Revista brasileira de anestesiologia最新文献

{"title":"Fatores de risco de NVPO após cesarianas","authors":"Gabriel Magalhães Nunes Guimarães","doi":"10.1016/j.bjan.2020.09.005","DOIUrl":"10.1016/j.bjan.2020.09.005","url":null,"abstract":"","PeriodicalId":21261,"journal":{"name":"Revista brasileira de anestesiologia","volume":"70 5","pages":"Page 451"},"PeriodicalIF":1.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bjan.2020.09.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38520679","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 musicoterapia sobre dor e estresse oxidativo na aspiração folicular: estudo clínico randomizado","authors":"Yavuz Orak ,&nbsp;Suleyman Murat Bakacak ,&nbsp;Asli Yaylali ,&nbsp;Fatma Inanc Tolun ,&nbsp;Hakan Kiran ,&nbsp;Omer Faruk Boran ,&nbsp;Akif Hakan Kurt ,&nbsp;Adem Doganer","doi":"10.1016/j.bjan.2020.04.015","DOIUrl":"10.1016/j.bjan.2020.04.015","url":null,"abstract":"<div><h3>Background and objective</h3><p>The aim was to investigate the effects of Turkish classical music on pain and oxidative stress in patients undergoing oocyte pick‐up.</p></div><div><h3>Methods</h3><p>The study was a randomized, controlled trial. The groups included were Group NM (Non‐Music), control group; Group PM, which comprised patients who listened to music before the operation; and Group CM, which comprised patients who listened to music both before and during the operation. Blood was drawn prior to the operation to measure the oxidative stress values. Pain, hemodynamic parameters, oxidative stress values were assessed postoperatively.</p></div><div><h3>Results</h3><p>The number of patients requiring additional propofol was higher in Group PM than in Groups NM and CM (<em>p</em> <!-->=<!--> <!-->0.003). The postoperative Visual Analog Scale (VAS) score were lower in Groups PM and CM than in Group NM (<em>p</em> <!-->=<!--> <!-->0.001, <em>p</em> <!-->=<!--> <!-->0.007) in the 1^st and 60^th minutes. The postoperative VAS score was lower in Group CM than in Group NM (<em>p</em> <!-->=<!--> <!-->0.045) in the 5^th minute. The postoperative additional analgesic requirements were lower in Groups PM and CM than in Group NM (<em>p</em> <!-->=<!--> <!-->0.045). The postoperative blood glutathione peroxidase values were significantly higher in Groups PM and CM than in Group NM (<em>p<!--> </em>=<!--> <!-->0.001). The postoperative catalase values were significantly higher in Groups PM and CM than in Group NM (<em>p</em> <!-->=<!--> <!-->0.008 and <em>p</em> ≤<!--> <!-->0.001). The preoperative malondialdehyde values were significantly lower in Groups PM and CM than in Group NM. The preoperative nitric oxide values were higher in Groups PM and CM than in Group NM (<em>p</em> ≤<!--> <!-->0.001), whereas the postoperative nitric oxide values were lower in Groups PM and CM than in Group NM (<em>p ≤</em> <!-->0.001).</p></div><div><h3>Conclusion</h3><p>Turkish classical music has beneficial effects on pain and oxidative stress in oocyte pick‐up patients.</p></div>","PeriodicalId":21261,"journal":{"name":"Revista brasileira de anestesiologia","volume":"70 5","pages":"Pages 491-499"},"PeriodicalIF":1.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bjan.2020.04.015","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38291014","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":"Correlação entre saturação venosa central de oxigênio perioperatória e mortalidade em cirurgia cardíaca: estudo prospectivo observacional","authors":"César de Araujo Miranda ,&nbsp;José F.A. Meletti ,&nbsp;Laís H.N. Lima ,&nbsp;Evaldo Marchi","doi":"10.1016/j.bjan.2020.04.014","DOIUrl":"10.1016/j.bjan.2020.04.014","url":null,"abstract":"<div><h3>Background</h3><p>Cardiac surgery can produce persistent deficit in the ratio of Oxygen Delivery (DO₂) to Oxygen Consumption (VO₂). Central venous oxygen Saturation (ScvO₂) is an accessible and indirect measure of DO₂/VO₂ ratio.</p></div><div><h3>Objective</h3><p>To monitor perioperative ScvO₂ and assess its correlation with mortality during cardiac surgery.</p></div><div><h3>Methods</h3><p>This prospective observational study evaluated 273 patients undergoing cardiac surgery. Blood gas samples were collected to measure ScvO₂ at three time points: T0 (after anesthetic induction), T1 (end of surgery), and T2 (24<!--> <!-->hours after surgery). The patients were divided into two groups (survivors and nonsurvivors). The following outcomes were analyzed: intrahospital mortality, length of Intensive Care Unit (ICU) and hospital stay (LOS), and variation in ScvO₂.</p></div><div><h3>Results</h3><p>Of the 273 patients, 251 (92%) survived and 22 (8%) did not. There was a significant perioperative reduction of ScvO₂ in both survivors (T0<!--> <!-->=<!--> <!-->78%<!--> <!-->± 8.1%, T1<!--> <!-->=<!--> <!-->75.4%<!--> <!-->±<!--> <!-->7.5%, and T2<!--> <!-->=<!--> <!-->68.5%<!--> <!-->±<!--> <!-->9%; <em>p</em> <!-->&lt;<!--> <!-->0.001) and nonsurvivors (T0<!--> <!-->=<!--> <!-->74.4%<!--> <!-->±<!--> <!-->8.7%, T1<!--> <!-->=<!--> <!-->75.4%<!--> <!-->±<!--> <!-->7.7%, and T2<!--> <!-->=<!--> <!-->66.7%<!--> <!-->±<!--> <!-->13.1%; <em>p</em> &lt;<!--> <!-->0.001). At T0, the percentage of patients with ScvO₂ &lt;<!--> <!-->70% was greater in the nonsurvivor group (31.8% vs. 13.1%; <em>p</em> <!-->=<!--> <!-->0.046) and the multiple logistic regression showed that ScvO₂ is an independent risk factor associated with death, OR<!--> <!-->=<!--> <!-->2.94 (95% CI 1.10<!--> <!-->−<!--> <!-->7.89) (<em>p</em> <!-->=<!--> <!-->0.032). The length of ICU and LOS were 3.6<!--> <!-->±<!--> <!-->3.1 and 7.4<!--> <!-->±<!--> <!-->6.0 days respectively and was not significantly associated with ScvO₂.</p></div><div><h3>Conclusions</h3><p>Early intraoperative ScvO₂ &lt;<!--> <!-->70% indicated a higher risk of death. A perioperative reduction of ScvO₂ was observed in patients undergoing cardiac surgery, with high intraoperative and lower postoperative levels.</p></div>","PeriodicalId":21261,"journal":{"name":"Revista brasileira de anestesiologia","volume":"70 5","pages":"Pages 484-490"},"PeriodicalIF":1.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bjan.2020.04.014","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38425418","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":"Antagonistas do receptor da neurocinina‐1 no tratamento de náusea e vômito no pós‐operatório: Revisão sistemática e meta‐análise","authors":"Chiaki Murakami ,&nbsp;Nami Kakuta ,&nbsp;Shiho Satomi ,&nbsp;Ryuji Nakamura ,&nbsp;Hirotsugu Miyoshi ,&nbsp;Atsushi Morio ,&nbsp;Noboru Saeki ,&nbsp;Takahiro Kato ,&nbsp;Naohiro Ohshita ,&nbsp;Katsuya Tanaka ,&nbsp;Yasuo M. Tsutsumi","doi":"10.1016/j.bjan.2020.04.005","DOIUrl":"10.1016/j.bjan.2020.04.005","url":null,"abstract":"<div><h3>Histórico</h3><p>Náusea e Vômito no Pós‐Operatório (NVPO) é um evento adverso frequente da anestesia geral. Várias classes de antieméticos, incluindo antagonistas do receptor 5‐Hidroxitriptamina3 (5‐HT3) e antagonistas do receptor da Neurocinina‐1 (NK‐1), têm sido utilizados para tratar a NVPO.</p></div><div><h3>Objetivo</h3><p>Comparar o efeito antiemético dos antagonistas do receptor NK‐1, incluindo o fosaprepitanto.</p></div><div><h3>Fontes de dados</h3><p>Foram utilizadas bases de dados <em>on‐line</em> (PubMed, MEDLINE, Scopus, The Cochrane Library).</p></div><div><h3>Critérios de elegibilidade do estudo, participantes e intervenções</h3><p>Foram incluídos Estudos Clínicos Randomizados (ECR) realizados em pacientes acima de 18 anos classificação ASA I a III, com o objetivo de avaliar a eficácia de antieméticos que incluíssem antagonistas do receptor NK‐1 e antagonistas do receptor 5‐HT3, e que comparassem a incidência de NVPO.</p></div><div><h3>Métodos de avaliação e síntese do estudo</h3><p>Todas as avaliações estatísticas foram realizadas por abordagem de efeito aleatório e foram calculadas razões de chances e Intervalos de Confiança de 95%.</p></div><div><h3>Resultados</h3><p>As doses de 40<!--> <!-->mg e 80<!--> <!-->mg de aprepitanto reduziram significantemente a incidência de vômito no período de 0 a 24 horas pós‐operatórias (razão de chances [OR = 0,40]; Intervalo de Confiança de 95% [95% IC] 0,30‐0,54; <em>p</em> &lt; 0,001 e OR = 0,32; 95% IC 0,19‐0,56; <em>p</em> &lt; 0,001). O fosaprepitanto pode também reduzir significantemente a incidência de vômito tanto de 0‐24<!--> <!-->horas como no período de 0‐48 horas pós‐operatórias (OR = 0,07; 95% IC 0,02‐0,24; <em>p</em> &lt; 0,001 e OR = 0,07; 95% IC 0,02‐0,23; <em>p</em> &lt; 0,001).</p></div><div><h3>Limitações</h3><p>Os fatores de risco para NVPO não foram analisados, ECRs usando múltiplos antieméticos foram incluídos, ECRs para fosaprepitanto tinham amostras pequenas, podendo haver algum viés.</p></div><div><h3>Conclusões e implicações dos principais achados</h3><p>Aprepitanto e fosaprepitanto podem ser drogas antieméticas profiláticas efetivas para vômito no pós‐operatório. No entanto, são necessários mais estudos para elaboração de meta‐análises de melhor qualidade.</p></div><div><h3>Número de registro da revisão sistemática</h3><p>CRD42019120188.</p></div><div><h3>Background</h3><p>Postoperative Nausea and Vomiting (PONV) is a common complication of general anesthesia. Several kinds of antiemetics, including 5‐Hydroxytryptamine3 (5‐HT3) receptor antagonists and Neurokinin‐1 (NK‐1) receptor antagonists, have been used to treat PONV.</p></div><div><h3>Objectives</h3><p>To compare the antiemetic effect of NK‐1 receptor antagonists, including fosaprepitant.</p></div><div><h3>Data sources</h3><p>Online databases (PubMed, MEDLINE, Scopus, The Cochrane Library databases) were used.</p></div><div><h3>Study eligibility criteria, participants, and interventions</h3><p>Randomized","PeriodicalId":21261,"journal":{"name":"Revista brasileira de anestesiologia","volume":"70 5","pages":"Pages 508-519"},"PeriodicalIF":1.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bjan.2020.04.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38237893","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":"Desafios perioperatórios e pontos de atenção no bloqueio neuromuscular durante timectomia robótica para miastenia gravis","authors":"Atish Pal,&nbsp;Vikas Gogia,&nbsp;Chetan Mehra","doi":"10.1016/j.bjan.2020.05.004","DOIUrl":"10.1016/j.bjan.2020.05.004","url":null,"abstract":"<div><p>Myasthenia Gravis (MG) is an autoimmune disease characterized by weakness and fatigability of skeletal muscles, with improvement following rest. It is a disease of great significance to the anesthesiologist because it affects the neuromuscular junction. Robotic thymectomy has come up in recent times due to the minimally invasive nature and its advantages. This presents a new set of challenges for the anesthesia team, and here we present the various anesthesia considerations and perioperative management in a series of 20 patients who underwent robotic thymectomy. As it is a recent upcoming procedure, there is a paucity of literature on this topic, and most of the available literature talks about One‐Lung Ventilation (OLV) and thoracic epidurals. To our notice, this is the first literature without the use of OLV and thoracic epidural for the management of robotic thymectomy.</p></div>","PeriodicalId":21261,"journal":{"name":"Revista brasileira de anestesiologia","volume":"70 5","pages":"Pages 549-552"},"PeriodicalIF":1.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bjan.2020.05.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38471352","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":"Cisto hidático na medula cervical complicada por via aérea difícil com potencial risco de vida: relato de caso","authors":"Dmitriy Viderman ,&nbsp;Aisa Nurpeisov ,&nbsp;Omirzhan Balabayev ,&nbsp;Yermek Urunbayev ,&nbsp;Guilherme de Almeida ,&nbsp;Federico Bilotta","doi":"10.1016/j.bjan.2020.08.004","DOIUrl":"10.1016/j.bjan.2020.08.004","url":null,"abstract":"<div><p>Hydatid cyst in the cervical region is an extremely rare condition that can create challenges for anesthesiologists. Timely recognition of difficult airway and preparing the management plan is crucial to avoid life‐threatening complications such as hypoxic brain damage. We describe a case of difficult airway management in a patient with massive cervical hydatid cyst. We used a low‐dose ketamine‐propofol sedation and lidocaine spray for local oropharyngeal anesthesia. Muscular relaxants were not used, and spontaneous breathing was maintained during intubation. Recognition, assessment, and perioperative planning are essential for difficult airway management in patients with cervical hydatid cyst.</p></div>","PeriodicalId":21261,"journal":{"name":"Revista brasileira de anestesiologia","volume":"70 5","pages":"Pages 553-555"},"PeriodicalIF":1.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bjan.2020.08.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38544944","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 anestesia intravenosa e inalatória na náusea e vômito pós‐operatórios em laparotomia: estudo clínico randomizado","authors":"Amir Ahmadzadeh Amiri ,&nbsp;Kasra Karvandian ,&nbsp;Mohammad Ashouri ,&nbsp;Mojgan Rahimi ,&nbsp;Ali Ahmadzadeh Amiri","doi":"10.1016/j.bjan.2020.04.019","DOIUrl":"10.1016/j.bjan.2020.04.019","url":null,"abstract":"<div><h3>Background</h3><p>Postoperative Nausea and Vomiting (PONV) is a multifactorial surgical complication with an unclear underlying cause. Anesthetic methods, patients’ characteristics and the type of surgery are considered as factors affecting PONV. This study was designed to compare the effect of inhalational and intravenous anesthesia in abdominal surgery on the incidence and severity of PONV.</p></div><div><h3>Methods</h3><p>A single‐blinded prospective randomized clinical trial on 105 patients aged 18<!--> <!-->−<!--> <!-->65 years was carried out. Patients were divided in two groups of Total Intravenous Anesthesia (TIVA) and Inhalational anesthesia. The incidence and severity of PONV were examined at 0, 2, 6, 12, and 24<!--> <!-->hours after the surgery. The use of a rescue antiemetic was also evaluated.</p></div><div><h3>Results</h3><p>Fifty point nine percent of the patients in the inhalation group and 17.3% of the patients in the intravenous group developed PONV (<em>p</em> &lt;<!--> <!-->0.001). The incidence of vomiting was reported in 11.3% of the Inhalational group and 3.8% of the TIVA group (<em>p</em> <!-->=<!--> <!-->0.15), and 24.5% of patients in the Inhalation group and 9.6% of patients in the intravenous group needed an antiemetic medication (<em>p</em> <!-->=<!--> <!-->0.043).</p></div><div><h3>Conclusion</h3><p>The incidence of postoperative nausea and vomiting and the need for administration of an antiemetic rescue drug, and the severity of nausea in patients were significantly lower in the TIVA group.</p></div>","PeriodicalId":21261,"journal":{"name":"Revista brasileira de anestesiologia","volume":"70 5","pages":"Pages 471-476"},"PeriodicalIF":1.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bjan.2020.04.019","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38468771","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 palonosetrona‐dexametasona e ondansetrona‐dexametasona na prevenção de náuseas e vômitos no pós‐operatório de cirurgia do ouvido médio: estudo clínico randomizado","authors":"Vinit Kumar Srivastava ,&nbsp;Saima Khan ,&nbsp;Sanjay Agrawal ,&nbsp;Sweta Anil Deshmukh ,&nbsp;Pooja Shree ,&nbsp;Partha Pratim Misra","doi":"10.1016/j.bjan.2020.04.016","DOIUrl":"10.1016/j.bjan.2020.04.016","url":null,"abstract":"<div><h3>Background</h3><p>Postoperative nausea and vomiting is the second most common complaint in the postoperative period after pain. The incidence of postoperative nausea and vomiting was 60−80% in middle ear surgeries in the absence of antiemetic prophylaxis. Because of this high incidence of postoperative nausea and vomiting, we aimed to assess the effect of palonosetron‐dexamethasone and ondansetron‐dexamethasone combination for the prevention of postoperative nausea and vomiting in patients of middle ear surgery.</p></div><div><h3>Methods</h3><p>Sixty‐four patients, scheduled for middle ear surgery, were randomized into two groups to receive the palonosetron‐dexamethasone and ondansetron‐dexamethasone combination intravenously before induction of anesthesia. Anesthesia technique was standardized in all patients. Postoperatively, the incidences and severity of nausea and vomiting, the requirement of rescue antiemetic, side effects and patient satisfaction score were recorded.</p></div><div><h3>Results</h3><p>Demographics were similar in the study groups. The incidence difference of nausea was statistically significant between groups O and P at a time interval of 2−6<!--> <!-->hours only (<em>p</em> <!-->=<!--> <!-->0.026). The incidence and severity of vomiting were not statistically significant between groups O and P during the whole study period. The overall incidence of postoperative nausea and vomiting (0−24<!--> <!-->hours postoperatively) was 37.5% in group O and 9.4% in group P (<em>p</em> <!-->=<!--> <!-->0.016). Absolute risk reduction with palonosetron‐dexamethasone was 28%, the relative risk reduction was 75%, and the number‐needed‐to‐treat was 4. The patient's satisfaction score was higher in group P than group O (<em>p</em> <!-->=<!--> <!-->0.016). The frequency of rescue medication was more common in group O than in group P patients (<em>p</em> <!-->=<!--> <!-->0.026).</p></div><div><h3>Conclusion</h3><p>The combination of palonosetron‐dexamethasone is superior to ondansetron‐dexamethasone for the prevention of postoperative nausea and vomiting after middle ear surgeries.</p></div>","PeriodicalId":21261,"journal":{"name":"Revista brasileira de anestesiologia","volume":"70 5","pages":"Pages 477-483"},"PeriodicalIF":1.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bjan.2020.04.016","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38526792","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":"Atualização sobre reações de hipersensibilidade perioperatória: documento conjunto da Sociedade Brasileira de Anestesiologia (SBA) e Associação Brasileira de Alergia e Imunologia (ASBAI) – Parte I: tratamento e orientação pós‐crise","authors":"Maria Anita Costa Spindola ,&nbsp;Dirceu Solé ,&nbsp;Marcelo Vivolo Aun ,&nbsp;Liana Maria Tôrres de Araújo Azi ,&nbsp;Luiz Antonio Guerra Bernd ,&nbsp;Daniela Bianchi Garcia ,&nbsp;Albertina Varandas Capelo ,&nbsp;Débora de Oliveira Cumino ,&nbsp;Alex Eustáquio Lacerda ,&nbsp;Luciana Cavalcanti Lima ,&nbsp;Edelton Flávio Morato ,&nbsp;Rogean Rodrigues Nunes ,&nbsp;Norma de Paula Motta Rubini ,&nbsp;Jane da Silva ,&nbsp;Maria Ângela Tardelli ,&nbsp;Alexandra Sayuri Watanabe ,&nbsp;Erick Freitas Curi ,&nbsp;Flávio Sano","doi":"10.1016/j.bjan.2020.06.004","DOIUrl":"10.1016/j.bjan.2020.06.004","url":null,"abstract":"<div><p>Experts from the Brazilian Association of Allergy and Immunology (ASBAI) and the Brazilian Society of Anesthesiology (SBA) interested in the issue of perioperative anaphylaxis, and aiming to strengthen the collaboration between the two societies, combined efforts to study the topic and to prepare a joint document to guide specialists in both areas. The purpose of the present series of two articles was to report the most recent evidence based on the collaborative assessment between both societies. This first article will consider the updated definitions, treatment and guidelines after a perioperative crisis. The following article will discuss the major etiologic agents, how to proceed with the investigation, and the appropriate tests.</p></div>","PeriodicalId":21261,"journal":{"name":"Revista brasileira de anestesiologia","volume":"70 5","pages":"Pages 534-548"},"PeriodicalIF":1.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bjan.2020.06.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10237025","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 plexo cervical como técnica anestésica alternativa para tireoplastia tipo I: relato de caso","authors":"Antoine Abi Lutfallah ,&nbsp;Khalil Jabbour ,&nbsp;Afrida Gergess ,&nbsp;Gemma Hayeck ,&nbsp;Nayla Matar ,&nbsp;Samia Madi‐Jebara","doi":"10.1016/j.bjan.2020.08.002","DOIUrl":"10.1016/j.bjan.2020.08.002","url":null,"abstract":"<div><h3>Introdução</h3><p>O papel da tireoplastia tipo I (TPI) está bem estabelecido no tratamento de insuficiência glótica após a paralisia das pregas vocais, mas o manejo anestésico ideal para a TPI ainda é controverso. Descrevemos uma nova técnica anestésica para a TPI usando o Bloqueio do Plexo Cervical (BPC) superficial e o BPC intermediário associados, em presença de analgo‐sedação leve e intermitente.</p></div><div><h3>Relato de caso</h3><p>Paciente de 51 anos de idade com paralisia da prega vocal esquerda e apneia obstrutiva do sono foi agendada para TPI. BPC intermediário guiado por ultrassom foi realizado usando acesso posterior, e 15 mL de ropivacaína a 0,5% foram injetados no espaço cervical posterior entre o músculo esternocleidomastoideo e a fáscia prevertebral. A seguir, para o BPC superficial, 10 mL de ropivacaína a 0,5% foram injetados na região subcutânea adjacente à borda posterior do músculo esternocleidomastoideo, sem transfixar a fáscia de revestimento. Analgo‐sedação intermitente com infusão alvo‐controlada de remifentanil (alvo de 0,5 ng.mL^‐1) foi usada para facilitar a inserção da prótese e a laringoscopia com fibra ótica. A técnica ofereceu via aérea segura durante a anestesia, boa condição para o cirurgião, possibilidade de monitorar a voz, além de ótimo conforto à paciente.</p></div><div><h3>Conclusões</h3><p>O uso de anestesia regional é uma técnica promissora para o cuidado anestésico durante a TPI, especialmente em pacientes com via aérea comprometida.</p></div><div><h3>Background</h3><p>The role of type I thyroplasty (TIP) is well established as the treatment for glottal insufficiency due to vocal fold paralysis, but the ideal anesthetic management for this procedure is still largely debated. We present the case of a novel anesthetic approach for TIP using combined intermediate and superficial Cervical Plexus Block (CPB) and intermittent mild sedation analgesia.</p></div><div><h3>Case report</h3><p>A 51‐year‐old presenting with left vocal fold paralysis and obstructive sleep apnea was scheduled for TIP. An ultrasound‐guided intermediate CPB was performed using the posterior approach, and 15 mL of ropivacaine 0.5% were injected in the posterior cervical space between the sternocleidomastoid muscle and the prevertebral fascia. Then, for the superficial CPB, a total of 10 mL 0.5% ropivacaine was injected subcutaneously, adjacently to the posterior border of the sternocleidomastoid muscle, without penetrating the investing fascia. An intermittent sedation analgesia with a target‐controlled infusion of remifentanyl (target 0.5 ng.mL^‐1) was used to facilitate prosthesis insertion and the fiberoptic laryngoscopy. This technique offered a safe anesthetic airway and good operating conditions for the surgeon, as well as feasible voice monitoring and optimal patient comfort.</p></div><div><h3>Conclusion</h3><p>The use of regional technique is a promising method for the anesthetic management in TIP, espe","PeriodicalId":21261,"journal":{"name":"Revista brasileira de anestesiologia","volume":"70 5","pages":"Pages 556-560"},"PeriodicalIF":1.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bjan.2020.08.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38451932","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}