Revista brasileira de anestesiologia
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Rev Bras Anestesiol · Nov 2010
Review Case ReportsIntracranial subdural hematoma post-spinal anesthesia: report of two cases and review of 33 cases in the literature.
Intracranial subdural hematoma is a rare complication of spinal anesthesia. We report two cases of women who developed chronic subdural hematoma post-spinal anesthesia diagnosed after prolonged clinical evolution of post-dural puncture headache (PDPH) and we analyze other 33 cases found on literature review. ⋯ The presence of any of the signs or symptoms mentioned above should alert for the possibility of an intracranial subdural hematoma as a complication of puncture of the dura mater, especially in those patients with PDPH for more than one week, at which time investigation by neuroimaging is necessary.
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Opioids are commonly used for pain control; however, they can cause hyperalgesia. The reason why this can happen is not known. The objective of this review was to describe the mechanisms, factors implicated, and drug modulation. ⋯ This is a very complex subject, which involves a series of pathophysiological mechanisms that could contribute for OIH and patient discomfort, bringing disastrous consequences.
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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.
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Rev Bras Anestesiol · Sep 2010
Randomized Controlled Trial Comparative StudyIntravenous and subcutaneous tramadol for inguinal herniorrhaphy: comparative study.
Inguinal herniorrhaphy is one of the most common surgeries in men. Neuroaxis block is the anesthetic technique used more often and in the majority of the cases the patient is ready to be discharged from the hospital a few hours after the procedure, as long as satisfactory analgesia is present and nausea and vomiting are absent. Tramadol is an analgesic drug that can be used in postoperative analgesia, but it has important side effects, such as nausea and vomiting whose incidence can range from 0% to 50%. The objective of the present study was to compare the incidence of nausea and vomiting and the quality of postoperative analgesia of subcutaneous and intravenous tramadol in patients undergoing inguinal herniorrhaphy. ⋯ The present study demonstrates the absence of statistically significant differences regarding the incidence of nausea and vomiting and quality of analgesia when using intravenous and subcutaneous Tramadol.