Revista brasileira de anestesiologia
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Rev Bras Anestesiol · Jan 2012
Case ReportsIntracranial subdural hematoma: a rare complication following spinal anesthesia: case report.
Intracranial subdural hematoma is a rare complication following spinal anesthesia. The diagnosis is usually difficult because initial symptoms are the same of post-dural puncture headache. The objective was to report a case of early diagnosed subdural hematoma after spinal anesthesia performed with a fine-gauge needle and single puncture. ⋯ Headache is the most frequent complication after spinal anesthesia and it is considered of benign evolution. In many cases however, it leads to the late or absent diagnosis of potentially fatal conditions, like subdural hematoma. This case describes a rare case of an acute subdural hematoma following spinal anesthesia with fine-gauge needle in a patient without risk factors for bleeding.
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Rev Bras Anestesiol · Jan 2012
Case ReportsAcute respiratory failure during pediatric anesthesia: atelectasis and hypertensive pneumothorax: case report.
The main anesthesiologist's task is to ensure appropriate oxygenation of patient. The objective of this report is to describe both diagnosis and behavior in case of acute respiratory failure during anesthesia, with educational purposes. ⋯ The anesthesiologist's attention to early diagnosis of respiratory complications and knowledge of priority measures in each moment may prevent serious adverse effects.
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Rev Bras Anestesiol · Jan 2012
ReviewSuprascapular nerve block: important procedure in clinical practice.
Shoulder pain is a frequent complaint that results in great functional disability in the affected shoulder as well as the decrease in patients' quality of life. Suprascapular nerve block is an effective therapeutic method and has been increasingly used by anesthesiologists both for regional anesthesia and postoperative analgesia of surgeries carried out in this articulation, which justifies this review, whose main purpose was to describe the applied technique and clinical indications. ⋯ Suprascapular nerve block is a safe and extremely effective procedure in shoulder pain therapy. It also has an easy reproducibility and has been very used by professionals of many medical specialties. When it is well-indicated, this method must be taken into consideration.
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Rev Bras Anestesiol · Jan 2012
ReviewDexmedetomidine: current role in anesthesia and intensive care.
To update and review the application of dexmedetomidine in anesthesia and intensive care. This study is a comprehensive review of clinical uses, pharmacology, pharmacokinetics, mechanism of action and adverse effects of dexmedetomidine. ⋯ Dexmedetomidine offers a unique ability of providing both sedation and analgesia without respiratory depression. It is a new agent with a wide safety margin, excellent sedative capacity and moderate analgesic properties. Although its wide use is currently in patients of surgical and non-surgical intensive care units, dexmedetomidine seems to have promising future applications in neuroprotection, cardioprotection and renoprotection. More detailed studies are required to define its role as sedative in critical, neurosurgical and pediatric patients, as anesthesia adjunct and sedative during procedures.
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Rev Bras Anestesiol · Jan 2012
The perioperative effect of increased body mass index on peripheral nerve blockade: an analysis of 528 ultrasound guided interscalene blocks.
Obese patients can pose a unique perioperative anesthetic challenge, making regional anesthetic techniques an intriguing means of providing analgesia for this population. Ultrasound guidance has been touted recently as being beneficial for this population in which surface landmarks can become obscured. In this study, the effect of increased Body Mass Index (BMI) on ultrasound guided interscalene peripheral nerve blockade is investigated. ⋯ Ultrasound guided interscalene nerve blocks for perioperative analgesia can be safely and effectively performed in the obese patient but they may be more difficult to perform and analgesia may not be as complete.