Revista brasileira de anestesiologia
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Rev Bras Anestesiol · Sep 2014
[Comparison of metaraminol, phenylephrine and ephedrine in prophylaxis and treatment of hypotension in cesarean section under spinal anesthesia].
Maternal hypotension is a common complication after spinal anesthesia for cesarean section, with deleterious effects on the fetus and mother. Among the strategies aimed at minimizing the effects of hypotension, vasopressor administration is the most efficient. The aim of this study was to compare the efficacy of phenylephrine, metaraminol, and ephedrine in the prevention and treatment of hypotension after spinal anesthesia for cesarean section. ⋯ Rescue boluses were higher only in the ephedrine group compared to metaraminol group. The incidence of nausea and vomiting and fetal acidosis were greater in the ephedrine group. The three drugs were effective in preventing hypotension; however, fetal effects were more frequent in the ephedrine group, although transient.
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Rev Bras Anestesiol · Sep 2014
[Intraoperative esmolol infusion reduces postoperative analgesic consumption and anaesthetic use during septorhinoplasty: a randomized trial].
Esmolol is known to have no analgesic activity and no anaesthetic properties; however, it could potentiate the reduction in anaesthetic requirements and reduce postoperative analgesic use. The objective of this study is to evaluate the effect of intravenous esmolol infusion on intraoperative and postoperative analgesic consumptions as well as its effect on depth of anaesthesia. ⋯ Intravenous infusion of esmolol reduced the intraoperative and postoperative analgesic consumption, reduced visual analogue scale scores in the early postoperative period and prolonged the time to first analgesia; however it did not influence the depth of anaesthesia.
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Rev Bras Anestesiol · Nov 2012
Randomized Controlled Trial Comparative StudySpinal anesthesia with low-dose bupivacaine-fentanyl combination: a good alternative for day case transurethral resection of prostrate surgery in geriatric patients.
We evaluated the effectiveness, block duration, postanesthesia care unit stay and adverse effects of using intrathecal low dose bupivacaine and fentanyl combination and compared with conventional dose prilocaine and fentanyl combination for day case transurethral resection of prostate surgery in geriatric patient population. ⋯ Intrathecal 4 mg bupivacaine + 25 μg fentanyl provided adequate spinal anesthesia with shorter block duration and postanesthesia care unit stay with stable hemodynamic profile than intrathecal 50 mg prilocaine + 25 μg fentanyl for day case transurethral resection of prostate surgery in geriatric patients.
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Rev Bras Anestesiol · Nov 2012
Randomized Controlled TrialSpinal anesthesia for cesarean section. Use of hyperbaric bupivacaine (10mg) combined with different adjuvants.
Combination of local anesthetics (LA) with adjuvants for spinal anesthesia improves block quality and prolongs the duration of analgesia. It was evaluated the maternal effects and neonatal repercussions of sufentanil, morphine, and clonidine combined with hyperbaric bupivacaine for elective cesarean section. ⋯ Addition of sufentanil and clonidine to hyperbaric bupivacaine provided adequate anesthesia for cesarean section and good postoperative analgesia. Clonidine caused more perioperative sedation and longer time to motor block recovery. Pruritus was evident when opioids were used.