Revista brasileira de anestesiologia
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Intravenous lidocaine has been used for several indications since the decade of 1960. Its multimodal mechanism of action was the objective of this review. ⋯ The final analgesic action of intravenous lidocaine is a reflection of its multifactorial action. It has been suggested that its central sensitization is secondary to a peripheral anti-hyperalgic action on somatic pain and central on neuropathic pain, which result on the blockade of central hyperexcitability. The intravenous dose should not exceed the toxic plasma concentration of 5 microg mL(-1); doses smaller than 5 mg kg(-1), administered slowly (30 minutes), under monitoring, are considered safe.
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Rev Bras Anestesiol · May 2008
Review Historical ArticleIntravenous regional anesthesia--first century (1908-2008). Beggining, development, and current status.
Intravenous regional block is celebrating its 10th anniversary in 2008. Since this is a widely used technique, this milestone should be recorded, the date celebrated, Brazilian anesthesiologists should be remembered of its evolutive process, especially in the last 40 years, and we should pay homage to the individual who started it: August Karl Gustav Bier. ⋯ Intravenous regional block is the anesthetic technique created by A. K. G Bier exactly 100 years ago. In the first half of the 20th Centuty, it evolved little and slowly, but in the last several years, it has seen an accentuated improvement, thanks to countless technical, pathophysiological, pharmacological, pharmacokinetic, and clinical developments, for which Brazilian Anesthesiology has contributed considerably. Since it is celebrating its 100th anniversary in 2008, intravenous regional block deserves to have its story told, and the date should not go unnoticed, but should be remembered and celebrated.
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Rev Bras Anestesiol · May 2008
Case ReportsPainful peripheral polyneuropathy after bariatric surgery. Case reports.
The number of patients undergoing bariatric surgery increases every year and the frequency of complications associated with this procedure has been increasing. The main complications reported are nutritional, metabolic, neurological, and psychological/psychiatric. Among the neurological complications, peripheral neuropathies are important due to their high incidence. The objective of this report was to stress the importance of this type of complication, in which the initial manifestation might be neuropathic pain followed or accompanied by motor involvement, and whose prognosis depends on early diagnosis and treatment. ⋯ Neurological complications are one of the most feared complications of bariatric surgeries. Nutritional deficiencies secondary to the surgery are the most important factors in its pathogeny. Nutritional surveillance, avoidance of severe and fast weight loss, and nutritional supplements are fundamental to avoid complications, especially neurological complications.
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Rev Bras Anestesiol · May 2008
Comparative StudyComparison of histologic spinal cord and neurologic changes in guinea pigs after subarachnoid block with large volumes of racemic bupivacaine, 50% enantiomeric excess bupivacaine (S75-R25), and levobupivacaine.
Levobupivacaine has less central nervous system side effects than racemic bupivacaine, but its anesthetic effect is not as intense. The objective of this experimental study was to compare the adverse effects of large volumes of bupivacaine, S75-R25 bupivacaine, and levobupivacaine injected in the subarachnoid space of guinea pigs. ⋯ Large volumes of levobupivacaine caused little damage in the central nervous system when compared with bupivacaine. Statistically significant changes were not observed between levobupivacaine and S75-R25 bupivacaine.
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Rev Bras Anestesiol · May 2008
The intraoperative use of warming blankets in patients undergoing radical prostatectomy is related with a reduction in post-anesthetic recovery time.
Anesthesia and the surgeries cause substantial thermal changes, and hypothermia can lead to cardiovascular complications, clotting disorders, immunologic changes, and disruption of water and electrolyte balances, besides decreasing drug metabolism and, therefore, increasing post-anesthetic recovery time (PART). Circulation of warm air (forced-air warming blanket) is the most effective non-invasive warming method currently available. The objective of the present study was to compare the time spent in the recovery room of patients undergoing radical prostatectomy with and without the intraoperative use of a forced-air warming blanket. ⋯ We concluded that the intraoperative use of the warming blanket in patients undergoing radical prostatectomy was associated with a significant reduction in the time patients spent in the recovery room.