Revista brasileira de anestesiologia
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Rev Bras Anestesiol · Jan 2011
Correlation between the body mass index (BMI) of pregnant women and the development of hypotension after spinal anesthesia for cesarean section.
Very few publications correlate hypotension in obese pregnant women, and especially morbidly obese, after spinal anesthesia for cesarean section. The objective of the present study was to evaluate the incidence of hypotension according to the BMI. ⋯ In the study sample, pregestational BMI ≥ 25 kg.m(-2) was a risk factor for hypotension after spinal anesthesia in patients undergoing cesarean section. The same group of patients required higher doses of vasopressors. Those results indicate that the anesthetic techniques in those patients should be improved to reduce the consequences of post-spinal anesthesia hypotension, both in pregnant women and fetuses.
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Rev Bras Anestesiol · Jan 2011
Reevaluation of the airways of obese patients undergone bariatric surgery after reduction in body mass index.
Difficulty intubating is a cause of mortality in anesthesiology and it can be related to obesity. The diagnosis of difficult intubation contributes for successful airways management. However, parameters that predict difficult airways are not well established. Mallampati classification, the interincisor gap, neck circumference, thyromental distance, and the presence of obstructive sleep apnea, are parameters that can indicate difficult intubation. Surgical treatment of obesity provides reduction in body mass index (BMI) with stabilization after about 2 years. The objective of the present study was to reevaluate the parameters described above and compare them with pre-surgical values. ⋯ Reduction of the BMI allows for an increased interincisor gap, thyromental distance, and reduction in neck circumference. Mallampati classification remains the same.
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Rev Bras Anestesiol · Jan 2011
Bioethics and anesthesia: a reflexive study of reports published in the Brazilian Journal of Anesthesiology.
There is a great lack of theoretical subsidies to guide ethical principles, specifically in the case of Anesthesiology. The objective of the present study was to analyze the bibliographic production regarding Bioethics in studies published by the Brazilian Journal of Anesthesiology between 1999 and 2009. ⋯ In the studies mentioned, Bioethics is considered an ideal to be achieved, facing difficulties to be applied in daily Anesthesia practice. The need of studies that focus on anesthesia and Bioethics more specifically, reflecting problems regarding both subjects, should be emphasized.
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The brachial plexus represents an important network of nerves, commonly approached in nerve blocks prior to surgical procedures. Therefore, the knowledge of its anatomy is indispensable so those procedures can be carried out accordingly. The objective of the present study was to analyze the morphology of brachial plexus cords with special emphasis to its topographic relationships. ⋯ The results were in concordance with the anatomical descriptions of classical authors. This study allowed the analysis of the morphology of the brachial plexus cords, demonstrating its main topographic relationships.
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Rev Bras Anestesiol · Nov 2010
Influence of central venous oxygen saturation on in-hospital mortality of surgical patients.
Low central venous oxygen saturation (ScvO₂) indicates an imbalance between cellular oxygen supply and consumption and, consequently, worse prognosis for critical patients. However, it is not clear what the value of this marker in surgical patients. The objective of the present study was to evaluate whether low perioperative ScvO₂ determines a worse prognosis. ⋯ Intraoperative ScvO₂ levels are higher than those both in the pre- and postoperative period. However, low preoperative ScvO₂ determines worse prognosis.