Revista brasileira de anestesiologia
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Rev Bras Anestesiol · Jul 2011
ReviewIntraoperative monitoring with transesophageal echocardiography in cardiac surgery.
Since its clinical introduction in the 80s, intraoperative transesophageal echocardiography (TEE) has represented one of the greatest advances in modern cardiac anesthesia. It is a semi-invasive technique that allows direct and fast visualization of structural anatomy of the heart and great vessels as well as contributes to hemodynamic and functional evaluation of the cardiovascular system. Thus, it has become an important monitor in aiding the diagnosis of cardiac pathologies and anesthesia and surgical interventions. The objective of this report was to perform a comprehensive review on the use of intraoperative TEE in cardiac surgery. ⋯ Intraoperative TEE is a safe method of cardiovascular monitoring, which is useful in the formulation of a surgical strategy, orientation of hemodynamic interventions, and immediate assessment of surgical outcomes. Once qualified to use the method, the anesthesiologist expands its role in perioperative medicine, providing clinical information necessary to the anesthetic-surgical procedure in cardiac surgery.
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Rev Bras Anestesiol · Jul 2011
Randomized Controlled Trial Comparative StudyComparison between the hemodynamic parameters of rigid laryngoscopy and lighted stylet in patients with coronariopathies.
Anesthesiologists are responsible for airway management whenever they assume the anesthesia of a patient. In this study, we compare the hemodynamic parameters of rigid laryngoscopy and lighted stylet in patients with coronariopathies. ⋯ It was possible to observe that both techniques are safe for tracheal intubation in patients with coronariopathies. However, lighted stylet has fewer repercussions on mean arterial pressure.
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Rev Bras Anestesiol · Jul 2011
Randomized Controlled TrialIncidence of regional pain syndrome after carpal tunnel release. Is there a correlation with the anesthetic technique?
Complex regional pain syndrome (CRPS) previously known as reflex sympathetic dystrophy refers to a set of signs and symptoms that include pain, increased sweating, and vasomotor instability. Pain is usually triggered by a noxious stimulus in a peripheral nerve, which is disproportionate to the triggering stimulus. Its development after surgery is not uncommon varying with the type of intervention. An incidence of 2.1 to 5% has been reported after carpal tunnel release (CTR). Sympathetic blockade may prevent the onset of CRPS. However, there is no study validating this technique to prevent CRPS after CTR. The objective of the present study was to define the incidence of CRPS after CTR and its relationship with four anesthetic techniques. ⋯ Complex regional pain syndrome has an incidence of 8.3% after CTR surgery without association with the anesthetic techniques investigated.
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Rev Bras Anestesiol · Jul 2011
Clinical TrialEffects of prophylactic continuous infusion of phenylephrine on reducing the mass of local anesthetic in patients undergoing spinal anesthesia for cesarean section.
Reducing the mass of local anesthetic minimizes the effects of hypotension after spinal anesthesia for cesarean section and the incidence of maternal adverse events preserving fetal well-being, but it may result in insufficient anesthesia. Hypotension associated with greater masses of subarachnoid anesthesia can be controlled by prophylactic continuous infusion of phenylephrine. The effects of prophylactic continuous infusion of phenylephrine on pressure control on maternal and fetus results in cesarean sections with different doses of hyperbaric bupivacaine in spinal anesthesia. ⋯ On maintaining the blood pressure with prophylactic continuous infusion of phenylephrine the incidence of maternal adverse events and conditions of birth do not differ whether spinal anesthesia is performed with 12 mg or 8 mg of hyperbaric bupivacaine.
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Rev Bras Anestesiol · Jul 2011
Comparative StudyHydroelectrolytic balance and cerebral relaxation with hypertonic isoncotic saline versus mannitol (20%) during elective neuroanesthesia.
Cerebral relaxation during intracranial surgery is necessary, and hiperosmolar therapy is one of the measures used to this end. Frequently, neurosurgical patients have sodium imbalances. The objective of the present study was to quantify and determine cerebral relaxation and duration of hydroelectrolytic changes secondary to the use of mannitol versus hypertonic isoncotic solution (HIS) during neurosurgery. ⋯ A single dose of hypertonic isoncotic saline solution [7.2% NaCl/6% HES (200/0.5)] and mannitol (20%) with equivalent osmolar loads were effective and safe in producing cerebral relaxation during elective neurosurgical procedures under general anesthesia.