Revista brasileira de anestesiologia
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Rev Bras Anestesiol · Feb 2004
Inhaled gases humidification and heating during artificial ventilation with low flow and minimal fresh gases flow.
Inhaled gas humidification and heating are necessary in patients under tracheal intubation or tracheostomy to prevent damage to respiratory system resulting from the contact of cold and dry gas with the airways. This study aimed at evaluating the effect of respiratory circle systems with carbon dioxide absorbers from Dräger's Cicero anesthesia machine (Germany) as to inhaled gases heating and humidification ability using low fresh gases flow (1 L min(-1)) or minimum flow (0.5 L min(-1)). ⋯ There have been no significant differences in inhaled gas humidity and temperature with fresh gases low flow or minimum flow.
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In has been shown in non-obstetric patients, that a fast acute fluid preload immediately after spinal anesthesia was more effective than a slow preload before regional block to decrease the incidence and severity of arterial hypotension after spinal anesthesia. This study aimed at comparing the incidence of arterial hypotension and vasopressants consumption in parturients submitted to C-section under spinal anesthesia with different fluid preload regimens. ⋯ Acute preload before or after spinal anesthesia performance, in a slow or fast rate, does not change vasopressants consumption, the incidence of maternal arterial hypotension, nausea and vomiting, as well as fetal wellbeing.
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Remifentanil is the newest opioid for anesthetic procedures. This study aimed at reviewing the literature, with emphasis on information of clinical interest published from January 2000 to December 2002. ⋯ Remifentanil is currently the best opioid for continuous intravenous infusion and may improve anesthesiologist's efficiency provided usage recommendations are followed.
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Rev Bras Anestesiol · Feb 2004
Influence of stimulation frequency on rocuronium and pancuronium-induced neuromuscular block onset. Acceleromyography evaluation.
Factors associated to patients and neuromuscular blockers (NMB), as well as others inherent to neuromuscular function monitoring, may affect neuromuscular block onset. This study aimed at the influence of two different stimulation frequencies on rocuronium and pancuronium-induced neuromuscular block. ⋯ Rocuronium and pancuronium-induced neuromuscular block onset and time required for complete adductor pollicis muscle neuromuscular block are shorter when higher stimulation frequencies are applied.
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Since controlling tracheal tube cuffs internal pressure is unusual and there is no detailed description in the literature on how to maintain it below 30 cmH2O without manometer, this study aimed at checking tracheal tube intra-cuff pressures in intensive care unit and operating room patients. A maneuver was tested to keep intra-cuff pressure below 30 cmH2O, but at minimum levels needed for ventilator cycling with no tidal volume leakage. ⋯ Both groups had intra-cuff pressures higher than necessary to keep ventilator cycling with no tidal volume leakage. Maneuver to keep intra-cuff pressure below 30 cmH2O was simple and cheap.