Brazilian Journal of Anesthesiology (Edicion en Espanol)最新文献

Endarterectomía carotídea: revisión de 10 años de práctica de la anestesia general y locorregional en un hospital terciario en Portugal 颈动脉内膜切除术:回顾葡萄牙一家三级医院10年全身麻醉和局部麻醉的实践

Brazilian Journal of Anesthesiology (Edicion en Espanol) Pub Date : 2015-07-01 DOI: 10.1016/j.bjanes.2014.03.012

Mercês Lobo, Joana Mourão, Graça Afonso

{"title":"Endarterectomía carotídea: revisión de 10 años de práctica de la anestesia general y locorregional en un hospital terciario en Portugal","authors":"Mercês Lobo, Joana Mourão, Graça Afonso","doi":"10.1016/j.bjanes.2014.03.012","DOIUrl":"10.1016/j.bjanes.2014.03.012","url":null,"abstract":"<div><h3>Background</h3><p>Retrospective and prospective randomized studies have compared general and locoregional anesthesia for carotid endarterectomy, but without definitive results.</p></div><div><h3>Objectives</h3><p>Evaluate the incidence of complications (medical, surgical, neurological, and hospital mortality) in a tertiary center in Portugal and review the literature.</p></div><div><h3>Method</h3><p>Retrospective analysis of patients undergoing endarterectomy between 2000 and 2011, using a software for hospital consultation.</p></div><div><h3>Results</h3><p>A total of 750 patients were identified, and locoregional anesthesia had to be converted to general anesthesia in 13 patients. Thus, a total of 737 patients were included in this analysis: 74% underwent locoregianal anesthesia and 26% underwent general anesthesia. There was no statistically significant difference between the 2 groups regarding perioperative variables. The use of shunt was more common in patients undergoing general anesthesia, a statistically significant difference. The difference between groups of strokes and mortality was not statistically significant. The average length of stay was shorter in patients undergoing locoregional anesthesia with a statistically significant difference.</p></div><div><h3>Conclusions</h3><p>We found that our data are overlaid with the literature data. After reviewing the literature, we found that the number of studies comparing locoregional and general anesthesia and its impact on delirium, cognitive impairment, and decreased quality of life after surgery is still very small and can provide important data to compare the 2 techniques. Thus, some questions remain open, which indicates the need for randomized studies with larger number of patients and in new centers.</p></div>","PeriodicalId":100199,"journal":{"name":"Brazilian Journal of Anesthesiology (Edicion en Espanol)","volume":"65 4","pages":"Pages 249-254"},"PeriodicalIF":0.0,"publicationDate":"2015-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bjanes.2014.03.012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54233741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Bloqueo paravertebral ecoguiado para la piloromiotomía en 3 neonatos con estenosis hipertrófica de píloro congénita 生态引导椎旁阻滞在3例新生儿先天性肥厚性幽门狭窄的幽门切开术中的应用

Brazilian Journal of Anesthesiology (Edicion en Espanol) Pub Date : 2015-07-01 DOI: 10.1016/j.bjanes.2014.03.010

Javier Mata-Gómez, Rosana Guerrero-Domínguez, Marta García-Santigosa, Antonio Ontanilla

{"title":"Bloqueo paravertebral ecoguiado para la piloromiotomía en 3 neonatos con estenosis hipertrófica de píloro congénita","authors":"Javier Mata-Gómez, Rosana Guerrero-Domínguez, Marta García-Santigosa, Antonio Ontanilla","doi":"10.1016/j.bjanes.2014.03.010","DOIUrl":"10.1016/j.bjanes.2014.03.010","url":null,"abstract":"<div><h3>Background and objectives</h3><p>Hypertrophic pyloric stenosis is a relatively common affection of gastrointestinal tract in childhood that results in symptoms, such as projectile vomiting and metabolic disorders that imply a high risk of aspiration during anesthetic induction. In this way, the carrying out of a technique with general anesthesia and intravenous rapid sequence induction, preoxygenation and cricoid pressure are recommended. After the correction of systemic metabolic alkalosis and pH normalization, cerebrospinal fluid can keep a state of metabolic alkalosis. This circumstance, in addition to the residual effect of neuromuscular blocking agents, inhalant anesthetics and opioids could increase the risk of postoperative apnea after a general anesthesia.</p></div><div><h3>Case report</h3><p>We present the successful management in 3 neonates in those a pyloromyotomy was carried out because they had presented congenital hypertrophic pyloric stenosis. This procedure was done under general anesthesia with orotracheal intubation and rapid sequence induction. Then, ultrasound-guided paravertebral block was performed as analgesic method without the need for administrating opioids within intraoperative period and keeping an appropriate analgesic level.</p></div><div><h3>Conclusions</h3><p>Local anesthesia has demonstrated to be safe and effective in pediatric practice. We consider the ultrasound-guided paravertebral block with one dose as a possible alternative for other local techniques described, avoiding the use of opioids and neuromuscular blocking agents during general anesthesia, and reducing the risk of central apnea within postoperative period.</p></div>","PeriodicalId":100199,"journal":{"name":"Brazilian Journal of Anesthesiology (Edicion en Espanol)","volume":"65 4","pages":"Pages 302-305"},"PeriodicalIF":0.0,"publicationDate":"2015-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bjanes.2014.03.010","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54234162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Bienestar ocupacional en anestesistas: su relación con la metodología educativa 麻醉师的职业幸福感：与教育方法的关系

Brazilian Journal of Anesthesiology (Edicion en Espanol) Pub Date : 2015-07-01 DOI: 10.1016/j.bjanes.2015.05.001

Pratyush Gupta, Roger Moore, Gastão F. Duval Neto

引用次数: 0

Utilización del sugammadex en el paciente quemado: estudio descriptivo sugammadex在烧伤患者中的应用:描述性研究

Brazilian Journal of Anesthesiology (Edicion en Espanol) Pub Date : 2015-07-01 DOI: 10.1016/j.bjanes.2014.10.001

Eduardo Rodríguez Sánchez M., Concepción Martínez Torres, Pablo Herrera Calo, Ignacio Jiménez

{"title":"Utilización del sugammadex en el paciente quemado: estudio descriptivo","authors":"Eduardo Rodríguez Sánchez M., Concepción Martínez Torres, Pablo Herrera Calo, Ignacio Jiménez","doi":"10.1016/j.bjanes.2014.10.001","DOIUrl":"10.1016/j.bjanes.2014.10.001","url":null,"abstract":"<div><h3>Objectives</h3><p>The burn patient is a challenge for the anesthesiologist, undergoing several surgeries during admission, and requiring general anesthesia and muscle relaxation most of the times. They have respiratory system impairment and a response to muscle relaxants that differs from the healthy patient, thus proper monitoring and reversal is crucial. We analyzed sugammadex effectiveness and safety in this population.</p></div><div><h3>Material and methods</h3><p>Prospectively descriptive study including 4 patients, all of them considered major burn patients, who underwent escharotomy with general anesthesia and neuromuscular relaxation. The main variable was the time for recovery of a TOF higher than 0.9 after the administration of sugammadex before extubation.</p></div><div><h3>Results</h3><p>Mean time of recovery from a TOF ratio higher than 0.9 following the administration of Sugammadex was of 4.95min 95% CI (3.25-6.64, <em>P</em>  <!-->.53);</p></div><div><h3>Conclusions</h3><p>the reversion of neuromuscular relaxation with sugammadex appears to be effective and safe in the burn patient. More analytical, comparative studies, of larger populations would be necessary to confirm this data.</p></div>","PeriodicalId":100199,"journal":{"name":"Brazilian Journal of Anesthesiology (Edicion en Espanol)","volume":"65 4","pages":"Pages 240-243"},"PeriodicalIF":0.0,"publicationDate":"2015-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bjanes.2014.10.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54234932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Anafilaxia perioperatoria Anafilaxia perioperatoria

Brazilian Journal of Anesthesiology (Edicion en Espanol) Pub Date : 2015-07-01 DOI: 10.1016/j.bjanes.2014.09.002

Marta Inés Berrío Valencia

引用次数: 0

Comparación de los efectos profilácticos del droperidol y del ondansetrón sobre el prurito provocado por la morfina subaracnoidea droperidol和ondansetron对蛛网膜下腔吗啡引起的瘙痒的预防作用的比较

Brazilian Journal of Anesthesiology (Edicion en Espanol) Pub Date : 2015-07-01 DOI: 10.1016/j.bjanes.2013.11.006

Fabio Ferreira da Cunha Brião , Marcio Leal Horta , Bernardo Lessa Horta , Guilherme Antônio Moreira de Barros , Ana Paula Behrensdorf , Ingrid Severo , Mariana Antunes Nunes , Roberta Boabaid , André Real

{"title":"Comparación de los efectos profilácticos del droperidol y del ondansetrón sobre el prurito provocado por la morfina subaracnoidea","authors":"Fabio Ferreira da Cunha Brião , Marcio Leal Horta , Bernardo Lessa Horta , Guilherme Antônio Moreira de Barros , Ana Paula Behrensdorf , Ingrid Severo , Mariana Antunes Nunes , Roberta Boabaid , André Real","doi":"10.1016/j.bjanes.2013.11.006","DOIUrl":"10.1016/j.bjanes.2013.11.006","url":null,"abstract":"<div><h3>Background and objectives</h3><p>The prophylactic effect of ondansetron on subarachnoid morphine-induced pruritus is controversial, while evidence suggests that droperidol prevents pruritus. The aim of this study is to compare the effects of droperidol and ondansetron on subarachnoid morphine-induced pruritus.</p></div><div><h3>Methods</h3><p>One hundred eighty patients ASA <span>I</span> or <span>II</span> patients scheduled to undergo cesarean sections under subarachnoid anesthesia combined with morphine 0.2mg were randomized to receive, after the child's birth, metoclopramide 10mg (Group <span>I-</span>control), droperidol 2.5mg (Group <span>II</span>) or ondansetron 8mg (Group <span>III</span>). Postoperatively, the patients were assessed for pruritus (absent, mild, moderate or severe) or other side effects by blinded investigators. Patients were also blinded to their group allocation. The tendency to present more severe forms of pruritus was compared between groups. NNT was also determined.</p></div><div><h3>Results</h3><p>Patients assigned to receive droperidol (proportional odds ratio: 0.45 [95% confidence interval 0.23-0.88]) reported less pruritus than those who received metoclopramide. Ondansetron effect was similar to metoclopramide (proportional odds ratio: 0.95 [95% confidence interval 0.49-1.83]). The NNT for droperidol and ondansetron was 4.0 and 14.7, respectively.</p></div><div><h3>Conclusions</h3><p>Ondansetron does not inhibit subarachnoid morphine-induced pruritus.</p></div>","PeriodicalId":100199,"journal":{"name":"Brazilian Journal of Anesthesiology (Edicion en Espanol)","volume":"65 4","pages":"Pages 244-248"},"PeriodicalIF":0.0,"publicationDate":"2015-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bjanes.2013.11.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54233427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Hematoma subdural bilateral secundario a punción dural accidental 双侧继发性硬脑膜下血肿punción硬脑膜意外

Brazilian Journal of Anesthesiology (Edicion en Espanol) Pub Date : 2015-07-01 DOI: 10.1016/j.bjanes.2014.07.001

Sofía Ramírez, Elena Gredilla, Blanca Martínez, Fernando Gilsanz

引用次数: 2

Eficacia analgésica del bloqueo del plano transverso del abdomen ecoguiado-revisión sistemática 超声引导腹部横平面阻滞的镇痛效果-系统综述

Brazilian Journal of Anesthesiology (Edicion en Espanol) Pub Date : 2015-07-01 DOI: 10.1016/j.bjanes.2013.10.015

Javier Ripollés , Sandra Marmaña Mezquita , Alfredo Abad , José Calvo

{"title":"Eficacia analgésica del bloqueo del plano transverso del abdomen ecoguiado-revisión sistemática","authors":"Javier Ripollés , Sandra Marmaña Mezquita , Alfredo Abad , José Calvo","doi":"10.1016/j.bjanes.2013.10.015","DOIUrl":"10.1016/j.bjanes.2013.10.015","url":null,"abstract":"<div><h3>Background</h3><p>The transverse abdominal plan blockade (TAP) is a block of abdominal wall that has diffused rapidly in the clinical practice as part of a multimodal analgesia for abdominal surgery. The performance of the ultrasound-guided technique has allowed the lowering of potential complications, as well as new approaches that according to the descriptions carried out and the prospective studies would make it possible to utilize the TAP in different surgical interventions; however, the results obtained in randomized clinical trials (RCTs) are inconsistent.</p></div><div><h3>Objectives</h3><p>To prepare a systematic review aiming to determine the efficacy of the ultrasound-guided TAP for different surgical interventions, as well as the indications according to the approaches and their influences.</p></div><div><h3>Methods</h3><p>Two research approaches, one manual, and the other in Pubmed returned 28 RCT where intervention with ultrasound-guided TAP were performed to compare the analgesic efficacy in contrast to another technique in adults, published between 2007 and October 2013, in English or Spanish, with Jadad score >1, according to the inclusion criteria for this review. The authors analyzed independently all the RCT.</p></div><div><h3>Conclusions</h3><p>The TAP have been shown to be an effective technique in colorectal surgery, cesarean section, cholecystectomy, hysterectomy, appendectomy, donor nephrectomy, retropubic prostatectomy, and bariatric surgery. However, the data found in RCT are not conclusive, and as a result, it is necessary to develop new and well designed RCT, with enough statistical power to compare different approaches, drugs, doses, and volumes for the same intervention, aiming to answer the current questions and their effects in the habitual clinical practice.</p></div>","PeriodicalId":100199,"journal":{"name":"Brazilian Journal of Anesthesiology (Edicion en Espanol)","volume":"65 4","pages":"Pages 255-280"},"PeriodicalIF":0.0,"publicationDate":"2015-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bjanes.2013.10.015","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54226516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Una pregunta sobre ropivacaína para la raquianestesia unilateral: solución hipobárica 关于罗哌卡因用于单侧脊髓麻醉的问题:低压氧溶液

Brazilian Journal of Anesthesiology (Edicion en Espanol) Pub Date : 2015-07-01 DOI: 10.1016/j.bjanes.2014.02.015

Da-Qiang Zhao

引用次数: 0

Manejo anestésico para la cirugía de atresia de esófago en un neonato con síndrome de Goldenhar Goldenhar综合征新生儿食道闭锁手术的麻醉处理

Brazilian Journal of Anesthesiology (Edicion en Espanol) Pub Date : 2015-07-01 DOI: 10.1016/j.bjanes.2013.07.013

Rosana Guerrero-Domínguez , Daniel López-Herrera-Rodríguez , Inmaculada Benítez-Linero , Antonio Ontanilla

{"title":"Manejo anestésico para la cirugía de atresia de esófago en un neonato con síndrome de Goldenhar","authors":"Rosana Guerrero-Domínguez , Daniel López-Herrera-Rodríguez , Inmaculada Benítez-Linero , Antonio Ontanilla","doi":"10.1016/j.bjanes.2013.07.013","DOIUrl":"10.1016/j.bjanes.2013.07.013","url":null,"abstract":"<div><h3>Background and objectives</h3><p>Goldenhar's syndrome is a polymalformative condition consisting of a craniofacial dysostosis that determines difficult airway in up to 40% of cases. We described a case of a newborn with Goldenhar's syndrome with esophageal atresia and tracheoesophageal fistula who underwent repair surgery.</p></div><div><h3>Case report</h3><p>We report the case of a 24-hour-old newborn with Goldenhar's syndrome. He had esophageal atresia with distal tracheoesophageal fistula. It was decided that an emergency surgery would be performed for repairing it. It was carried out under sedation, intubation with fibrobronchoscope distal to the fistula, to limit the air flow into the esophagus, and possible abdominal distension. Following complete repair of the esophageal atresia and fistula ligation, the patient was transferred to the intensive care unit and intubated under sedation and analgesia.</p></div><div><h3>Conclusions</h3><p>The finding of a patient with Goldenhar's syndrome and esophageal atresia assumes an exceptional situation and a challenge for anesthesiologists, since the anesthetic management depends on the patient comorbidity, the type of tracheoesophageal fistula, the usual hospital practice and the skills of the anesthesiologist in charge, with the main peculiarity being maintenance of adequate pulmonary ventilation in the presence of a communication between the airway and the esophagus. Intubation with fibrobronchoscope distal to the fistula deals with the management of a probably difficult airway and limits the passage of air to the esophagus through the fistula.</p></div>","PeriodicalId":100199,"journal":{"name":"Brazilian Journal of Anesthesiology (Edicion en Espanol)","volume":"65 4","pages":"Pages 298-301"},"PeriodicalIF":0.0,"publicationDate":"2015-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bjanes.2013.07.013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54225122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0