Revista brasileira de anestesiologia
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Rev Bras Anestesiol · Jul 2008
Thoracic epidural block performed safely in anesthetized patients. A study of a series of cases.
The development of paraplegia following the insertion of epidural catheter in anesthetized patients raised questions by some authors about the procedure, even without the confirmation that the lesion occurred because the patient was anesthetized. For this reason, we designed this study, with the objective to evaluate the frequency of neurological complications and development of sequelae after thoracic epidural block in patients under general anesthesia. ⋯ The cases studied here did not develop any neurologic complications. When performed judiciously and with specific care, thoracic epidural block can be safely done in the anesthetized patient.
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Rev Bras Anestesiol · Jul 2008
Standardization of anesthesia in swine for experimental cardiovascular surgeries.
Although dogs are the animals used more often in Experimental Surgeries, the use of sheep, bovine, and swine as models for scientific experiments has been growing. Thus, further learning on the treatment and basic standardization of more complex surgeries in swine are necessary. The objective of this study was to evaluate sedation and analgesia, obtained by the intramuscular administration of midazolam and ketamine, and local anesthetics with 2% lidocaine without vasoconstrictor, in tracheostomy and dissection of femoral artery and vein. ⋯ An adequate plane of anesthesia for the proposed procedure was achieved.
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Rev Bras Anestesiol · May 2008
Comparative StudyContinuous infusion of remifentanil versus sufentanil in videolaparoscopic surgeries. A comparative study.
Continuous infusion (CI) of remifentanil is common in total intravenous anesthesia. On the other hand, CI of sufentanil for short/medium-term surgeries has not been widely used. The objective of this study was to compare two techniques of total intravenous anesthesia, using CI of remifentanil or sufentanil, regarding their intraoperative behavior and characteristics of recovery of patients undergoing videolaparoscopic surgeries. ⋯ Hemodynamic control was satisfactory in both groups. Continuous infusion of sufentanil promoted better postoperative pain control with decreased consumption of rescue analgesic and, consequently, reduced incidence of PONV and reduced time of stay in the recovery room.
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Rev Bras Anestesiol · May 2008
Randomized Controlled Trial Comparative StudyA comparative study between one and two effective doses (ED95) of rocuronium for tracheal intubation.
Neuromuscular blockers (NMB) are used to induce relaxation of skeletal muscles and facilitate tracheal intubation (TI). According to the literature, two effective doses (ED95) of NMB are ideal for TI. Rocuronium is a steroid-type, synthetic, non-depolarizing neuromuscular blocker of medium duration. The objective of this study was to evaluate and compare the conditions of tracheal intubation with one and two effective doses (ED95) of rocuronium, following the criteria of the Copenhagen Consensus Conference. ⋯ Both doses of rocuronium, 0.3 mg kg(-1) and 0.6 mg kg(-1) ED95, provided clinically satisfactory parameters of TI in elective procedures.
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Rev Bras Anestesiol · May 2008
ReviewBreakage of epidural catheters: etiology, prevention, and management.
The objective of this study was to review published cases of breakage of epidural catheters and, with the data gathered in the literature, to identify predisposing factors for catheter breakage, and list the recommended conducts to prevent and treat this complication. ⋯ The catheter should not be inserted more than five centimeters into de epidural space. Exploratory laminectomy should be undertaken if the patient develops signs or symptoms of neurologic changes, if the catheter is inside the subarachnoid space, or whenever the tip of the catheter is emerging out of the skin. Due to the difficulty to localize retained fragments by imaging exams, catheters should be manufactured with materials that improve their visualization.