Revista brasileira de anestesiologia最新文献

{"title":"Efeitos do rocurônio, sugamadex e complexo rocurônio‐sugamadex sobre a coagulação em ratos","authors":"Ismar Lima Cavalcanti ,&nbsp;Estêvão Luiz Carvalho Braga ,&nbsp;Nubia Verçosa ,&nbsp;Alberto Schanaider ,&nbsp;Louis Barrucand ,&nbsp;Hans Donald de Boer ,&nbsp;Luiz Vane","doi":"10.1016/j.bjan.2020.08.007","DOIUrl":"10.1016/j.bjan.2020.08.007","url":null,"abstract":"<div><h3>Background and objectives</h3><p>Sugammadex is an alternative pharmacological drug capable of reversing neuromuscular blockades without the limitations that are presented by anticholinesterase drugs. Coagulation disorders that are related to treatment with sugammadex were reported. The exact mechanism of the effects on coagulation are not fully understood. The objective of this research is to evaluate the effects of rocuronium, sugammadex and the rocuronium‐sugammadex complex on coagulation in an experimental model in rats.</p></div><div><h3>Methods</h3><p>This is an experimental randomized animal study. Wistar rats were randomly assigned into the following groups: the Control Group; the Ssal Group – 0.5 mL of intravenous saline; the Sugammadex Group – intravenous sugammadex (100 mg.kg^‐1); and the Rocuronium‐Sugammadex Group – intravenous solution with rocuronium (3.75 mg.kg^‐1) and sugammadex (100 mg.kg^‐1). Anesthesia was performed by using isoflurane with controlled ventilation. Coagulation factors were measured 10 minutes after the end of the preoperative preparation and 30 minutes after the administration of the drugs in accordance with the chosen groups.</p></div><div><h3>Results</h3><p>Platelet counts, prothrombin times and activated partial thromboplastin times were similar between the groups and between the moments within each group. There were reductions in the plasma fibrinogen levels between sample times 1 and 2 in the Rocuronium‐Sugammadex group (<em>p</em> <!-->=<!--> <!-->0.035).</p></div><div><h3>Conclusions</h3><p>The rocuronium‐sugammadex complex promoted reductions in plasma fibrinogen counts, although the levels were still within normal limits.</p></div>","PeriodicalId":21261,"journal":{"name":"Revista brasileira de anestesiologia","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bjan.2020.08.007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38627803","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":"Dexametasona perineural em bloqueio de plexo braquial interescalênico com levobupivacaína guiado por ultrassonografia para artroscopia de ombro em regime ambulatorial: ensaio clínico controlado e randomizado","authors":"Mateus Meira Vasconcelos ,&nbsp;João Paulo Jordão Pontes ,&nbsp;Alexandre de Menezes Rodrigues ,&nbsp;Demócrito Ribeiro de Brito Neto ,&nbsp;Rodrigo Rodrigues Alves ,&nbsp;Fernando Cássio do Prado Silva ,&nbsp;Denis Fabiano de Souza","doi":"10.1016/j.bjan.2020.07.003","DOIUrl":"10.1016/j.bjan.2020.07.003","url":null,"abstract":"<div><h3>Background and objectives</h3><p>In shoulder arthroscopy, on an outpatient basis, the patient needs a good control of the postoperative pain that can be achieved through regional blocks. Perineural dexamethasone may prolong the effect of these blocks. The aim of this study was to evaluate the effect of perineural dexamethasone on the prolongation of the sensory block in the postoperative period for arthroscopic shoulder surgery in outpatient setting.</p></div><div><h3>Methods</h3><p>After approval by the Research Ethics Committee and informed consent, patients undergoing arthroscopic shoulder surgery under general anesthesia and ultrasound‐guided interscalene brachial plexus block were randomized into Group D – blockade performed with 30 mL of 0.5% levobupivacaine with vasoconstrictor and 6 mg (1.5 mL) of dexamethasone and Group C – 30 mL of 0.5% levobupivacaine with vasoconstrictor and 1.5 mL of 0.9% saline. The duration of the sensory block was evaluated in 4 postoperative moments (0, 4, 12 and 24 hours) as well as the need for rescue analgesia, nausea and vomiting incidence, and Visual Analog Pain Scale (VAS).</p></div><div><h3>Results</h3><p>Seventy‐four patients were recruited and 71 completed the study (Group C, n<!--> <!-->=<!--> <!-->37; Group D, n<!--> <!-->=<!--> <!-->34). Our findings showed a prolongation of the mean time of the sensitive blockade in Group D (1440<!--> <!-->±<!--> <!-->0 min vs. 1267<!--> <!-->±<!--> <!-->164 min, <em>p</em> <!-->&lt;<!--> <!-->0.001). It was observed that Group C had a higher mean pain score according to VAS (2.08<!--> <!-->±<!--> <!-->1.72 vs. 0.02<!--> <!-->±<!--> <!-->0.17, <em>p</em> &lt;<!--> <!-->0.001) and a greater number of patients (68.4% vs. 0%, <em>p</em> &lt;<!--> <!-->0.001) required rescue analgesia in the first 24 hours. The incidence of postoperative nausea and vomiting was not statistically significant.</p></div><div><h3>Conclusion</h3><p>Perineural dexamethasone significantly prolonged the sensory blockade promoted by levobupivacaine in interscalene brachial plexus block, reduced pain intensity and rescue analgesia needs in the postoperative period.</p></div>","PeriodicalId":21261,"journal":{"name":"Revista brasileira de anestesiologia","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bjan.2020.07.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38600237","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":"Anafilaxia por corante azul patente V: relato de caso e revisão da literatura","authors":"Diogo Costa,&nbsp;Mauro Mendonça,&nbsp;Michael Lopes,&nbsp;Ana Luísa Fernandes,&nbsp;Sara Nunes,&nbsp;Sofia Müller","doi":"10.1016/j.bjan.2020.05.005","DOIUrl":"10.1016/j.bjan.2020.05.005","url":null,"abstract":"<div><h3>Background</h3><p>Anaphylaxis is a constant perioperative concern due to the exposure to several agents capable of inducing hypersensitivity reactions. Patent blue V (PBV), also known as Sulfan Blue, a synthetic dye used in sentinel node research in breast surgery, is responsible for 0.6% of reported anaphylactic conditions. We present a case of a 49‐year‐old female patient who underwent left breast tumorectomy with sentinel lymph node staging using PBV and experienced an anaphylactic reaction.</p></div><div><h3>Methods</h3><p>We conducted a literature search through PubMed for case reports, case series, reviews, and systematic reviews since 2005 with the keywords “anaphylaxis” and “patent blue”. We then included articles found in these publications’ reference sections.</p></div><div><h3>Results</h3><p>We found 12 relevant publications regarding this topic. The main findings are summarized, with information regarding the clinical presentation, management, and investigation protocol. Hypotension is the most common clinical manifestation. The presentation is usually delayed when compared with anaphylaxis from other agents, and cutaneous manifestations are occasionally absent. Patients may have had previous exposure to the dye, used also as a food, clothes and drug colorant.</p></div><div><h3>Conclusion</h3><p>The diagnosis of anaphylaxis in patients under sedation or general anesthesia may be difficult due to particularities of the perioperative context. According to the published literature, the presentation of the reaction is similar in most cases and a heightened clinical sense is key to address the situation appropriately. Finding the agent responsible for the allergic reaction is of paramount importance to prevent future episodes.</p></div>","PeriodicalId":21261,"journal":{"name":"Revista brasileira de anestesiologia","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bjan.2020.05.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38676144","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":"ESPID – escore simplificado preditivo de intubação difícil","authors":"Vinícius Caldeira Quintão ,&nbsp;Cláudia Marquez Simões ,&nbsp;Maria José Carvalho Carmona","doi":"10.1016/j.bjan.2020.10.004","DOIUrl":"10.1016/j.bjan.2020.10.004","url":null,"abstract":"","PeriodicalId":21261,"journal":{"name":"Revista brasileira de anestesiologia","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bjan.2020.10.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38678222","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":"Nível de S100B e disfunção cognitiva após prostatectomia radical laparoscópica assistida por robô: estudo observacional prospectivo","authors":"Nilgun Kavrut Ozturk ,&nbsp;Ali Sait Kavakli ,&nbsp;Ulku Arslan ,&nbsp;Guzin Aykal ,&nbsp;Murat Savas","doi":"10.1016/j.bjan.2020.06.006","DOIUrl":"10.1016/j.bjan.2020.06.006","url":null,"abstract":"<div><h3>Background</h3><p>The present study investigated the association between Postoperative Cognitive Dysfunction (POCD) and increased serum S100B level after Robotic‐Assisted Laparoscopic Radical Prostatectomy (RALRP).</p></div><div><h3>Methods</h3><p>The study included 82 consecutive patients who underwent RALRP. Serum S100B levels were determined preoperatively, after anesthesia induction, and at 30 minutes and 24 hours postoperatively. Cognitive function was assessed using neuropsychological testing preoperatively and at 7 days and 3 months postoperatively.</p></div><div><h3>Results</h3><p>Twenty‐four patients (29%) exhibited POCD 7 days after surgery, and 9 (11%) at 3 months after surgery. Serum S100B levels were significantly increased at postoperative 30<!--> <!-->minutes and 24 hours in patients displaying POCD at postoperative 7 days (<em>p</em> <!--> <!-->=<!--> <!--> 0.0001 for both) and 3 months (<em>p</em> = 0.001 for both) compared to patients without POCD. Duration of anesthesia was also significantly longer in patients with POCD at 7 days and 3 months after surgery compared with patients without POCD (<em>p</em> = 0.012, <em>p</em> = 0.001, respectively), as was duration of Trendelenburg (<em>p</em> = 0.025, <em>p</em> = 0.002, respectively). Composite Z score in tests performed on day 7 were significantly correlated with duration of Trendelenburg and duration of anesthesia (<em>p</em> = 0.0001 for both).</p></div><div><h3>Conclusions</h3><p>S100B increases after RALRP and this increase is associated with POCD development. Duration of Trendelenburg position and anesthesia contribute to the development of POCD.</p></div><div><h3>Trial Registry Number</h3><p>Clinicaltrials.gov (N° NCT03018522).</p></div>","PeriodicalId":21261,"journal":{"name":"Revista brasileira de anestesiologia","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bjan.2020.06.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38717439","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":"Segurança ocupacional da equipe na prática de ECT durante a pandemia de COVID‐19","authors":"Renato Ferreira Araujo,&nbsp;Lucio de Oliveira Quites","doi":"10.1016/j.bjan.2020.10.002","DOIUrl":"10.1016/j.bjan.2020.10.002","url":null,"abstract":"","PeriodicalId":21261,"journal":{"name":"Revista brasileira de anestesiologia","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bjan.2020.10.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38610293","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":"Anestesia geral sem opioide e recuperação induzida da anestesia em paciente com distrofia miotônica tipo‐1: relato de caso","authors":"Hande Gurbuz ,&nbsp;Kemal Tolga Saracoglu","doi":"10.1016/j.bjan.2020.07.004","DOIUrl":"10.1016/j.bjan.2020.07.004","url":null,"abstract":"<div><p>Myotonic dystrophy type‐1 (Steinert disease) is an autosomal dominant, progressive multisystem disease in which myotonic crisis can be triggered by several factors including pain, emotional stress, hypothermia, shivering, and mechanical or electrical stimulation. In this report, dexmedetomidine‐based general anesthesia, in combination with a thoracic epidural for laparoscopic cholecystectomy in a patient with Steinert disease, is presented. An Aintree intubation catheter with the guidance of a fiberoptic bronchoscope was used for intubation to avoid laryngoscopy. Prolonged anesthetic effects of propofol were reversed, and recovery from anesthesia was accelerated using an intravenous infusion of theophylline.</p></div>","PeriodicalId":21261,"journal":{"name":"Revista brasileira de anestesiologia","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bjan.2020.07.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38601650","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":"Propofol‐cetamina versus dexmedetomidina‐cetamina para sedação durante endoscopia digestiva alta em pacientes pediátricos: estudo clínico randomizado","authors":"Akram M. Amer,&nbsp;Azza M. Youssef,&nbsp;Hala S. El‐Ozairy,&nbsp;Ahmed M. El‐Hennawy","doi":"10.1016/j.bjan.2020.08.005","DOIUrl":"10.1016/j.bjan.2020.08.005","url":null,"abstract":"<div><h3>Background and objectives</h3><p>Day‐case pediatric sedation is challenging. Dexmedetomidine is a sedative analgesic that does not induce respiratory depression. We compared dexmedetomidine to propofol when it was added to ketamine for sedation during pediatric endoscopy, regarding recovery time and hemodynamic changes.</p></div><div><h3>Methods</h3><p>We enrolled 120 patients (2−7 years in age) and randomly assigned them into two groups. Each patient received intravenous (<span>IV</span>) ketamine at a dose of 1 mg.kg^‐1 in addition to either propofol (1 mg.kg^‐1) or dexmedetomidine (0.5 μg.kg^‐1). The recovery time was compared. Hemodynamics, oxygen saturation, need for additional doses, postoperative complications and endoscopist satisfaction were monitored.</p></div><div><h3>Results</h3><p>There was no significant difference in hemodynamics between the groups. The Propofol‐Ketamine (P‐K) group showed significantly shorter recovery times than the Dexmedetomidine‐Ketamine (D‐K) group (21.25 and 29.75 minutes respectively, <em>p</em> &lt;<!--> <!-->0.001). The P‐K group showed more oxygen desaturation. Eleven and six patients experienced SpO₂ &lt;<!--> <!-->92% in groups P‐K and D‐K, respectively. A significant difference was noted regarding the need for additional doses; 10% of patients in the D‐K group needed one extra dose, and 5% needed two extra doses, compared to 25% and 20% in the P‐K group, respectively (<em>p</em> <!-->=<!--> <!-->0.001). The P‐K group showed less post‐procedure nausea and vomiting. No statistically significant difference between both groups regarding endoscopist satisfaction.</p></div><div><h3>Conclusions</h3><p>The P‐K combination was associated with a shorter recovery time in pediatric upper gastrointestinal endoscopy, while the D‐K combination showed less need for additional doses.</p></div><div><h3>Registration number</h3><p>Clinical trials.gov (NCT02863861).</p></div>","PeriodicalId":21261,"journal":{"name":"Revista brasileira de anestesiologia","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bjan.2020.08.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38350403","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":"Comparação entre morfina subaracnoidea e bloqueio do nervo femoral para analgesia após reconstrução ligamentar de joelho: estudo clínico randomizado","authors":"Joana Zulian Fiorentin ,&nbsp;Alexandre Vieira Martins ,&nbsp;Juan Manuel Vélez Cañola ,&nbsp;Linda Cecilia Gutierrez ,&nbsp;Fábio Perches ,&nbsp;Thiago Mamôru Sakae ,&nbsp;Sérgio Bernardo Tenório","doi":"10.1016/j.bjan.2019.08.006","DOIUrl":"10.1016/j.bjan.2019.08.006","url":null,"abstract":"<div><h3>Background and objectives</h3><p>There is no consensus of the ideal technique to provide analgesia in knee ligament reconstructions. The aim of this study was to compare the intensity of postoperative pain in these patients under different modalities of analgesia.</p></div><div><h3>Method</h3><p>Randomized and controlled clinical trial of patients undergoing reconstruction of the anterior cruciate ligament (ACL) with flexor tendons between December 2013 and 2014. All patients underwent spinal anesthesia and rescue analgesia with tramadol. The Groups C, M, R0,375 and R0,25 were compared with only the previously described technique, subarachnoid morphine (100 μg) or femoral nerve block with 25 mL of 0.375% ropivacaine and 0.25%, respectively. Pain intensity at 6, 12 and 24<!--> <!-->hours, age, sex, rescue analgesia, adverse reactions and satisfaction were evaluated.</p></div><div><h3>Results</h3><p>Among the 83 eligible patients, a predominance of males (85.7%) was observed, between 28 and 31 years. The Group C requested more opioid (27.3%) than the other groups, without significance when compared. There were no significant differences in pain intensity at 6, 12 and 24<!--> <!-->hours. There was a higher incidence of urinary retention in the Group M (23.8%) than in the R0,375 (0%) and prolonged quadriceps motor block in the R0,375 Group (30%) than in the M and C Groups (0%), with statistical significance (<em>p</em> &lt; 0.05).</p></div><div><h3>Conclusion</h3><p>There was no difference in the intensity of postoperative pain in patients submitted to anterior cruciate ligament reconstruction with flexor tendons under the analgesic modalities evaluated, despite the predominance of urinary retention in the M Group and motor block in the R0,375 Group.</p></div>","PeriodicalId":21261,"journal":{"name":"Revista brasileira de anestesiologia","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bjan.2019.08.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38468768","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":"Efeito da pré‐administração de flurbiprofeno axetil na CE50 do propofol durante anestesia em pacientes não estimulados: estudo clínico randomizado","authors":"Jing Ma,&nbsp;Mian Peng,&nbsp;Fei Wang,&nbsp;Lei Chen,&nbsp;Zong‐Ze Zhang,&nbsp;Yan‐Lin Wang","doi":"10.1016/j.bjan.2020.08.006","DOIUrl":"10.1016/j.bjan.2020.08.006","url":null,"abstract":"<div><h3>Background and objectives</h3><p>Preoperative use of flurbiprofen axetil (FA) is extensively adopted to modulate the effects of analgesia. However, the relationship between FA and sedation agents remains unclear. In this study, we aimed to investigate the effects of different doses of FA on the median Effective Concentration (EC50) of propofol.</p></div><div><h3>Methods</h3><p>Ninety‐six patients (ASA I or II, aged 18–65 years) were randomly assigned into one of four groups in a 1:1:1:1 ratio. Group A (control group) received 10 mL of Intralipid, and groups B, C and D received 0.5 mg.kg^‐1, 0.75 mg.kg^‐1 and 1 mg.kg^‐1 of FA, respectively, 10 minutes before induction. The depth of anesthesia was measured by the Bispectral Index (BIS). The “up‐and‐down” method was used to calculate the EC50 of propofol. During the equilibration period, if BIS ≤ 50 (or BIS &gt; 50), the next patient would receive a 0.5 μg.mL^‐1‐lower (or‐higher) propofol Target‐Controlled Infusion (TCI) concentration. The hemodynamic data were recorded at baseline, 10 minutes after FA administration, after induction, after intubation, and 15 minutes after intubation.</p></div><div><h3>Results</h3><p>The EC50 of propofol was lower in Group C (2.32 μg.mL^‐1, 95% Confidence Interval [95% CI] 1.85–2.75) and D (2.39 μg.mL^‐1, 95% CI 1.91–2.67) than in Group A (2.96 μg.mL^‐1, 95% CI 2.55–3.33) (<em>p</em> = 0.023, <em>p</em> = 0.048, respectively). There were no significant differences in the EC50 between Group B (2.53 μg.mL^‐1, 95% CI 2.33–2.71) and Group A (<em>p</em> ˃ 0.05). There were no significant differences in Heart Rate (HR) among groups A, B and C. The HR was significantly lower in Group D than in Group A after intubation (66 ± 6 vs. 80 ± 10 bpm, <em>p</em> &lt; 0.01) and 15 minutes after intubation (61 ± 4 vs. 70 ± 8 bpm, <em>p</em> &lt; 0.01). There were no significant differences among the four groups in Mean Arterial Pressure (MAP) at any time point. The MAP of the four groups was significantly lower after induction, after intubation, and 15 minutes after intubation than at baseline (<em>p</em> &lt; 0.05).</p></div><div><h3>Conclusion</h3><p>High‐dose FA (0.75 mg.kg^‐1 or 1 mg.kg^‐1) reduces the EC50 of propofol, and 1 mg.kg^‐1 FA reduces the HR for adequate anesthesia in unstimulated patients. Although this result should be investigated in cases of surgical stimulation, we suggest that FA pre‐administration may reduce the propofol requirement when the depth of anesthesia is measured by BIS.</p></div>","PeriodicalId":21261,"journal":{"name":"Revista brasileira de anestesiologia","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bjan.2020.08.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38736168","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}