Revista brasileira de anestesiologia
-
Rev Bras Anestesiol · Nov 2008
Randomized Controlled Trial Comparative StudyEffects of the addition of subarachnoid clonidine to the anesthetic solution of sufentanil and hyperbaric or hypobaric bupivacaine for labor analgesia.
The addition of subarachnoid clonidine (alpha-agonist) prolongs the analgesia produced by the combination of sufentanil and isobaric bupivacaine in combined labor analgesia(1). The objective of this study was to compare the quality of analgesia and the prevalence of side effects after the addition of subarachnoid clonidine to the anesthetic solution in labor analgesia. ⋯ Under the conditions of the present study, the association of a small dose of clonidine (30 microg) with sufentanil caused a higher incidence of hypotension when the isobaric solution of the local anesthetic was used. For all other side effects, both hyperbaric and isobaric solutions showed similar behavior.
-
Rev Bras Anestesiol · Nov 2008
Postoperative continuous plexular analgesia. A study on the side effects and risk factors of catheter infection.
The importance of postoperative analgesia has increased over the years. Plexular catheters represent a good option for high quality analgesia with reduced systemic repercussions. The objective of the present study was to evaluate the incidence of side effects and complications in postoperative analgesia with plexular catheters and identify risk factors for bacterial colonization of the catheters. ⋯ The use of antibiotics preoperatively and the type of needle were the risk factors of infection identified.
-
Rev Bras Anestesiol · Nov 2008
Randomized Controlled Trial Comparative StudyA comparative study between 25 x 0.70 mm and 20 x 0.55 mm needles for retrobulbar block with small volume of anesthetic for the treatment of cataracts by phacoemulsification.
The objective of this study was to compare the quality and safety of retrobulbar block for the treatment of cataracts by phacoemulsification using needles of different sizes: 27 x 0.70 mm and 20 x 0.55 mm. ⋯ Retrobulbar block with a single inferolateral puncture with a 20 x 0.55 mm needle, using low doses of anesthetics, is an effective and safe option for the treatment of cataracts by phacoemulsification.
-
Sellick described the importance of applying pressure in the cricoid cartilage during anesthesia induction to prevent regurgitation of gastric contents. Since then, the maneuver has been widely accepted by anesthesiologists as a fundamental step during induction with the rapid sequence technique. The objective of the present report was to discuss the indications, technique, complications, and reasons why some authors have refuted the efficacy of this technique. ⋯ The cricoid cartilage pressure maneuver requires knowledge of the anatomy of upper airways and the correct force to be used. Endoscopic and radiologic studies, as well as patients who developed pulmonary aspiration despite the use of Sellick maneuver, have raised doubts about the usefulness of this technique. Besides, can cause deformity of the cricoid cartilage, closure of the vocal cords, and difficulty to ventilate if it is not used properly. Despite the importance given to Sellick maneuver in preventing pulmonary aspiration, there are no guarantees it will protect the airways of all patients, especially when the technique is not properly used.
-
Postoperative delirium is a common complication in the elderly whose pathophysiology is not well known. It seems to be related to central cholinergic activity. A literature review was undertaken to describe the etiology, diagnosis, prophylactic strategies, and treatment of postoperative delirium. ⋯ The incidence of postoperative delirium is higher in the elderly, and prophylactic measures should be taken to reduce the mortality associated with this complication.