Articles: postoperative.
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Epidural blocks (caudal, lumbar or thoracic) are of common use in paediatric patients for special procedures such as open fundoplication as well as for postoperative analgesia. However, because neonates and infants have lower metabolic capacities and specific anatomy as compared to adults, the dose of local anaesthetics and the way of their administration need careful attention. ⋯ Pharmacokinetic studies allowing safer dosing, especially with ropivacaine have recently been published. New techniques of thoracic epidural with puncture at the lumbar level are also proposed. However, all these new techniques need to pass the test of time.
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To describe the red blood cell transfusion practices of pediatric intensivists. ⋯ This survey documented a significant variation in transfusion practice patterns among pediatric critical care practitioners with respect to the threshold hemoglobin concentration for red blood cell transfusion. The volume of packed red blood cells given was not adjusted to the hemoglobin concentration.
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Rev Bras Anestesiol · Sep 2002
[Association of fentanyl or sufentanil an 0.5% isobaric bupivacaine in spinal anesthesia: a comparative study.].
Since the discovery of opioid receptors and the increase in spinal cord neuropharma- cological knowledge as to transmission and inhibition of nociceptive stimulations, there has been an increased interest in spinal drugs for anesthesiology and pain relief. This study aimed at prospectively evaluating the clinical efficacy of fentanyl (25 microg) and sufentanil (5 microg) with isobaric bupivacaine (10 mg), in patients submitted to spinal anesthesia for varicose vein surgery. ⋯ The addition of fentanyl (25 microg) and sufentanil (5 microg) to isobaric bupivacaine (10 mg) in spinal anesthesia affects sensory block levels.
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Rev Bras Anestesiol · Sep 2002
[Tomographic identification of popliteal nerves epineural sheath during foot intermittent regional anesthesia: case report.].
Lower limb regional nervous blocks are common procedures for surgery and postoperative analgesia. This study aimed at describing a rare and casual tomographic image of a catheter in the popliteal fossa, which was originally directed to the sciatic nerve, and of anesthetic solution spread during intermittent analgesia for foot trauma. ⋯ Relevant enhanced tomographic findings of the popliteal region have proven a recent anatomic study on the individualization of the neural sheath involving popliteal nerves with implications in blockade outcome. Anesthesia obtained by a catheter in the popliteal fossa was effective only in the superficial fibular nerve dermatome (medial dorsum of foot and hallux).
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Rev Bras Anestesiol · Sep 2002
[Comparison of intravenous and epidural morphine analgesia after thoracotomy.].
Patients undergoing thoracotomy experience severe postoperative pain. This study aimed at evaluating postoperative analgesia with the association of intravenous and epidural morphine as compared to a single route. ⋯ There has been a better analgesic effect with intravenous morphine or the association of intravenous and epidural morphine, with lower drug doses. This difference was significant when lower analgesic doses were used in these groups and represented an effective postoperative analgesic method for thoracotomy, with lower respiratory depression and emetic effects.