Revista brasileira de anestesiologia
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Rev Bras Anestesiol · Aug 2006
[Postoperative analgesia for cesarean section: does the addiction of clonidine to subarachnoid morphine improve the quality of the analgesia?].
The mechanism of action of alpha2-adrenergic analgesia has been explored for more than one hundred years. The increased duration of the sensitive and motor blockades caused by clonidine is dose-dependent and has antinociceptive properties. The objective of this study was to evaluate whether the addition of 15 to 30 microg of clonidine to spinal anesthesia for cesarean sections with 0.5% hyperbaric bupivacaine (12.5 mg) and morphine (100 microg) improves the quality of postoperative analgesia. ⋯ The addition of clonidine to spinal anesthesia with 0.5% hyperbaric bupivacaine (12.5 mg) and morphine (100 microg) for cesarean section improved the quality of the postoperative analgesia without increasing the incidence of side effects. We suggest that the dose of 15 microg of clonidine should be used.
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Rev Bras Anestesiol · Aug 2006
[Dexmedetomidine for neurocognitive testing in awake craniotomy: case report.].
Tumor resections in the speech areas of the brain are more safely done using cognitive tests to determine their exact location. Patients must be awake, comfortable, and cooperative for the precise identification of the areas to be preserved. The objective of this report is to present a surgical procedure done with the patient awake, without endotracheal intubation, using sevofluorane initially, followed by dexmedetomidine. This technique allowed the realization of motor and speech evaluation tests. ⋯ Awake craniotomy with the proper mapping of speech and motor cortical areas was successfully done with the continuous infusion of dexmedetomidine. Both the patient and the surgical team were pleased with the technique.
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Rev Bras Anestesiol · Aug 2006
[Catheters and anesthetic solutions in regional peripheral anesthesia: Quo Vadis? Case Reports.].
The clinical results of regional peripheral blockades are not always what we hope for. Sometimes the results are short of our intent and sometimes are exaggerated. To understand and learn those phenomena, radioimaging techniques are very helpful. The objective of this study is to demonstrate the different trajectories and distribution of catheters and anesthetics (local anesthetic with contrast), respectively, used in regional blockades of the upper and lower limbs. ⋯ Contrast X-rays are very useful to verify the position of catheters and solve unexpected anesthetic effects, because they are able to relate the unpredictable dispersion of anesthetics to the signs and symptoms of peripheral blockades.
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Rev Bras Anestesiol · Jun 2006
[Simplified posterior sciatic nerve block at mid gluteofemoral dulcus: comparison of different 1% lidocaine volumes].
Subgluteus sciatic nerve block has been successfully described in a previous study and is one more option among several possible approaches. The sciatic nerve becomes superficial at inferior gluteus maximus muscle where it is easily located and accessed with minor discomfort and low risk of accidental great vessels puncture. Our study aimed at evaluating this simplified sciatic nerve block approach with different 1% lidocaine volumes. ⋯ This is an effective and easy approach and total anesthetic dose may be decreased without impairing quality.
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Rev Bras Anestesiol · Jun 2006
[Hemodynamic effects of aortic occlusion during inhalational anesthesia with isoflurane and sevoflurane: experimental study in dogs].
Aortic flow suppression and release during aortic procedures promote major hemodynamic disorders. This study aimed at evaluating these disorders in dogs anesthetized with isoflurane or sevoflurane. ⋯ This study has shown that isoflurane is a better indication for such interventions for promoting less hemodynamic changes.