Revista brasileira de anestesiologia
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Rev Bras Anestesiol · Jun 2007
[Combined spinal-epidural for labor analgesia: does the addition of sufentanil to the local anesthetic influence apgar scores of the newborns?].
Combined spinal-epidural (CSE) is a very common obstetric technique. However, the literature does not present a standardization regarding the technique, doses, and anesthetics used, besides there is also the controversy about the possibility that the addition of opioids to the local anesthetic causes fetal bradycardia and affects its vitality. The aim of this study was to identify the techniques and anesthetics used in the Anesthesiology Service of the Hospital Universitário of Universidade de São Paulo (USP) and determine whether the use of sufentanil associated with the local anesthetic affects Apgar scores of newborns. ⋯ The use of sufentanil in the combined spinal-epidural did not change Apgar scores of the newborns.
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Rev Bras Anestesiol · Apr 2007
[Hematoma after epidural anesthesia: conservative treatment. Case report.].
Hematoma associated with spinal compression after epidural anesthesia is a severe neurological complication, despite the reduced incidence reported (1:150,000). It is an acute episode and the traditional treatment includes urgent surgical decompression. More recently, treatment with corticosteroids has been used as an alternative, in specific cases, with good neurological resolution. The objective of this report was to present the case of an epidural hematoma treated conservatively with complete neurological recovery. ⋯ The efficacy of the conservative approach demonstrated that it is an important alternative to surgery in specific cases. The evaluation of the progression or stabilization of the neurological deficit, especially 8 hours after the epidural puncture, is essential in choosing the treatment.
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Rev Bras Anestesiol · Apr 2007
[Side effects of subarachnoid and epidural sufentanil associated with a local anesthetic in patients undergoing labor analgesia.].
The association of an opioid with a local anesthetic improves the quality of labor analgesia and reduces the risk of systemic toxicity of the local anesthetic. However, opioids are not devoid of side effects. The aim of this study was to compare the side effects of subarachnoid sufentanil associated with bupivacaine to those caused by epidural sufentanil associated with ropivacaine in the doses used in the Anesthesiology Department in pregnant women undergoing labor analgesia. ⋯ Subarachnoid or epidural sufentanil, in the doses used in this study, associated with local anesthetics, had the same effect on the duration of labor after analgesia and in the Apgar score of newborns. Sedation was the most frequent side effect in patients receiving epidural sufentanil.
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The use of alpha2-adrenergic agonists is increasingly more frequent in Anesthesiology, as adjuvant or the sole anesthetic drug. Currently, dexmedetomidine is gaining popularity due to its greater selectivity for the alpha2-adrenergic receptors and its pharmacokinetic profile. The aim of this review was to analyze the use of dexmedetomidine in neurosurgery. ⋯ The pharmacokinetic and pharmacodynamic profile of dexmedetomidine favors its use in several neurosurgical procedures. Its use in craniotomy for the treatment of aneurysms and tumor removal is recent. Besides, its use in functional surgical interventions is promising.
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Rev Bras Anestesiol · Feb 2007
[Effect of pretreatment with lidocaine, intravenous paracetamol and lidocaine-fentanyl on propofol injection pain. Comparative study.
Performed a randomized, double blind study to assess the efficacy of intravenous (IV) pretreatment with lidocaine, IV paracetamol (Perfalgan) or lidocaine mixed with fentanyl in reducing propofol injection pain. ⋯ Propofol, a commonly used anesthetic. Given as a venous retention pretreatment 60 seconds before propofol, lidocaine and lidocaine-fentanyl were found to significantly reduce the propofol injection pain, whereas IV paracetamol (Perfalgan) slightly reduced the propofol injection pain.