Revista brasileira de anestesiologia
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Rev Bras Anestesiol · Jan 2009
Comparative StudyComparison of the FiO2 delivered by seven models of the self-inflating bag-mask system.
Since resuscitators with self-inflating bag-mask systems manufactured and/or commercialized in Brazil are widely available and used in health services, both out- and intra-hospitals, the objective of this study was to determine the O2 fractions delivered by seven resuscitators receiving different O2 flows. ⋯ All resuscitators capable of being connected to an O2 reservoir delivered a higher O2 concentration when connected to this device. Resuscitators that do not have this capability delivered a higher O2 concentration than the ones that could be connected to this device but are used without it.
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The bispectral index (BIS) is a multifactorial parameter derived from the electroencephalogram (EEG), which allows monitoring of the hypnotic component of anesthesia. It was obtained from the algorithm based on the analysis of a large number of EEGs from volunteers and patients undergoing sedation and general anesthesia with different anesthetic agents. The use of BIS to monitor the depth of anesthesia reduces the incidence of intraoperative awakening and recall, among other benefits. The objective of this review was to present clinical situations in which the BIS gives false results, either elevated or decreased, due to conditions related to the patient or anesthetic actions unforeseen when the algorithm was elaborated. ⋯ Although the BIS algorithm underwent several changes since its first version, the anesthesiologist should be aware of situations that cause false BIS readings to avoid complications, may it be secondary to anesthetic overdose or underdosing, which might cause intraoperative awakening and recall.
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Rev Bras Anestesiol · Jan 2009
Randomized Controlled Trial Comparative StudyEphedrine versus phenylephrine: prevention of hypotension during spinal block for cesarean section and effects on the fetus.
Hypotension during spinal block for cesarean section is secondary to the sympathetic blockade and aorto-caval compression by the uterus and it can be deleterious to both the fetus and the mother. Ephedrine and phenylephrine improve venous return after sympathetic blockade during the spinal block. The objective of this study was to compare the efficacy of ephedrine and phenylephrine in the prevention and treatment of maternal hypotension during spinal block and to evaluate their side effects and fetal changes. ⋯ Ephedrine was more effective than phenylephrine in the prevention of hypotension. Both drugs had similar incidence of side effects. Fetal repercussions were less frequent with phenylephrine and were transitory with the use of ephedrine.
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Rev Bras Anestesiol · Jan 2009
ReviewReview of the use of gabapentin in the control of postoperative pain.
Gabapentin has been used as adjuvant in the treatment of postoperative pain with a neuropathic component. It is responsible for the inhibition of central sensitization, decreasing postoperative pain. ⋯ Gabapentin, used before as well as before and after surgery, decreased pain severity and the need of analgesic supplementation.