Articles: postoperative.
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Dexmedetomidine is a new alpha2-adrenergic agonist with a selectivity ratio of 1600:1 (alpha2:alpha1). It has important sedative and analgesic effects, good hemodynamic control at stress situations and may, by itself, induce anesthesia. This drug has been used to promote postoperative and intensive care sedation and analgesia. Due to such properties, dexmedetomidine has recently become a co adjuvant drug for anesthesia. So, this is a review of the literature about dexmedetomidine in anesthesia. ⋯ Dexmedetomidine premedication, infusion during anesthesia or in the postoperative period improves hemodynamic stability. Anesthetic consumption is decreased during anesthesia. Patients sedated with dexmedetomidine may awake, when requested and become cooperative. Even high dexmedetomidine doses do not cause respiratory depression. Bradycardia is a frequent side effect which may be minimized by slow drug infusion. So, dexmedetomidine is an important additional resource to anesthetic practice that may be used in different patients and surgical procedures.
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Rev Bras Anestesiol · Feb 2003
[Evaluation of maternal acid-base status after different doses of spinal sufentanil for cesarean section and its effects on the neonates.].
Spinal sufentanil in obstetric anesthesia promotes immediate pain relief, improves anesthesia quality and prolongs postoperative analgesia, its major side effect being respiratory depression. This study aimed at evaluating maternal acid-base status after different doses of spinal sufentanil associated to hyperbaric bupivacaine for cesarean section, and its effects on neonates' vitality. ⋯ The association of spinal hyperbaric 0.5% bupivacaine to low sufentanil doses has shown to be safe to both mother and neonate, preserving their hemodynamic and acid-base status.
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Rev Bras Anestesiol · Feb 2003
[Total intravenous anesthesia for thymectomy in a Myasthenia Gravis patient: case report.].
Patients with neuromuscular diseases, as Myasthenia Gravis, react abnormally to anesthetics, depending on the technique and on the drugs. This report aimed at showing a case of Myasthenia Gravis patient submitted to thymectomy under total intravenous anesthesia with propofol and remifentanil. ⋯ Total intravenous anesthesia, with short-lasting anesthetics without active metabolites has favored recovery and early extubation of a Myasthenia Gravis patient submitted to thymectomy.
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This review will bring to the reader's attention recent developments in the literature regarding regional anesthesia in the outpatient setting, and allow the reader to evaluate whether these developments are appropriate for inclusion in clinical practice. ⋯ Recent publications suggest additional ways to add regional anesthesia techniques to outpatient surgical practice, particularly with the promise of extensive postoperative pain relief for the ambulatory surgery patient.
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Ambulatory surgery is now one of the major areas of surgical and anesthetic practice, with up to 70% of procedures performed in the ambulatory setting. This review focuses on some of the recent studies performed in day case anesthesia. ⋯ Careful patient selection can minimize perioperative events. The concept of multimodal analgesic and antiemetic therapy, in combination with newer anesthetic drugs, help expand the field of ambulatory surgery.