Revista brasileira de anestesiologia
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Rev Bras Anestesiol · May 2011
Randomized Controlled Trial[Effects of sedation produced by the association of midazolam and ketamine s(+) on encephalographic variables].
Ketamine S(+) is important in pain modulation in surgical patients. The objective of the present study was to evaluate the relationship between the levels of sedation produced by low doses of ketamine S(+), as well as encephalographic variables: BIS, SEF 95%, pEMG, suppression rate, and presence of burst-suppression. ⋯ Sedation levels showed significant correlation with the increase in ketamine S(+) dosage. However, increased BIS levels may have reflected increased pEMG induced by ketamine S(+).
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Rev Bras Anestesiol · May 2011
Case Reports[Latex-induced anaphylactic reaction in a patient undergoing open appendectomy. Case report].
Despite the increase of latex allergy in general population, severe anaphylactic events during some surgical procedures are still rare; however, they are associated with increased morbidity and mortality. Prevention, diagnosis, treatment, and follow-up of patients affected by this event represent a challenge for anesthesiologists. The objective of this report was to describe a case of severe latex induced anaphylactic reaction and discuss its diagnosis and treatment. ⋯ Anesthesiologists should focus on patient's history, even in urgent procedures, being aware of the limitations arising on these situations. The prognosis of anaphylaxis depends on prompt initiation of adequate treatment; diagnosis is not limited to the event occasion, but to the determination of the causative factor. Creating the means of following-up these patients, similar to other international centers, seems to be the example to be followed.
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Rev Bras Anestesiol · May 2011
[Non-invasive monitoring based on bioreactance reveals significant hemodynamic instability during elective cesarean delivery under spinal anesthesia].
Blood pressure monitoring offers a limited understanding of the hemodynamic consequences of spinal anesthesia for cesarean delivery. The purpose of this study was to assess, with the aid of a non-invasive cardiac output monitor based on bioreactance, the hemodynamic changes during elective cesarean delivery under spinal anesthesia in which intermittent boluses of phenylephrine were used to prevent and treat hypotension. ⋯ A new non-invasive monitor based on bioreactance reveals significant hemodynamic fluctuations during cesarean delivery under spinal anesthesia, despite attempts to maintain blood pressure at baseline levels with intermittent boluses of phenylephrine.
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Rev Bras Anestesiol · Mar 2011
Randomized Controlled TrialImpact of alveolar recruitment maneuver in the postoperative period of videolaparoscopic bariatric surgery.
Pulmonary complications in bariatric surgery are common and, therefore, alveolar recruitment maneuvers (ARM) have been used to prevent or reduce them in the postoperative period (POP). The aim of this study was to evaluate the impact of ARM performed intraoperatively in patients undergoing bariatric surgery by videolaparoscopy in the incidence of postoperative pulmonary complications. ⋯ We conclude that ARM is a safe and effective technique when used for prevention of pulmonary complications in patients undergoing bariatric surgery, resulting in more favorable radiological and spirometric findings in the experimental group compared to the control group in the PO.
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Rev Bras Anestesiol · Mar 2011
Difficult intubation in children: applicability of the Mallampati index.
The concern of facing difficult airways brought the need of developing predictive testing for difficult intubation. Those tests were developed primarily for adult populations. In pediatric patients studies always focus on patients with congenital malformation, polytraumatized, and newborns. The objective of the present study was to determine the applicability of the predictive test used more often in adults, the Mallampati index, in patients 4 to 8 years old, correlating it with the Cormack-Lehane index. ⋯ The Mallampati index was proven to be applicable in children 4 to 8 years old.