Revista brasileira de anestesiologia最新文献

{"title":"Lidocaína em cirurgia oncológica: o papel do bloqueio dos canais de sódio dependentes de voltagem. Revisão narrativa","authors":"German Soto ,&nbsp;Fernanda Calero ,&nbsp;Marusa Naranjo","doi":"10.1016/j.bjan.2020.04.018","DOIUrl":"10.1016/j.bjan.2020.04.018","url":null,"abstract":"<div><h3>Background</h3><p>The current evidence suggests that oncological surgery, which is a therapy used in the treatment of solid tumors, increases the risk of metastasis. In this regard, a wide range of tumor cells express Voltage‐Gated Sodium Channels (VGSC), whose biological roles are not related to the generation of action potentials. In epithelial tumor cells, VGSC are part of cellular structures named invadopodia, involved in cell proliferation, migration, and metastasis. Recent studies showed that lidocaine could decrease cancer recurrence through its direct effects on tumor cells and immunomodulatory properties on the stress response.</p></div><div><h3>Objective</h3><p>The aim of this narrative review is to highlight the role of VGSC in tumor cells, and to describe the potential antiproliferative effect of lidocaine during the pathogenesis of metastasis.</p></div><div><h3>Contents</h3><p>A critical review of literature from April 2017 to April 2019 was performed. Articles found on PubMed (2000<!--> <!-->−<!--> <!-->2019) were considered. A free text and MeSH‐lidocaine; voltage‐gated sodium channels; tumor cells; invadopodia; surgical stress; cell proliferation; metastasis; cancer recurrence<!--> <!-->−<!--> <!-->for articles in English, Spanish and Portuguese language<!--> <!-->−<!--> <!-->was used. A total of 62 were selected.</p></div><div><h3>Conclusion</h3><p>In animal studies, lidocaine acts by blocking VGSC and other receptors, decreasing migration, invasion, and metastasis. These studies need to be replicated in humans in the context of oncological surgery.</p></div>","PeriodicalId":21261,"journal":{"name":"Revista brasileira de anestesiologia","volume":"70 5","pages":"Pages 527-533"},"PeriodicalIF":1.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bjan.2020.04.018","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38399390","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":"Efeitos da acupuntura para a prevenção de náuseas e vômitos após colecistectomia laparoscópica: estudo clínico randomizado","authors":"Luiz Eduardo Miranda ,&nbsp;Luiz de França Maia e Silva Filho ,&nbsp;Ana Carolina Brainer de Siqueira ,&nbsp;Ana Clara Miranda ,&nbsp;Bianca Rodrigues Castelo Branco Rocha ,&nbsp;Ian Victor Paiva de Lima ,&nbsp;Victor Soares Gomes da Silva ,&nbsp;Diego Laurentino de Lima ,&nbsp;Holmes Naspollini","doi":"10.1016/j.bjan.2019.08.001","DOIUrl":"10.1016/j.bjan.2019.08.001","url":null,"abstract":"<div><h3>Background and objectives</h3><p>Postoperative nausea and vomiting (PONV) is a common and undesirable complication observed after laparoscopic cholecystectomy (LC). We investigated the effects of auriculoacupuncture (AA) on the prevention of postoperative nausea and vomiting in the immediate postoperative period of uncomplicated laparoscopic cholecystectomy.</p></div><div><h3>Methods</h3><p>Sixty‐eight patients were randomly divided into two groups, auriculoacupuncture (n = 35) and control (n = 33) and then they were evaluated prospectively. The needle was placed before anaesthesia induction and remained for 20 minutes. Nausea intensity was evaluated using an analogic visual scale and PONV events were registered immediately after anaesthesia care unit admission and in the second, fourth and sixth hours after the surgery.</p></div><div><h3>Results</h3><p>The auriculoacupuncture group had a significantly smaller incidence of nausea and vomiting than the control group throughout the whole postoperative period (16/35 vs. 27/33, <em>p</em> = 0.03 and 4/35 vs. 15/33, <em>p</em> = 0.005, respectively); the AA group had fewer nausea events 2<!--> <!-->hours (<em>p</em> = 0.03) and 6<!--> <!-->hours (<em>p</em> = 0.001) after surgery and fewer vomiting events 2<!--> <!-->hours (<em>p</em> = 0.01) and 6<!--> <!-->hours (<em>p</em> = 0.02) after surgery.</p></div><div><h3>Conclusions</h3><p>Auriculoacupuncture can partially prevent postoperative nausea and vomiting when compared to metoclopramide alone after uncomplicated laparoscopic cholecystectomy. Auriculoacupuncture can be recommended as an adjuvant therapy for postoperative nausea and vomiting prevention in selected patients.</p></div>","PeriodicalId":21261,"journal":{"name":"Revista brasileira de anestesiologia","volume":"70 5","pages":"Pages 520-526"},"PeriodicalIF":1.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bjan.2019.08.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38324790","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":"Prevenção de náusea e vômito no pós‐operatório: novos pontos de vista no cuidado do paciente","authors":"André P. Schmidt","doi":"10.1016/j.bjan.2020.09.004","DOIUrl":"10.1016/j.bjan.2020.09.004","url":null,"abstract":"","PeriodicalId":21261,"journal":{"name":"Revista brasileira de anestesiologia","volume":"70 5","pages":"Pages 452-454"},"PeriodicalIF":1.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bjan.2020.09.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38436060","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":"COVID‐19 e a retomada das cirurgias eletivas. Como voltaremos à normalidade?","authors":"Florentino Fernandes Mendes","doi":"10.1016/j.bjan.2020.09.001","DOIUrl":"10.1016/j.bjan.2020.09.001","url":null,"abstract":"","PeriodicalId":21261,"journal":{"name":"Revista brasileira de anestesiologia","volume":"70 5","pages":"Pages 455-456"},"PeriodicalIF":1.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bjan.2020.09.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38450312","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":"O efeito de epinefrina, norepinefrina e fenilefrina no tratamento da hipotensão pós‐raquianestesia: estudo clínico comparativo","authors":"Ebru Biricik ,&nbsp;Feride Karacaer ,&nbsp;İlker Ünal ,&nbsp;Mete Sucu ,&nbsp;Hakkı Ünlügenç","doi":"10.1016/j.bjan.2020.04.017","DOIUrl":"10.1016/j.bjan.2020.04.017","url":null,"abstract":"<div><h3>Background and objectives</h3><p>Limited data are present on safety and efficiency of epinephrine for the prophylaxis and treatment of spinal‐hypotension. This study was conducted to compare the effect of epinephrine with norepinephrine and phenylephrine on the treatment of spinal‐hypotension and ephedrine requirement during cesarean delivery.</p></div><div><h3>Methods</h3><p>One hundred and sixty parturients with uncomplicated pregnancies undergoing elective cesarean delivery under spinal anesthesia were recruited. They were allocated randomly to receive norepinephrine 5 μg.mL^‐1 (n<!--> <!-->=<!--> <!-->40), epinephrine 5 μg.mL^‐1 (n<!--> <!-->=<!--> <!-->40), phenylephrine 100 μg.mL^‐1 (n<!--> <!-->=<!--> <!-->40) or 0.9% saline infusions (n<!--> <!-->=<!--> <!-->40) immediately after induction of spinal anesthesia. Whenever systolic blood pressure drops to less than 80% of baseline, 5 mg of iv ephedrine was administered as rescue vasopressor. The incidence of hypotension, total number of hypotension episodes, the number of patients requiring ephedrine, the mean amount of ephedrine consumption and side effects were recorded.</p></div><div><h3>Results</h3><p>There was no statistically significant difference in incidence of maternal hypotension between groups. The number of patients requiring ephedrine was significantly greater in group saline than in group phenylephrine (<em>p &lt;</em> <!-->0.001). However, it was similar between phenylephrine, norepinephrine, and epinephrine groups. The mean ephedrine consumption was significantly higher in group saline than in norepinephrine, epinephrine, phenylephrine groups (<em>p</em> <!-->=<!--> <!-->0.001).</p></div><div><h3>Conclusion</h3><p>There is no statistically significant difference in incidence of hypotension and ephedrine consumption during spinal anesthesia for cesarean delivery with the use of epinephrine when compared to norepinephrine or phenylephrine. Epinephrine can be considered as an alternative agent for management of spinal hypotension.</p></div>","PeriodicalId":21261,"journal":{"name":"Revista brasileira de anestesiologia","volume":"70 5","pages":"Pages 500-507"},"PeriodicalIF":1.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bjan.2020.04.017","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38422786","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":"Fatores de risco para náusea e vômitos após cesariana: estudo prognóstico prospectivo","authors":"Gabriel Magalhães Nunes Guimarães ,&nbsp;Helga Bezerra Gomes da Silva ,&nbsp;Hazem Adel Ashmawi","doi":"10.1016/j.bjan.2020.08.003","DOIUrl":"10.1016/j.bjan.2020.08.003","url":null,"abstract":"<div><h3>Background</h3><p>Postoperative Nausea and Vomiting (PONV) risk factors have not been defined for obstetric patients. In this study, our objective was to identify potential risk factors for PONV after cesarean sections performed under spinal anesthesia.</p></div><div><h3>Methods</h3><p>One cohort of patients submitted to cesarean under spinal anesthesia was used to investigate potential risk factors for PONV. The best numerical risk factors were dichotomized using chi‐squared method. A conditional independence (incremental association method) casual network was used to select the best predictors for PONV.</p></div><div><h3>Results</h3><p>Two hundred and fifty of 260 patients remained in the study. Odds ratio for PONV of younger maternal age (&lt; 25 years: 2.9 [1.49−5.96]), lower spinal bupivacaine dose (&lt; 13 mg, inf [2.4‐inf]), lower spinal morphine dose (&lt; 80 mg, 0.03 [0−0.97]), history of motion sickness (2.5 [1.27−5.25]), significant nausea during the first trimester (0.3 [0.16−0.64]), intraoperative nausea and vomiting (8.2 [3.67−20.47]), and lower gestational age (&lt; 38 weeks, 2.0 [1.01−4.08]) were statistically significant. The causal network selected absence of significant nausea during the first gestational trimester, intraoperative nausea, and gestational age &lt; 38 weeks as the main direct risk factors for PONV.</p></div><div><h3>Conclusions</h3><p>Intraoperative nausea and maternal age &lt; 25 years were the main risk factors for PONV after cesareans under spinal anesthesia. Absence of self‐reported nausea during the first trimester was a protective factor for post‐cesarean nausea and vomiting.</p></div>","PeriodicalId":21261,"journal":{"name":"Revista brasileira de anestesiologia","volume":"70 5","pages":"Pages 457-463"},"PeriodicalIF":1.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bjan.2020.08.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38521104","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":"A saga do anestesiologista: guerreiro da linha de frente da COVID‐19","authors":"Rashmi Syal,&nbsp;Kamlesh Kumari,&nbsp;Rakesh Kumar,&nbsp;Kriti Chaudhary,&nbsp;Bharat Paliwal","doi":"10.1016/j.bjan.2020.09.002","DOIUrl":"10.1016/j.bjan.2020.09.002","url":null,"abstract":"","PeriodicalId":21261,"journal":{"name":"Revista brasileira de anestesiologia","volume":"70 5","pages":"Page 566"},"PeriodicalIF":1.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bjan.2020.09.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38544945","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 palonosetrona, ondansetrona e dexametasona na prevenção de náusea e vômito pós‐operatório em videocolecistectomia com anestesia venosa total com propofol‐remifentanil – ensaio clínico randomizado duplo cego","authors":"Neuber Martins Fonseca ,&nbsp;Ludmila Ribeiro Pedrosa ,&nbsp;Natália Melo ,&nbsp;Ricardo de Ávila Oliveira","doi":"10.1016/j.bjan.2020.08.001","DOIUrl":"10.1016/j.bjan.2020.08.001","url":null,"abstract":"<div><h3>Introduction and objectives</h3><p>The incidence of Postoperative Nausea and Vomiting (PONV) after video cholecystectomy is high. Progress in pharmacological PONV prophylaxis includes a new generation of 5‐HT₃ antagonists. This study aims to assess the effect of the 5‐HT₃ antagonist in postanesthetic antiemetic management of patients submitted to laparoscopic cholecystectomy with total intravenous anesthesia.</p></div><div><h3>Methods</h3><p>Sixty individuals who underwent video cholecystectomy were randomized into three groups of 20 individuals according to the treatment administered: 0.125 mg of palonosetron (Group 1); 4 mg of ondansetron associated with 4 mg of dexamethasone (Group 2); 4 mg of dexamethasone (Group 3). General intravenous anesthesia was performed with propofol, remifentanil and rocuronium. The group to which the participant belonged was concealed from the investigator who assessed drug effect. PONV was assessed using the Rhodes Scale at 12 and 24 hours after surgery. Rescue medication was 0.655 to 1.5 mg of droperidol.</p></div><div><h3>Results</h3><p>Group 1 presented a lower incidence of PONV and required less rescue medication in the first postoperative hour. There was no significant difference among the three groups regarding PONV incidence in the first 12 postoperative hours. Groups 1 and 2 were superior to Group 3 regarding the control of PONV from 12 to 24 hours, and after rescue medication from 12 to 24 hours. Group 1 showed significantly superior nausea control in the first 12 postoperative hours.</p></div><div><h3>Conclusions</h3><p>The present study showed evidence that palonosetron is superior to the drugs compared regarding a protracted antiemetic effect and less requirement of rescue drugs, mainly related to its ability to completely inhibit the uncomfortable symptom of nausea.</p></div>","PeriodicalId":21261,"journal":{"name":"Revista brasileira de anestesiologia","volume":"70 5","pages":"Pages 464-470"},"PeriodicalIF":1.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bjan.2020.08.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38550917","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":"Lombalgia crônica: devemos adotar as novas técnicas de analgesia?","authors":"Inês Gonçalves Morais,&nbsp;Ana Martin","doi":"10.1016/j.bjan.2020.09.003","DOIUrl":"10.1016/j.bjan.2020.09.003","url":null,"abstract":"","PeriodicalId":21261,"journal":{"name":"Revista brasileira de anestesiologia","volume":"70 5","pages":"Page 565"},"PeriodicalIF":1.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bjan.2020.09.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38544062","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":"Bloqueio do gânglio esfenopalatino autoaplicado para cefaleia pós‐punção dural: relato de quatro casos","authors":"Andrés Rocha-Romero ,&nbsp;Priodarshi Roychoudhury ,&nbsp;Rodrigo Benavides Cordero ,&nbsp;Maynor Lopez Mendoza","doi":"10.1016/j.bjan.2020.07.002","DOIUrl":"10.1016/j.bjan.2020.07.002","url":null,"abstract":"<div><h3>Background and objectives</h3><p>The Sphenopalatine Ganglion Block (SGB) is an effective, low‐risk treatment option for Postdural Puncture Headache (PDPH) refractory to conservative management.</p></div><div><h3>Case report</h3><p>This report presents four complex cases of patients with headache related to low cerebrospinal fluid pressure. Three of them were successfully treated with the application of local anesthetic topical drops through the nasal cavity.</p></div><div><h3>Conclusion</h3><p>The novel approach described in this report has minimal risks of discomfort or injury to the nasal mucosa. It is quick to apply and can be administered by the patient himself.</p></div>","PeriodicalId":21261,"journal":{"name":"Revista brasileira de anestesiologia","volume":"70 5","pages":"Pages 561-564"},"PeriodicalIF":1.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bjan.2020.07.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38468769","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}