Revista brasileira de anestesiologia最新文献_第2页

Pandemia COVID‐19: A demanda cria sua própria oferta em programa de residência COVID - 19大流行:需求创造了自己的住院医师项目供应

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Revista brasileira de anestesiologia Pub Date : 2020-11-01 DOI: 10.1016/j.bjan.2020.10.005

Yadolah Zarezadeh , Karim Naseri

引用次数: 1

Sequência de segurança de intubação: o algoritmo 10 “Ps” e ferramenta cognitiva para manuseio de vias aéreas em pacientes com COVID‐19 插管安全顺序:COVID - 19患者气道处理的10“Ps”算法和认知工具

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Revista brasileira de anestesiologia Pub Date : 2020-11-01 DOI: 10.1016/j.bjan.2020.10.001

Poonam Arora, Ankita Kabi, Mridul Dhar, Bharat Bhushan Bhardwaj

引用次数: 0

Atualização sobre reações de hipersensibilidade perioperatória: documento conjunto da Sociedade Brasileira de Anestesiologia (SBA) e Associação Brasileira de Alergia e Imunologia (ASBAI) – Parte II: etiologia e diagnóstico 围手术期超敏反应更新:巴西麻醉学会(SBA)和巴西过敏和免疫学协会(ASBAI)联合文件-第二部分:病因和诊断

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Revista brasileira de anestesiologia Pub Date : 2020-11-01 DOI: 10.1016/j.bjan.2020.08.008

Dirceu Solé , Maria Anita Costa Spindola , Marcelo Vivolo Aun , Liana Maria Tôrres de Araújo Azi , Luiz Antonio Guerra Bernd , Daniela Bianchi Garcia , Albertina Varandas Capelo , Débora de Oliveira Cumino , Alex Eustáquio Lacerda , Luciana Cavalcanti Lima , Edelton Flávio Morato , Rogean Rodrigues Nunes , Norma de Paula Motta Rubini , Jane da Silva , Maria Angela Tardelli , Alexandra Sayuri Watanabe , Erick Freitas Curi , Flavio Sano

{"title":"Atualização sobre reações de hipersensibilidade perioperatória: documento conjunto da Sociedade Brasileira de Anestesiologia (SBA) e Associação Brasileira de Alergia e Imunologia (ASBAI) – Parte II: etiologia e diagnóstico","authors":"Dirceu Solé , Maria Anita Costa Spindola , Marcelo Vivolo Aun , Liana Maria Tôrres de Araújo Azi , Luiz Antonio Guerra Bernd , Daniela Bianchi Garcia , Albertina Varandas Capelo , Débora de Oliveira Cumino , Alex Eustáquio Lacerda , Luciana Cavalcanti Lima , Edelton Flávio Morato , Rogean Rodrigues Nunes , Norma de Paula Motta Rubini , Jane da Silva , Maria Angela Tardelli , Alexandra Sayuri Watanabe , Erick Freitas Curi , Flavio Sano","doi":"10.1016/j.bjan.2020.08.008","DOIUrl":"10.1016/j.bjan.2020.08.008","url":null,"abstract":"<div><p>This second joint document, written by experts from the Brazilian Association of Allergy and Immunology (ASBAI) and Brazilian Society of Anesthesiology (SBA) concerned with perioperative anaphylaxis, aims to review the pathophysiological reaction mechanisms, triggering agents (in adults and children), and the approach for diagnosis during and after an episode of anaphylaxis. As anaphylaxis assessment is extensive, the identification of medications, antiseptics and other substances used at each setting, the comprehensive data documentation, and the use of standardized nomenclature are key points for obtaining more consistent epidemiological information on perioperative anaphylaxis.</p></div>","PeriodicalId":21261,"journal":{"name":"Revista brasileira de anestesiologia","volume":"70 6","pages":"Pages 642-661"},"PeriodicalIF":1.0,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bjan.2020.08.008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10237037","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

Eficácia do escore simplificado preditivo de dificuldade de intubação e da altura tiromentoniana em cirurgias de cabeça e pescoço: estudo observacional 头颈部手术插管困难和甲状腺高度简化预测评分的有效性:一项观察性研究

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Revista brasileira de anestesiologia Pub Date : 2020-11-01 DOI: 10.1016/j.bjan.2020.06.005

Onur Selvi , Seda Tugce Kahraman , Serkan Tulgar , Ozgur Senturk , Talat Ercan Serifsoy , David Thomas , Ayse Surhan Cinar , Zeliha Ozer

{"title":"Eficácia do escore simplificado preditivo de dificuldade de intubação e da altura tiromentoniana em cirurgias de cabeça e pescoço: estudo observacional","authors":"Onur Selvi , Seda Tugce Kahraman , Serkan Tulgar , Ozgur Senturk , Talat Ercan Serifsoy , David Thomas , Ayse Surhan Cinar , Zeliha Ozer","doi":"10.1016/j.bjan.2020.06.005","DOIUrl":"10.1016/j.bjan.2020.06.005","url":null,"abstract":"<div><h3>Background and objectives</h3><p>In this study, we aimed to investigate the predictive value of different airway assessment tools, including parts of the Simplified Predictive Intubation Difficulty Score (SPIDS), the SPIDS itself and the Thyromental Height Test (TMHT), in intubations defined as difficult by the Intubation Difficulty Score (IDS) in a group of patients who have head and neck pathologies.</p></div><div><h3>Methods</h3><p>One hundred fifty‐three patients who underwent head and neck surgeries were included in the study. The Modified Mallampati Test (MMT) result, Thyromental Distance (TMD), Ratio of the Height/Thyromental Distance (RHTMD), TMHT, maximum range of head and neck motion, and mouth opening were measured. The SPIDSs were calculated, and the IDSs were determined.</p></div><div><h3>Results</h3><p>A total of 25.4% of the patients had difficult intubations. SPIDS scores > 10 had 86.27% sensitivity, 71.57% specificity and 91.2% Negative Predictive Value (NPV). The results of the Receiver Operating Curve (ROC) analysis for the airway screening tests and SPIDS revealed that the SPIDS had the highest area under the curve; however, it was statistically similar to other tests, except for the MMT.</p></div><div><h3>Conclusions</h3><p>The current study demonstrates the practical use of the SPIDS in predicting intubation difficulty in patients with head and neck pathologies. The performance of the SPIDS in predicting airway difficulty was found to be as efficient as those of the other tests evaluated in this study. The SPIDS may be considered a comprehensive, detailed tool for predicting airway difficulty.</p></div>","PeriodicalId":21261,"journal":{"name":"Revista brasileira de anestesiologia","volume":"70 6","pages":"Pages 595-604"},"PeriodicalIF":1.0,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bjan.2020.06.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38601280","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

A ativação autofágica atenua a neurotoxicidade dos anestésicos locais ao diminuir a atividade da caspase‐3 em ratos 自噬激活通过降低大鼠caspase - 3的活性来降低局麻药的神经毒性

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Revista brasileira de anestesiologia Pub Date : 2020-11-01 DOI: 10.1016/j.bjan.2020.04.020

Xing Xue , Ying Lv , Yufang Leng , Yan Zhang

{"title":"A ativação autofágica atenua a neurotoxicidade dos anestésicos locais ao diminuir a atividade da caspase‐3 em ratos","authors":"Xing Xue , Ying Lv , Yufang Leng , Yan Zhang","doi":"10.1016/j.bjan.2020.04.020","DOIUrl":"10.1016/j.bjan.2020.04.020","url":null,"abstract":"<div><h3>Background and objectives</h3><p>The mechanisms by which local anaesthetics cause neurotoxicity are very complicated. Apoptosis and autophagy are highly coordinated mechanisms that maintain cellular homeostasis against stress. Studies have shown that autophagy activation serves as a protective mechanism <em>in vitro</em>. However, whether it also plays the same role <em>in vivo</em> is unclear. The aim of this study was to explore the role of autophagy in local anaesthetic‐induced neurotoxicity and to elucidate the mechanism of neurotoxicity in an intrathecally injected rat model.</p></div><div><h3>Methods</h3><p>Eighteen healthy adult male Sprague‐Dawley rats were randomly divided into three groups. Before receiving an intrathecal injection of 1% bupivacaine, each rat received an intraperitoneal injection of vehicle or rapamycin (1 mg.kg<sup>‐1</sup>) once a day for 3 days. The pathological changes were examined by Haematoxylin and Eosin (HE) staining. Apoptosis was analysed by TdT‐mediated dUTP Nick‐End Labelling (TUNEL) staining. Caspase‐3, Beclin1 and LC3 expression was examined by Immunohistochemical (IHC) staining. Beclin1 and LC3 expression and the LC3‐II/LC3‐I ratio were detected by western blot analysis.</p></div><div><h3>Results</h3><p>After bupivacaine was injected intrathecally, pathological damage occurred in spinal cord neurons, and the levels of apoptosis and caspase‐3 increased. Enhancement of autophagy with rapamycin markedly alleviated the pathological changes and decreased the levels of apoptosis and caspase‐3 while increasing the expression of LC3 and Beclin1 and the ratio of LC3‐II to LC3‐I.</p></div><div><h3>Conclusions</h3><p>Enhancement of autophagy decreases caspase‐3‐dependent apoptosis and improves neuronal survival <em>in vivo</em>. Activation of autophagy may be a potential therapeutic strategy for local anaesthetic‐induced neurotoxicity.</p></div>","PeriodicalId":21261,"journal":{"name":"Revista brasileira de anestesiologia","volume":"70 6","pages":"Pages 627-634"},"PeriodicalIF":1.0,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bjan.2020.04.020","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38678018","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

Em resposta a: Uso preventivo de cetamina nebulizada para controle da dor após amigdalectomia em crianças: estudo randômico e controlado 针对:儿童扁桃体切除术后雾化氯胺酮预防使用控制疼痛:随机对照研究

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Revista brasileira de anestesiologia Pub Date : 2020-11-01 DOI: 10.1016/j.bjan.2020.10.006

Matheus Medina, Vinícius Dokkedal‐Silva, Sergio Tufik, Monica Levy Andersen

引用次数: 0

Biomarcadores séricos de lesão cerebral: proteína S100B, disfunção cognitiva e cirurgia não cardíaca de grande porte 脑损伤血清生物标志物:S100B蛋白、认知功能障碍和大型非心脏手术

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Revista brasileira de anestesiologia Pub Date : 2020-11-01 DOI: 10.1016/j.bjan.2020.10.003

André P. Schmidt , Maria José C. Carmona

引用次数: 0

Antinocicepção intravenosa sem opioides orientada pelo Índice de Analgesia/Nocicepção: relato de caso 镇痛/痛觉指数指导的非阿片类静脉抗痛觉:病例报告

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Revista brasileira de anestesiologia Pub Date : 2020-11-01 DOI: 10.1016/j.bjan.2020.07.005

Sean Coeckelenbergh , Jean‐Pierre Estebe

引用次数: 4

Aumento da pressão do balonete do tubo endotraqueal em pacientes submetidos a artroscopia do ombro: estudo de coorte 肩关节镜检查患者气管内袖带压力增加:队列研究

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Revista brasileira de anestesiologia Pub Date : 2020-11-01 DOI: 10.1016/j.bjan.2020.04.021

Hey Ran Choi , Seunghwan Kim , Hyo‐Jin Kim , Eun‐Jin Ahn , Kyung Woo Kim , Si Ra Bang

{"title":"Aumento da pressão do balonete do tubo endotraqueal em pacientes submetidos a artroscopia do ombro: estudo de coorte","authors":"Hey Ran Choi , Seunghwan Kim , Hyo‐Jin Kim , Eun‐Jin Ahn , Kyung Woo Kim , Si Ra Bang","doi":"10.1016/j.bjan.2020.04.021","DOIUrl":"10.1016/j.bjan.2020.04.021","url":null,"abstract":"<div><h3>Background and objectives</h3><p>Several airway complications can occur during shoulder arthroscopy including airway obstruction, pleural puncture, and subcutaneous emphysema. It was hypothesized that the irrigation fluid used during a shoulder arthroscopic procedure might increase the cuff pressure of the endotracheal tube, which can cause edema and ischemic damage to the endotracheal mucosa. Therefore, this study aimed to evaluate the relationship between irrigation fluid and endotracheal tube cuff pressures.</p></div><div><h3>Methods</h3><p>Forty patients aged 20 to 70 years with an American Society of Anesthesiologists (ASA) score I or II, scheduled for elective arthroscopic shoulder surgery under general anesthesia, participated in our study. We recorded endotracheal tube cuff pressures and neck circumferences every hour from the start of the operation. We also recorded the total duration of the anesthesia, operation, and the total volume of fluid used for irrigation.</p></div><div><h3>Results</h3><p>A positive correlation was shown between endotracheal tube cuff pressures and the amount of irrigation fluid (r = 0.385, 95% CI 0.084 to 0.62, <em>p</em> = 0.0141). The endotracheal tube cuff pressure significantly increased at 2 and 3hours after starting the operation (<em>p</em> = 0.0368 and <em>p</em> = 0.0245, respectively). However, neck circumference showed no significant difference.</p></div><div><h3>Conclusions</h3><p>Endotracheal tube cuff pressures increased with operation time and with increased volumes of irrigation fluid used in patients who underwent shoulder arthroscopy. We recommend close monitoring of endotracheal tube cuff pressures during shoulder arthroscopy, especially during long operations using a large amount of irrigation fluid, to prevent complications caused by raised cuff pressures.</p></div>","PeriodicalId":21261,"journal":{"name":"Revista brasileira de anestesiologia","volume":"70 6","pages":"Pages 583-587"},"PeriodicalIF":1.0,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bjan.2020.04.021","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38676146","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

Comparação entre a posição de rampa e posição olfativa durante intubação traqueal: revisão sistemática e meta‐análise 气管插管时斜坡位置和嗅觉位置的比较:系统综述和meta分析

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Revista brasileira de anestesiologia Pub Date : 2020-11-01 DOI: 10.1016/j.bjan.2020.08.009

Samuel Ern Hung Tsan , Ka Ting Ng , Jiaying Lau , Navian Lee Viknaswaran , Chew Yin Wang

{"title":"Comparação entre a posição de rampa e posição olfativa durante intubação traqueal: revisão sistemática e meta‐análise","authors":"Samuel Ern Hung Tsan , Ka Ting Ng , Jiaying Lau , Navian Lee Viknaswaran , Chew Yin Wang","doi":"10.1016/j.bjan.2020.08.009","DOIUrl":"10.1016/j.bjan.2020.08.009","url":null,"abstract":"<div><h3>Objectives</h3><p>Positioning during endotracheal intubation (ETI) is critical to ensure its success. We aimed to determine if the ramping position improved laryngeal exposure and first attempt success at intubation when compared to the sniffing position.</p></div><div><h3>Methods</h3><p>PubMed, EMBASE, and Cochrane CENTRAL databases were searched systematically from inception until January 2020. Our primary outcomes included laryngeal exposure as measured by Cormack‐Lehane Grade 1 or 2 (CLG 1/2), CLG 3 or 4 (CLG 3/4), and first attempt success at intubation. Secondary outcomes were intubation time, use of airway adjuncts, ancillary maneuvers and complications during ETI.</p></div><div><h3>Results</h3><p>Seven studies met our inclusion criteria, of which 4 were RCTs and 3 were cohort studies. The meta‐analysis was conducted by pooling the effect estimates for all 4 included RCTs (n=632). There were no differences found between ramping and sniffing positions for odds of CLG 1/2, CLG 3/4, first attempt success at intubation, intubation time, use of ancillary airway maneuvers and use of airway adjuncts, with evidence of high heterogeneity across studies. However, the ramping position in surgical patients is associated with increased likelihood of CLG 1/2 (OR=2.05, 95% CI 1.26 to 3.32, <em>p</em>    =0.004), moderate quality of evidence.</p></div><div><h3>Conclusion</h3><p>Our meta‐analysis demonstrated that the ramping position may benefit surgical patients undergoing ETI by improving laryngeal exposure. Large‐scale well‐designed multicentre RCTs should be carried out to further elucidate the benefits of the ramping position in the surgical and intensive care unit patients.</p></div>","PeriodicalId":21261,"journal":{"name":"Revista brasileira de anestesiologia","volume":"70 6","pages":"Pages 667-677"},"PeriodicalIF":1.0,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bjan.2020.08.009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38695772","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