Revista brasileira de anestesiologia
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Rev Bras Anestesiol · Nov 2008
Case ReportsTako-Tsubo syndrome secondary to residual neuromuscular blockade. Case report.
Tako-Tsubo syndrome is a rare postoperative complication with a 5% mortality rate. The objective of this report was to present residual neuromuscular blockade as a trigger for this syndrome, discuss this disorder, and call attention to the risks of residual neuromuscular blockade. ⋯ Residual neuromuscular blockade associated with diaphragmatic paralysis and possible pulmonary atelectasis leading to respiratory failure, hypercapnia, and adrenergic discharge triggered the Tako-Tsubo syndrome with severe clinical repercussion.
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Rev Bras Anestesiol · Nov 2008
Comparative StudyComparative study between thoracic epidural block and general anesthesia for oncologic mastectomy.
Thoracic epidural block is frequently used for esthetic breast surgeries but reports of its use in mastectomies with axillary exploration are very rare. The present study compared this technique with general anesthesia in oncologic surgeries of the breasts. ⋯ Epidural block has some advantages when compared with general anesthesia and can be considered an anesthesia option in oncologic mastectomies with axillary lymph node dissection.
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Rev Bras Anestesiol · Nov 2008
Comparative StudyComparative study of anti-emetics and their association, in the prevention of postoperative nausea and vomiting in patients undergoing gynecologic surgeries.
Prophylaxis of postoperative nausea and vomiting has been the subject of several studies. The objective of the present study was to compare anti-emetics, and their association, in the prevention of postoperative nausea and vomiting. ⋯ The association dexamethasone-droperidol-ondansetron and ondansetron alone were more effective in the prophylaxis of nausea and vomiting.
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Breakage of epidural catheters during their removal is rare, but it has been described. The anesthesiologist should be aware of the complications and proper handling of those catheters. The objective of this report was to present a case of breakage of an epidural catheter in labor analgesia. ⋯ Epidural catheters in the lumbar region are, occasionally, hard to remove. Factors that increase the chances of knot formation and the risk of breakage of catheters were listed. In the present case, one of the main factors was the excessive introduction of the epidural catheter. Luckily, neurologic complications are even less frequent, and applying gentle traction, in the absence of paresthesias, the catheter is usually successfully removed.