. ⋯ Our results allowed to conclude that the association of clonidine or dexmedetomidine to 0.75% ropivacaine induces analgesia and sedation in 2 and 6 hours after anesthetic recovery in patients submitted to subcostal cholecystectomy and that clonidine promotes more prolonged analgesia.
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Rev Bras Anestesiol · Aug 2004
[Epidural caudal block: evaluation of length of analgesia with the association of lidocaine, fentanyl and clonidine.].
The association of different substances to local anesthetics aims to improve the blockade quality and prolonging analgesia. The aims of this study were to compare the effectiveness of the association of clonidine, clonidine and fentanyl, and fentanyl, to lidocaine for postoperative analgesia. ⋯ Clonidine, associated or not to fentanyl, has prolonged postoperative analgesia after epidural caudal blockade with lidocaine.
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Rev Bras Anestesiol · Aug 2004
[Bilateral pleural block: analgesia and pulmonary functions in postoperative of median laparotomies.].
Notwithstanding pleural block having become almost an analgesic panacea, contradictory results have been published. This study aimed at observing analgesic and spirometric behavior of pulmonary function in the immediate postoperative period of 21 patients submitted to urgency median laparotomies under bilateral pleural block. ⋯ In our study, postoperative pain control with bilateral pleural block after urgency median laparotomies was null with saline. With bupivacaine, however, analgesia was not considered fully effective in all patients during movements on bed and deep breathing. Pleural block does not seem to have the same analgesic outcome for all patients.
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Rapid sequence induction anesthesia is primarily used to protect airways when there is gastric content aspiration risk. This study aimed at reviewing the technique and different protocols looking for the rational use of available drugs, in the search for ideal tracheal intubation conditions without increasing the risk of gastric content aspiration or other complications. ⋯ Tracheal intubation after rapid sequence induction of anesthesia is indicated for patients at risk for gastric content aspiration without suspicion of difficult intubation. The adequate indication of the technique, its judicious application and the rational use of available drugs may promote excellent intubation conditions, with fast onset, early return to consciousness and spontaneous breathing in case of tracheal intubation failure.
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Rev Bras Anestesiol · Jun 2004
[Continuous epidural analgesia: analysis of efficacy, side effects and risk factors.].
Epidural analgesia with local anesthetics and opioids has a reputation of high efficacy with low incidence of side effects. This study aimed at determining incidence, type and severity of postoperative complications related to epidural analgesia and catheter insertion. ⋯ Continuous epidural analgesia is effective and safe. Complications were not severe. However, strict vigilance is mandatory to achieve satisfactory analgesia and a low incidence of complications.