Revista brasileira de anestesiologia
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Rev Bras Anestesiol · Mar 2009
Target-controlled total intravenous anesthesia associated with femoral nerve block for arthroscopic knee meniscectomy.
The increased popularity of minimally invasive surgical techniques reduced recovery time of procedures that were usually associated with prolonged hospitalization. This study reports the technique of total intravenous anesthesia with propofol and remifentanil associated with femoral nerve block using the inguinal perivascular approach. ⋯ All patients were maintained within established parameters.
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Rev Bras Anestesiol · Mar 2009
Case ReportsCombined spinal-epidural block in a patient with amyotrophic lateral sclerosis: case report.
Amyotrophic lateral sclerosis starts between the fifth and sixth decades of life, causing degeneration and death of upper and lower motor neurons. When the muscles responsible for ventilation are affected, the patient dies of respiratory failure within a few years. ⋯ The evidence has demonstrated that neuroaxis blocks can be safely performed in patients with amyotrophic lateral sclerosis since it avoids manipulation of the airways and respiratory complications.
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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.