Revista brasileira de anestesiologia
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There are reports on epidural blood patch in Jehovah's Witness patients using a closed system which allows blood collection and epidural injection without loss of continuity. This report aimed at presenting two cases of Jehovah's Witness patients with post-dural puncture headache and treated with epidural blood patch in a closed venous blood transfusion system to the epidural space. Cases were reported by two different hospitals in two different cities. ⋯ In Jehovah's Witness patients refractory to clinical treatment, autologous blood injection may be performed through the above-described technique after patients informed consent.
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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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The possibility to achieve unilateral spinal anesthesia with 0.15% bupivacaine was studied with the purpose of minimizing hemodynamic changes, limiting the cephalad dispersion of the anesthetic and promoting a faster recovery. ⋯ Hypobaric bupivacaine (5 mg) is able to provide a predominant unilateral block with the patient being kept twenty minutes in the lateral position. Major unilateral spinal anesthesia advantage is hemodynamic stability.