Articles: postoperative.
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Pain and anxiety may cause major discomfort, increase the risk for postoperative complications in surgical patients and may even prolong their hospital stay. This study aimed at reviewing concepts of sedation and analgesia in intensive care, updating knowledge and reviewing information available in the literature as well as already published consensus. ⋯ In spite of the therapeutic armamentarium available, there is a lack of understanding about major characteristics of drugs used for sedation and analgesia in Intensive Care. Developed consensus try to explain qualities and side-effects of most popular drugs, normalizing their use for ICU analgesia and sedation to benefit and faster recover patients.
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Gynecological laparoscopic surgery procedures are often complicated by postoperative pain resulting in an unpleasant experience for the patient, delayed discharge, and increased cost. Glucocorticosteroids have been suggested to reduce the severity and incidence of postoperative pain. ⋯ There was a lack of efficacy of preoperative sustained release betamethasone in reducing postoperative pain despite maintaining a therapeutic concentration during the postoperative period. Intraoperative Ketorolac did afford some short-term pain relief in the postoperative period and reduced the need for additional pain relief drugs.
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The elderly population is increasing in number each year, and more patients are presenting for anesthesia and surgery. One of the key areas for improving the care of the elderly is a better understanding of the influence of aging on drug pharmacokinetics and dynamics. ⋯ The effects of comorbidity and intercurrent medications may alter the normal anesthetic practice of the clinician's care of the elderly patient. Further studies in these key areas may lead to improved outcomes.
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Rev Bras Anestesiol · Aug 2003
[Effects of low spinal morphine doses associated to intravenous and oral ketoprofen in patients submitted to cesarean sections].
Low spinal morphine doses are effective in relieving postoperative pain of patients submitted to Cesarean sections, with low incidence of side-effects. This study aimed at evaluating postoperative analgesia and the incidence of side-effects in patients submitted to Cesarean sections under spinal anesthesia with hyperbaric bupivacaine and 0.05 mg and 0.1 mg morphine associated to intravenous and oral ketoprofen. ⋯ Spinal 0.05 mg and 0.1 mg morphine associated to intravenous and oral ketoprofen have provided the same postoperative analgesia and have determined the same incidence of side-effects.
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Rev Bras Anestesiol · Aug 2003
[Comparison between pressure controlled and controlled mandatory ventilation in the treatment of postoperative hypoxemia after myocardial revascularization].
Pressure controlled ventilation (PCV) has been used as the ventilation mode of choice in coronary artery bypass graft surgery patients who develop severe hypoxemia in the immediate postoperative period. However, there are no evidences showing that pressure controlled ventilation is more effective in reversing postoperative hypoxemia than controlled mandatory ventilation (CMV). This study aimed at comparing the effects of both ventilation modes on systemic oxygenation in cardiac surgery patients who develop hypoxemia characterized by PaO2/FiO2 ratio lower than 200 in the immediate postoperative period. ⋯ Both ventilatory modes were equally effective in reversing hypoxemia observed in the immediate cardiac surgery postoperative period. Results show that inspiratory flow patterns are not relevant in the treatment of post cardiac surgery hypoxemia.