Revista brasileira de anestesiologia
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Rev Bras Anestesiol · Nov 2011
Comparative StudyThe efficacy of terlipressin versus adrenaline in swine cardiopulmonary resuscitation.
The objective of the present study was to evaluate the efficacy of terlipressin (TP) vs. adrenaline (ADR) in increasing coronary perfusion pressure (CPP) and return of spontaneous circulation (ROSC) in swine CPR. ⋯ Adrenaline and TP + ADR were effective on maintaining CPP/ROSC in this experimental model, but isolated TP did not differ from placebo. However, in surviving animals in the TP + ADR group, greater hemodynamic stability was observed after ROSC, suggesting that TP can be a useful medication in the management of post-CPR hypotension.
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Rev Bras Anestesiol · Nov 2011
Randomized Controlled Trial Comparative StudyMethadone and morphine during anesthesia induction for cardiac surgery. Repercussion in postoperative analgesia and prevalence of nausea and vomiting.
Pain is an aggravating factor in postoperative morbidity and mortality especially in large size surgeries. Methods to effectively fend pain collide with elevated costs and for this reason they are not accessible in every service. The option would be the use of an opioid with long half-life, such as methadone. The objective of the present study was to compare the requirements of postoperative analgesia in patients who received methadone, morphine, or placebo during anesthetic induction, besides the prevalence of postoperative nausea and vomiting. ⋯ Methadone during anesthetic induction was effective for analgesia in large size surgeries. Lower incidence of nausea and vomiting was observed in the methadone group and therefore it is a low cost option available among us that should be stimulated.
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Sex is an important factor in painful experience modulation. Large volume of evidence shows that experience is different for males and females, as well as the answer to some classes of analgesics. ⋯ The differences in pain perception related to sex may be associated with hyperalgesia in women, but also to the hypoactivity of the inhibitory system of pain in females. The purpose of this review besides showing some relationship for gonadal hormones, central nervous system and pain is to provide reference points for the discussion of one of the most intriguing aspects of the pathophysiology of pain: the differences in the presence of painful stimuli related to gender.
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Rev Bras Anestesiol · Nov 2011
Comparative StudyAssessing the use of 50% enantiomeric excess bupivacaine-loaded microspheres after sciatic nerve block in rats.
To achieve better therapeutic benefits of local anesthetics in the control of postoperative pain through controlled-release carrier. The objective of this study was to compare the characteristics of sensory and motor blockade between microspheres without local anesthetic: racemic bupivacaine-loaded microspheres; 50% enantiomeric excess bupivacaine-loaded microspheres; and free 50% enantiomeric excess bupivacaine. ⋯ Controlled-release of 50% enantiomeric excess bupivacaine-loaded microspheres showed similar results regarding analgesia and less motor blockade when compared to other anesthetic formulations.
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Rev Bras Anestesiol · Nov 2011
Cephalad angulation of epidural needle insertion may be an important factor for safe epidural space approach: a mathematical model.
Epidural approach angle is one of the determining factors for needle traveling length to reach the epidural space. Likewise, the margin of safety against accidental dural puncture should be affected by epidural approach angle because the space available for epidural needle tip movement in the epidural space is depending on the inserting angle to the epidural space. The purpose of this study is to conjecture the effect of the angle formed with the skin and an epidural needle on the margin of safety against accidental dural puncture using a mathematical model. ⋯ Acute cephalad angulation should be considered to increase the margin of safety for epidural approach and catheterization.