Javier Ripollés , Ángel Espinosa , Rubén Casans , Ana Tirado , Alfredo Abad , Cristina Fernández , José Calvo
{"title":"Coloides versus cristaloides en fluidoterapia guiada por objetivos, revisión sistemática y metaanálisis. Demasiado pronto o demasiado tarde para obtener conclusiones","authors":"Javier Ripollés , Ángel Espinosa , Rubén Casans , Ana Tirado , Alfredo Abad , Cristina Fernández , José Calvo","doi":"10.1016/j.bjanes.2014.07.002","DOIUrl":"10.1016/j.bjanes.2014.07.002","url":null,"abstract":"<div><h3>Introduction</h3><p>Several clinical trials on Goal directed fluid therapy (GDFT) were carried out, many of those using colloids in order to optimize the preload. After the decision of European Medicines Agency, there is such controversy regarding its use, benefits, and possible contribution to kidney failure. The objective of this systematic review and meta-analysis is to compare the use of last-generation colloids, derived from corn, with crystalloids, in GDFT, to determine complications and mortality associated associated.</p></div><div><h3>Methods</h3><p>A bibliographic research was carried out in MEDLINE Pubmed, EMBASE and Cochrane Library, corroborating randomized clinical trials in those crystalloids are compared to colloids in GDFT for mayor non-cardiac surgery in adults.</p></div><div><h3>Results</h3><p>One hundred thirty references were found, among those 38 were selected, and 29 analyzed; of these, 6 were included for systematic review and meta-analysis, including 390 patients. It was perceived that the use of colloids it not associated with the increase of complications, but rather with a tendency to a higher mortality (RR [95% IC] 3.87 [1.121, 13, 38]); I<sup>2</sup> <!-->=<!--> <!-->0.0%; <em>P</em> <!-->=<!--> <!-->.635).</p></div><div><h3>Conclusiones</h3><p>Due to this meta-analysis’ limitations for small number of randomized clinical trials and patients included, the results should be taken cautiously, and it is proposed to carry out new randomized clinical trials, with enough statistical power, comparing balanced and non-balanced colloids to balanced and non-balanced crystalloids, following the protocols of GDFT, respecting current guidelines and suggestions made by groups of experts.</p></div>","PeriodicalId":100199,"journal":{"name":"Brazilian Journal of Anesthesiology (Edicion en Espanol)","volume":"65 4","pages":"Pages 281-291"},"PeriodicalIF":0.0,"publicationDate":"2015-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bjanes.2014.07.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54234767","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}
Fabiano Timbó Barbosa , Tatiana Rosa Bezerra Wanderley Barbosa , Rafael Martins da Cunha
{"title":"Efecto de la rotación de la cabeza en la presión intraocular en decúbito ventral: estudio aleatorizado","authors":"Fabiano Timbó Barbosa , Tatiana Rosa Bezerra Wanderley Barbosa , Rafael Martins da Cunha","doi":"10.1016/j.bjanes.2014.02.014","DOIUrl":"10.1016/j.bjanes.2014.02.014","url":null,"abstract":"","PeriodicalId":100199,"journal":{"name":"Brazilian Journal of Anesthesiology (Edicion en Espanol)","volume":"65 4","pages":"Pages 310-311"},"PeriodicalIF":0.0,"publicationDate":"2015-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bjanes.2014.02.014","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54234008","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}
Alexandre Takeda, Leonardo Henrique Cunha Ferraro, André Hosoi Rezende, Eduardo Jun Sadatsune, Luiz Fernando dos Reis Falcão, Maria Angela Tardelli
{"title":"Concentración mínima efectiva de bupivacaína para el bloqueo del plexo braquial vía axilar guiado por ecografía","authors":"Alexandre Takeda, Leonardo Henrique Cunha Ferraro, André Hosoi Rezende, Eduardo Jun Sadatsune, Luiz Fernando dos Reis Falcão, Maria Angela Tardelli","doi":"10.1016/j.bjanes.2013.11.004","DOIUrl":"10.1016/j.bjanes.2013.11.004","url":null,"abstract":"<div><h3>Introduction</h3><p>The use of ultrasound in regional anesthesia allows reducing the dosis of local anesthetic used for peripheral nerve block. The present study was performed to determine the minimum effective concentration (MEC90) of bupivacaine for axillary brachial plexus block.</p></div><div><h3>Methods</h3><p>Patients undergoing hand surgery were recruited. To estimate the MEC90, a sequential up-down biased coin method of allocation was used. The bupivacaine dosis was 5<!--> <!-->mL for each nerve (radial, ulnar, median, and musculocutaneous). The initial concentration was 0.35%. This concentration was changed by 0.05% depending on the previous block: a blockade failure resulted in increased concentration for the next patient; in case of success, the next patient could receive or reduction (0.1 probability) or the same concentration (0.9 probability). Surgical anesthesia was defined as driving force<!--> <!-->≤<!--> <!-->2 according to the modified Bromage scale, lack of thermal sensitivity and response to pinprick. Postoperative analgesia was assessed in the recovery room with numeric pain scale and the amount of drugs used within 4<!--> <!-->h after the blockade.</p></div><div><h3>Results</h3><p>MEC90 was 0.241% [R2: 0.978, confidence interval: 0.20-0.34%]. No successful block patient reported pain after 4<!--> <!-->h.</p></div><div><h3>Conclusion</h3><p>This study demonstrated that ultrasound guided axillary brachial plexus block can be performed with the use of low concentration of local anesthetics, increasing the safety of the procedure. Further studies should be conducted to assess blockade duration at low concentrations.</p></div>","PeriodicalId":100199,"journal":{"name":"Brazilian Journal of Anesthesiology (Edicion en Espanol)","volume":"65 3","pages":"Pages 163-169"},"PeriodicalIF":0.0,"publicationDate":"2015-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bjanes.2013.11.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54233319","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}
Fabiano Timbó Barbosa , Tatiana Rosa Bezerra Wanderley Barbosa , Rafael Martins da Cunha , Amanda Karine Barros Rodrigues , Fernando Wagner da Silva Ramos , Célio Fernando de Sousa-Rodrigues
{"title":"Bases anatómicas para el bloqueo anestésico del nervio isquiático al nivel de la rodilla","authors":"Fabiano Timbó Barbosa , Tatiana Rosa Bezerra Wanderley Barbosa , Rafael Martins da Cunha , Amanda Karine Barros Rodrigues , Fernando Wagner da Silva Ramos , Célio Fernando de Sousa-Rodrigues","doi":"10.1016/j.bjanes.2014.03.011","DOIUrl":"10.1016/j.bjanes.2014.03.011","url":null,"abstract":"<div><h3>Background and objectives</h3><p>Recently, administration of sciatic nerve block has been revised due to the potential benefit for postoperative analgesia and patient satisfaction after the advent of ultrasound. The aim of this study was to describe the anatomical relations of the sciatic nerve in the popliteal fosa to determine the optimal distance the needle must be positioned in order to realize the sciatic nerve block anterior to its bifurcation into the tibial and common fibular nerve.</p></div><div><h3>Method</h3><p>The study was conducted by dissection of human cadavers’ popliteal fosa, fixed in 10% formalin, from the Laboratory of Human Anatomy and Morphology Departments of the Universidade Federal de Alagoas and Universidade de Ciências de la Saúde de Alagoas. Access to the sciatic nerve was obtained.</p></div><div><h3>Results</h3><p>Fourty four popliteal fosa were analyzed. The bifurcation of the sciatic nerve in relation to the apex of the fosa was observed. There was bifurcation in: 67.96% below the apex, 15.90% above the apex, 11.36% near the apex, and 4.78% in the gluteal region.</p></div><div><h3>Conclusions</h3><p>The sciatic nerve bifurcation to its branches occurs at various levels, and the chance to succeed when the needle is placed between 5 and 7<!--> <!-->cm above the popliteal is 95.22%.</p></div>","PeriodicalId":100199,"journal":{"name":"Brazilian Journal of Anesthesiology (Edicion en Espanol)","volume":"65 3","pages":"Pages 177-179"},"PeriodicalIF":0.0,"publicationDate":"2015-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bjanes.2014.03.011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54233708","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}
Bruno Prata Martinez , Joilma Ribeiro Silva , Vanessa Salgado Silva , Mansueto Gomes Neto , Luiz Alberto Forgiarini Júnior
{"title":"Influencia de diferentes posiciones corporales en la capacidad vital en pacientes en el postoperatorio abdominal superior","authors":"Bruno Prata Martinez , Joilma Ribeiro Silva , Vanessa Salgado Silva , Mansueto Gomes Neto , Luiz Alberto Forgiarini Júnior","doi":"10.1016/j.bjanes.2014.06.001","DOIUrl":"10.1016/j.bjanes.2014.06.001","url":null,"abstract":"<div><h3>Background</h3><p>The changes in body position can cause changes in lung function, it is necessary to understand them, especially in the postoperative upper abdominal surgery, since these patients are susceptible to postoperative pulmonary complications.</p></div><div><h3>Objective</h3><p>To assess the vital capacity in the supine position (head at 0° and 45°), sitting and standing positions in patients in the postoperative upper abdominal surgery.</p></div><div><h3>Methods</h3><p>A cross-sectional study conducted between August 2008 and January 2009 in a hospital in Salvador/BA. The instrument used to measure vital capacity (VC) was analogic spirometer, the choice of the sequence of positions followed a random order obtained from the draw of the four positions. Secondary data were collected from the medical records of each patient.</p></div><div><h3>Results</h3><p>The sample consisted of 30 subjects with a mean age of 45.2<!--> <!-->±<!--> <!-->11.2 years, BMI 20.2<!--> <!-->±<!--> <!-->1.0<!--> <!-->kg/m<sup>2</sup>. The position on orthostasis showed higher values of CV regarding standing (mean change: 0.15<!--> <!-->±<!--> <!-->0.03<!--> <!-->L, p<!--> <!-->=<!--> <!-->0.001), the supine to 45̊ (average difference: 0.32<!--> <!-->±<!--> <!-->0.04<!--> <!-->L, p<!--> <!-->=<!--> <!-->0.001) and 0° (0.50<!--> <!-->±<!--> <!-->0.05<!--> <!-->L, p<!--> <!-->=<!--> <!-->0.001). There was a positive trend between the values of forced VC supine to upright posture (1.68<!--> <!-->±<!--> <!-->0.47; 1.86<!--> <!-->±<!--> <!-->0.48, 2.02<!--> <!-->±<!--> <!-->0.48 and 2.18<!--> <!-->±<!--> <!-->0.52<!--> <!-->L, respectively).</p></div><div><h3>Conclusion</h3><p>Body position affects the values of CV in patients in the postoperative upper abdominal surgery, increasing in postures where the chest is vertical.</p></div>","PeriodicalId":100199,"journal":{"name":"Brazilian Journal of Anesthesiology (Edicion en Espanol)","volume":"65 3","pages":"Pages 217-221"},"PeriodicalIF":0.0,"publicationDate":"2015-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bjanes.2014.06.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54234590","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}
{"title":"¿Existe una correlación entre el volumen ecográfico de la glándula tiroides y la intubación difícil? Un estudio observacional","authors":"Basak Ceyda Meco , Zekeriyya Alanoglu , Ali Abbas Yilmaz , Cumhur Basaran , Neslihan Alkis , Seher Demirer , Handan Cuhruk","doi":"10.1016/j.bjanes.2014.06.002","DOIUrl":"10.1016/j.bjanes.2014.06.002","url":null,"abstract":"<div><h3>Background and objectives</h3><p>Preoperative ultrasonographic evaluation of the thyroid gland done by surgeons could let us foresee airway management challenges. The aim of this observational study was to evaluate the effects of thyroid-related parameters assessed preoperatively by surgeons via ultrasonography and chest X-ray on intubation conditions.</p></div><div><h3>Methods</h3><p>Fifty patients undergoing thyroid surgery were enrolled. Thyromental distance, Mallampati score, neck circumference and range of neck movement were evaluated before the operation. Thyroid volume, signs of invasion or compression and tracheal deviation on chest X-ray were also noted. The intubation conditions were assessed with Cormack and Lehane score and the intubation difficulty scale (IDS). Statistical analyses were done with SPSS 15.0 software.</p></div><div><h3>Results</h3><p>The mean thyroid volume of the patients was 26.38<!--> <!-->±<!--> <!-->14<!--> <!-->mL. The median IDS 1 (0-2). Thyromental distance (<em>P</em> <!-->=<!--> <!-->.011; <em>r</em> <!-->=<!--> <!-->0.36; 95% CI 0.582-0.088), Mallampati score (<em>P</em> <!-->=<!--> <!-->.041; <em>r</em> <!-->=<!--> <!-->0.29; 95% CI 0.013-0.526), compression or invasion signs (<em>P</em> <!-->=<!--> <!-->0.041; <em>r</em> <!-->=<!--> <!-->0.28; 95% CI 0.006-0.521) and tracheal deviation on chest X-ray (<em>P</em> <!-->=<!--> <!-->0.041; <em>r</em> <!-->=<!--> <!-->0.52; 95% CI 0.268-0.702) were correlated with IDS. Also patients were classified into 2 groups related to their IDS (group <span>I</span>, <em>n</em> <!-->=<!--> <!-->19: IDS<!--> <!-->=<!--> <!-->0; group <span>II</span>, <em>n</em> <!-->=<!--> <!-->31: 1<!--> <!--><<!--> <!-->IDS<!--> <!-->≤<!--> <!-->5) and difficult intubation predictors and thyroid-related parameters were compared. Only Mallampati score was significantly different between groups (<em>P</em> <!-->=<!--> <!-->.025).</p></div><div><h3>Conclusion</h3><p>The thyroid volume is not associated with difficult intubation. However clinical assessment parameters may predict difficult intubation.</p></div>","PeriodicalId":100199,"journal":{"name":"Brazilian Journal of Anesthesiology (Edicion en Espanol)","volume":"65 3","pages":"Pages 230-234"},"PeriodicalIF":0.0,"publicationDate":"2015-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bjanes.2014.06.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54235010","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}
Recep Aksu , Cihangir Biçer , Ayşe Ülgey , Adnan Bayram , Işın Güneş , Ahmet Güney , Mustafa Denizhan Yıldırım , Günhan Gökahmetoğlu , Karamehmet Yıldız
{"title":"Comparación de bloqueo del plexo braquial por vía interescalénica y administración de anestésico local intraarticular en el manejo del dolor en el postoperatorio de cirugía artroscópica del hombro","authors":"Recep Aksu , Cihangir Biçer , Ayşe Ülgey , Adnan Bayram , Işın Güneş , Ahmet Güney , Mustafa Denizhan Yıldırım , Günhan Gökahmetoğlu , Karamehmet Yıldız","doi":"10.1016/j.bjanes.2014.06.003","DOIUrl":"10.1016/j.bjanes.2014.06.003","url":null,"abstract":"<div><h3>Background and objectives</h3><p>In this study, the aim was to compare postoperative analgesia effects of the administration of ultrasound-guided interscalene brachial plexus block and intraarticular bupivacaine carried out with bupivacaine.</p></div><div><h3>Methods</h3><p>In the first group of patients 20<!--> <!-->mL 0.25% bupivacaine and ultrasound-guided interscalene brachial plexus block (ISPB) were applied, while 20<!--> <!-->mL 0.25% bupivacaine was given vía intraarticular (IA) administration to the second group patients after surgery. Patients in the third group were considered the control group and no block was performed. Patient-controlled analgesia with morphine was used in all three groups for postoperative analgesia.</p></div><div><h3>Results</h3><p>In the ISPB group, morphine consumption in the periods between 0-4, 6-12 and 12-24 postoperative hours and total consumption within 24<!--> <!-->h was lower than in the other 2 groups. Morphine consumption in the IA group was lower than in the control group in the period from 0-6<!--> <!-->h and the same was true for total morphine consumption in 24<!--> <!-->h. Postoperative VASr scores in the ISPB group were lower than both of the other groups in the first 2<!--> <!-->h and lower than the control group in the 4th and 6th<!--> <!-->h (<em>P</em> <!--><<!--> <!-->.05). In the IA group, VASr and VASm scores in the 2nd, 4th and 6th<!--> <!-->h were lower than in the control group (<em>P</em> <!--><<!--> <!-->.05).</p></div><div><h3>Conclusion</h3><p>ISPBl plexus block was found to be more effective than intraarticular local anesthetic injection for postoperative analgesia.</p></div>","PeriodicalId":100199,"journal":{"name":"Brazilian Journal of Anesthesiology (Edicion en Espanol)","volume":"65 3","pages":"Pages 222-229"},"PeriodicalIF":0.0,"publicationDate":"2015-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bjanes.2014.06.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54235037","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}
Mefkur Bakan , Tarik Umutoglu , Ufuk Topuz , Harun Uysal , Mehmet Bayram , Huseyin Kadioglu , Ziya Salihoglu
{"title":"Anestesia venosa total libre de opiáceos, con infusiones de propofol, dexmedetomidina y lidocaína para la colecistectomía laparoscópica: estudio prospectivo, aleatorizado y doble ciego","authors":"Mefkur Bakan , Tarik Umutoglu , Ufuk Topuz , Harun Uysal , Mehmet Bayram , Huseyin Kadioglu , Ziya Salihoglu","doi":"10.1016/j.bjanes.2014.05.008","DOIUrl":"10.1016/j.bjanes.2014.05.008","url":null,"abstract":"<div><h3>Background and objectives</h3><p>Intraoperative use of opioids may be associated with postoperative hyperalgesia and increased analgesic consumption. Side effects due to perioperative use of opioids, such as postoperative nausea and vomiting may delay discharge. We hypothesized that total intravenous anesthesia consisting of lidocaine and dexmedetomidine as an opioid substitute may be an alternative technique for laparoscopic cholecystectomy and would be associated with lower fentanyl requirements in the postoperative period and less incidence of postoperative nausea and vomiting.</p></div><div><h3>Methods</h3><p>Eighty ASA I-II adults were scheduled for elective laparoscopic cholecystectomy. Patients were randomly allocated into 2 groups to have either opioid-free anesthesia with dexmedetomidine, lidocaine, and propofol infusions (Group DL) or opioid-based anesthesia with remifentanil, and propofol infusions (Group RF). All patients received a standard multimodal analgesia regimen. A patient controlled analgesia device was set to deliver intravenous fentanyl for 6<!--> <!-->h after surgery. The primary outcome variable was postoperative fentanyl consumption.</p></div><div><h3>Results</h3><p>Fentanyl consumption at postoperative 2nd hour was statistically significantly less in Group DL, compared with Group RF, which were 75<!--> <!-->±<!--> <!-->59<!--> <!-->μg and 120<!--> <!-->±<!--> <!-->94<!--> <!-->μg respectively, while it was comparable at postoperative 6<!--> <!-->th hour. During anesthesia, there were more hypotensive events in Group RF, while there were more hypertensive events in Group DL, which were both statistically significant. Despite higher recovery times, Group DL had significantly lower pain scores, rescue analgesic and ondansetron need.</p></div><div><h3>Conclusion</h3><p>Opioid-free anesthesia with dexmedetomidine, lidocaine and propofol infusions may be an alternative technique for laparoscopic cholecystectomy especially in patients with high risk for postoperative nausea and vomiting.</p></div>","PeriodicalId":100199,"journal":{"name":"Brazilian Journal of Anesthesiology (Edicion en Espanol)","volume":"65 3","pages":"Pages 191-199"},"PeriodicalIF":0.0,"publicationDate":"2015-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bjanes.2014.05.008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54234546","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}
Débora Miranda Diogo Stabille , Augusto Diogo Filho , Beatriz Lemos da Silva Mandim , Lúcio Borges de Araújo , Priscila Miranda Diogo Mesquita , Miguel Tanús Jorge
{"title":"Frecuencia de colonización y bacterias aisladas de punta de catéter epidural implantado para analgesia postoperatoria","authors":"Débora Miranda Diogo Stabille , Augusto Diogo Filho , Beatriz Lemos da Silva Mandim , Lúcio Borges de Araújo , Priscila Miranda Diogo Mesquita , Miguel Tanús Jorge","doi":"10.1016/j.bjanes.2014.05.006","DOIUrl":"10.1016/j.bjanes.2014.05.006","url":null,"abstract":"<div><h3>Objectives</h3><p>The increased use of epidural analgesia with catheter leads to the need to demonstrate the safety of this method and know the incidence of catheter colonization, inserted postoperatively for epidural analgesia, and the bacteria responsible for this colonization.</p></div><div><h3>Methods</h3><p>From November 2011 to April 2012, patients electively operated and maintained under epidural catheter for postoperative analgesia were evaluated. The catheter tip was collected for semiquantitative and qualitative microbiological analysis.</p></div><div><h3>Results</h3><p>Of 68 cultured catheters, 6 tips (8.8%) had positive cultures. No patient had superficial or deep infection. The mean duration of catheter use was 43.45<!--> <!-->h (18-118) (<em>P</em> <!-->=<!--> <!-->.0894). The type of surgery (contaminated or uncontaminated), physical status of patients, and surgical time showed no relation with the colonization of catheters. Microorganisms isolated from the catheter tip were <em>Staphylococcus aureus</em>, <em>Pseudomonas aeruginosa</em> and <em>Sphingomonas paucimobilis</em>.</p></div><div><h3>Conclusion</h3><p>Postoperative epidural catheter analgesia, under this study conditions, was found to be low risk for bacterial colonization in patients at surgical wards.</p></div>","PeriodicalId":100199,"journal":{"name":"Brazilian Journal of Anesthesiology (Edicion en Espanol)","volume":"65 3","pages":"Pages 200-206"},"PeriodicalIF":0.0,"publicationDate":"2015-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bjanes.2014.05.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54234406","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}
Tania Cursino de Menezes Couceiro , Luciana Cavalcanti Lima , Léa Menezes Couceiro Burle , Marcelo Moraes Valença
{"title":"Lidocaína intravenosa en el tratamiento del dolor posmastectomía: ensayo clínico aleatorizado, encubierto, placebo controlado","authors":"Tania Cursino de Menezes Couceiro , Luciana Cavalcanti Lima , Léa Menezes Couceiro Burle , Marcelo Moraes Valença","doi":"10.1016/j.bjanes.2014.05.007","DOIUrl":"10.1016/j.bjanes.2014.05.007","url":null,"abstract":"<div><h3>Background and objective</h3><p>Postoperative pain treatment in mastectomy remains a major challenge despite the multimodal approach. The aim of this study was to investigate the analgesic effect of intravenous lidocaine in patients undergoing mastectomy, as well as the postoperative consumption of opioids.</p></div><div><h3>Methods</h3><p>After approval by the Human Research Ethics Committee of the Instituto de Medicina Integral Prof. Fernando Figueira in Recife, Pernambuco, a randomized, blind, controlled trial was conducted with intravenous lidocaine at a dose of 3<!--> <!-->mg/kg infused over one hour in 45 women undergoing mastectomy under general anesthesia. One patient from placebo group was</p></div><div><h3>Results</h3><p>Groups were similar in age, body mass index, type of surgery, and postoperative need for opioids. Two of 22 patients in lidocaine group and 3 of 22 patients in placebo group requested opioid (<em>P</em> <!-->=<!--> <!-->.50). Pain on awakening was identified in 4/22 of lidocaine group and 5/22 of placebo group (<em>P</em> <!-->=<!--> <!-->.50); in the post-anesthetic recovery room in 14/22 and 12/22 (<em>P</em> <!-->=<!--> <!-->.37) of lidocaine and placebo groups, respectively. Pain evaluation 24<!--> <!-->h after surgery showed that 2/22 and 3/22 patients (<em>P</em> <!-->=<!--> <!-->.50) of lidocaine and placebo groups, respectively, complained of pain.</p></div><div><h3>Conclusion</h3><p>Intravenous lidocaine at a dose of 3<!--> <!-->mg/kg administered over a period of an hour during mastectomy did not promote additional analgesia compared to placebo in the first 24<!--> <!-->h, and has not decreased opioid consumption. However, a beneficial effect of intravenous lidocaine in selected and/or other therapeutic regimens patients can not be ruled out.</p></div>","PeriodicalId":100199,"journal":{"name":"Brazilian Journal of Anesthesiology (Edicion en Espanol)","volume":"65 3","pages":"Pages 207-212"},"PeriodicalIF":0.0,"publicationDate":"2015-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bjanes.2014.05.007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54234474","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}