Articles: postoperative.
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Curr Opin Anaesthesiol · Jun 2003
Awake spinal or caudal anaesthesia in preterms for herniotomies: what is the evidence based benefit compared with general anaesthesia?
Postoperative apnoea is known to threaten preterm and ex-preterm infants undergoing surgery for inguinal hernia. Awake regional anaesthesia, initially spinal and later caudal anaesthesia have been suggested as effective techniques to avoid these complications. However, most herniotomies in this group of patients are still performed under general anaesthesia without deleterious consequences. Whereas some experts continue to claim advantages for awake regional over general anaesthesia for preterm infants, others consider awake regional anaesthesia to be an exclusive, technically difficult and unreliable technique of unconfirmed benefit. ⋯ The available evidence does not allow unequivocal conclusions to be drawn or recommendations to be made. Awake regional anaesthesia for herniotomies in preterm infants has been found to be superior in most studies; however, it requires technical expertise and dedication on the part of the anaesthetist and surgeon. When light general anaesthesia with modern anaesthetic agents such as sevoflurane or desflurane is combined with a caudal block, postoperative apnoea is very rare, and can easily be recognized and managed with good postoperative monitoring and therapy.
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Duchennes Muscular Dystrophy is an X-linked recessive disorder, generally diagnosed in childhood, which progressively worsens to degenerate respiratory function. This report aimed at presenting the case of a patient with Duchennes Muscular Dystrophy diagnosed 2 years before, submitted to postectomy under general anesthesia with ketamine S. ⋯ Very careful pre-anesthetic evaluation, adequate monitoring and drugs not predisposing to complications make surgery and postoperative period safe for Duchennes Muscular Dystrophy patients.
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Postoperative pulmonary complications, including pneumonia, bronchospasm, respiratory failure and prolonged mechanical ventilation, occur commonly and are a significant source of morbidity and mortality. This review will discuss the etiology of postoperative pulmonary complications and the interventions that reduce their risk. ⋯ Understanding risk factors for the development of postoperative pulmonary complications allows targeted interventions aimed at reducing their frequency and severity. Further research is needed to define the role of regional analgesic and anesthetic techniques in reducing postoperative pulmonary complications, and also to define the nature of risk factors and develop better predictive models of patients at risk of developing postoperative pulmonary complications.
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Rev Bras Anestesiol · Apr 2003
[Postoperative analgesia following orthopedic surgery: a study comparing perivascular lumbar plexus inguinal block with ropivacaine (3 in 1) and spinal anesthesia with morphine.].
Perivascular Lumbar plexus inguinal block, (3-in-1 block) has been used for postoperative analgesia. This study aimed at comparing postoperative analgesia of 3-in-1 block and spinal morphine in patients submitted to lower limb orthopedic surgeries (LL). ⋯ Postoperative analgesia induced by 3-in-1 blockade showed less side-effects as compared to spinal morphine with similar analgesia duration.
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Rev Bras Anestesiol · Apr 2003
[Continuous epidural anesthesia with 0.2% ropivacaine associated to general anesthesia for upper abdominal surgery in children.].
Several anesthetic techniques have been proposed for different pediatric surgeries to promote postoperative analgesia, among other advantages. This study aimed at evaluating propofol infusion rate and postanesthetic recovery of children submitted to upper abdominal surgeries under epidural anesthesia with 0.2% ropivacaine associated to general anesthesia with propofol or propofol plus sufentanil. ⋯ Continuous thoracic epidural anesthesia with 0.2% ropivacaine (1.5 mg.kg-1) associated to propofol infusion provides effective and safe anesthesia for upper pediatric abdominal surgeries. Propofol infusion rate and sedation duration were decreased with the association of sufentanil.