Revista brasileira de anestesiologia
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Rev Bras Anestesiol · Mar 2010
Randomized Controlled TrialSpinal block with 10 mg of hyperbaric bupivacaine associated with 5 microg of sufentanil for cesarean section. Study of different volumes.
Several factors affect the cephalad dispersion of the anesthetic solution in the subarachnoid space; among them, physiological changes of pregnancy and the dose and volume of the local anesthetics should be mentioned. The objective of this study was to assess the effectivity and side effects of different volumes of the subarachnoid administration of the association of hyperbaric bupivacaine and sufentanil in cesarean sections. ⋯ Four milliliter of anesthetic solution composed of hyperbaric bupivacaine, 10 mg, associated with 5 microg of sufentanil was more effective than 3 ml of the same solution, providing better intra-and postoperative analgesia without maternal-fetal repercussions.
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Rev Bras Anestesiol · Mar 2010
Randomized Controlled Trial Comparative StudyHypobaric 0.15% bupivacaine versus hypobaric 0.6% lidocaine for posterior spinal anesthesia in outpatient anorectal surgery.
Low doses of bupivacaine and lidocaine have been used for spinal anesthesia in outpatient surgery. The objective of this study was to compare hypobaric solutions of bupivacaine and lidocaine in outpatient anorectal surgery. ⋯ Hypobaric solution of bupivacaine or lidocaine promotes, predominantly, sensorial blockade after subarachnoid injection in patients in the jackknife position. Hypobaric lidocaine provides analgesia with the same dispersion of that of bupivacaine, but with shorter duration. Hemodynamic stability and the absence of motor blockade represent the major advantages.
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Rev Bras Anestesiol · Mar 2010
Randomized Controlled TrialInterscalene brachial plexus block. Effects on pulmonary function.
The interscalene is one of the most common approaches used in brachial plexus block. However, the association of this approach with the ipsilateral blockade of the phrenic nerve has been demonstrated. The resulting diaphragmatic dysfunction causes changes in lung mechanics, which can be potentially deleterious in patients with limited respiratory reserve. The objective of the present study was to evaluate the repercussion of interscalene brachial plexus block on pulmonary function by measuring forced vital capacity (FVC). ⋯ Interscalene block reduces FVC in most cases. Changes were more pronounced in the Ropivacaine group.
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Rev Bras Anestesiol · Jan 2010
Randomized Controlled Trial Comparative StudyDisposable versus reusable laryngeal tube suction for ventilation in patients undergoing laparoscopic cholecystectomy.
The laryngeal tube suction II (LTS-II) is a recent version of reusable supraglottic airway devices allowing gastric drainage. In this prospective, randomized study we compared insertion and ventilation of disposable LTS-II (LTS-D) with reusable type (LTS-II) for airway management under conditions with elevated intra abdominal pressure induced by capnoperitoneum. ⋯ Both devices provide a secure airway under conditions of elevated intra abdominal pressure.
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Rev Bras Anestesiol · Jan 2010
Randomized Controlled TrialAnalgesic efficacy of the intra-articular administration of high doses of morphine in patients undergoing total knee arthroplasty.
Although the efficacy of intraarticular (IA) morphine is still controversial, it has been shown that higher doses promote better results and consequently decrease postoperative analgesic consumption, characterizing a dose-dependent peripheral action. A controlled, randomized, double-blind study was undertaken to evaluate the efficacy of the intra-articular administration of 10 mg of morphine in patients undergoing total knee arthroplasty. ⋯ The treatment group had lower NS than the control group in M1 and M2, while significant differences were not observed in the other moments. The time until the first request of analgesics was significantly higher in the treatment group, and analgesic consumption in the first 24 hours was also lower in this group. The incidence of side effects did not differ between both groups. We concluded that the postoperative IA administration of 10 mg of morphine promoted a longer period without rescue analgesics and reduced their consumption in the first 24 hours.