Revista brasileira de anestesiologia
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Myocardial protection defines the set of strategies aiming at attenuating the intensity of myocardial ischemia-reperfusion injury during heart surgery and its harmful consequences on myocardial function. A better understanding of pathophysiological phenomena related to ischemia-reperfusion events and of the anesthetic-induced heart protection has given to the anesthesiologist a major role in intraoperative myocardial protection. The objective of this update was to review the mechanisms of ischemia-reperfusion-induced myocardial injury and myocardial protection modalities focusing on anesthetic techniques. ⋯ The association of adequate anesthetic technique using heart protecting agents to usual myocardial protection modalities performed by the surgeon may contribute to the prevention of cardiac surgery-induced myocardial dysfunction and improve postoperative outcome.
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Rev Bras Anestesiol · Oct 2005
[Postoperative nausea and vomiting: a review of the 'minor-major' problem.].
Notwithstanding continuous investigations and the development of new drugs and techniques, postoperative nausea and vomiting (PONV) are frequent and may contribute to the development of complications, thus increasing hospital and human costs. This article aimed at reviewing physiological mechanisms, risk factors and therapeutic approaches available to manage PONV. ⋯ Although the management of PONV has improved in recent years, it is still common among high-risk patients. Current strategy to prevent and treat PONV is not yet established and Gan guidelines should be adapted to each population and institution.
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Rev Bras Anestesiol · Aug 2005
Effects of intravenous lidocaine on the pharmacodynamics of rocuronium.
Rocuronium is an intermediate nondepolarizing neuromuscular blocker (NMB) with faster onset and indicated in situations requiring rapid tracheal intubation. Intravenous lidocaine is often used to decrease hemodynamic responses to tracheal intubation. The association of NMB to local anesthetics results in potentiation of NMB effects. The purpose of this study was to evaluate the influence of lidocaine on rocuronium's pharmacodynamics determined by acceleromyography. ⋯ Lidocaine associated to rocuronium has prolonged early blockade recovery stage without interfering with onset or late recovery stage.
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Low doses of ketamine or isomers are promising possibilities for anesthesia and postoperative analgesia. This study aimed at reviewing major properties of low ketamine doses, which may justify their use in anesthesia and postoperative analgesia. ⋯ Most studies with low S(+) ketamine doses have shown preventive effects, decreasing central nervous system sensitization, opioid-induced tolerance and hyperalgesia, anesthetic and analgesic consumption, and the incidence of postoperative adverse effects.
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Rev Bras Anestesiol · Aug 2005
Posterior brachial plexus block with nerve stimulator and 0.5% ropivacaine.
There are several approaches to the brachial plexus depending on the experience of the anesthesiologist and the site of the surgery. Posterior brachial plexus block may be an alternative for shoulder, clavicle and proximal humerus surgery. This study aims at presenting the results of patients submitted to posterior brachial plexus block with 0.5% ropivacaine and the aid of nerve stimulator. ⋯ Posterior brachial plexus block with the aid of nerve stimulator provides effective anesthesia, is very comfortable for patients and easy to perform.