Brazilian Journal of Anesthesiology最新文献

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Comparison of the recovery profile of sufentanil and remifentanil in total intravenous anesthesia: a systematic review and meta-analysis of randomized controlled trials 舒芬太尼和瑞芬太尼在全静脉麻醉中的恢复情况比较:随机对照试验的系统回顾和荟萃分析。
IF 1.7 4区 医学
Brazilian Journal of Anesthesiology Pub Date : 2024-09-07 DOI: 10.1016/j.bjane.2024.844558
Igor Seror Cuiabano , Rafael Pagliaro Naves , Rodrigo Bouchabki de A. Diehl
{"title":"Comparison of the recovery profile of sufentanil and remifentanil in total intravenous anesthesia: a systematic review and meta-analysis of randomized controlled trials","authors":"Igor Seror Cuiabano ,&nbsp;Rafael Pagliaro Naves ,&nbsp;Rodrigo Bouchabki de A. Diehl","doi":"10.1016/j.bjane.2024.844558","DOIUrl":"10.1016/j.bjane.2024.844558","url":null,"abstract":"<div><h3>Introduction</h3><div>Remifentanil is a short-acting opioid and can be administered during surgery without the risk of delayed postoperative recovery but concerns about hyperalgesia and the shortages of remifentanil lead anesthetists to consider long-acting opioids for Total Intravenous Anesthesia (TIVA). Sufentanil is a more potent opioid with a longer context-sensitive half-life but can promote good postoperative analgesia due to its residual effect. This meta-analysis aimed to compare the recovery profile of remifentanil and sufentanil for TIVA.</div></div><div><h3>Methods</h3><div>The search strategy was performed in PubMed, CENTRAL, and Web of Science for RCTs comparing sufentanil and remifentanil as part of TIVA in adults undergoing noncardiac surgery. Risk of bias and the quality of evidence were performed using RoB2 and GRADEpro, respectively. The primary outcome was time to tracheal extubation. Secondary analyses included postoperative analgesia, respiratory depression, and Postoperative Nausea and Vomiting (PONV).</div></div><div><h3>Results</h3><div>Sufentanil increases the time to extubate, MD = 4.29 min; 95% CI: 2.33 to 6.26; <em>p</em> = 0.001. It also reduces the need for postoperative rescue analgesia, logOR = -1.07; 95% CI: -1.62 to -0.52; <em>p</em> = 0.005. There were no significant differences between both opioids for PONV, logOR = 0.50; 95% CI: -0.10 to 1.10; <em>p</em> = 0.10 and respiratory depression, logOR = 1.21; 95% CI: -0.42 to 2.84; <em>p</em> = 0.15.</div></div><div><h3>Conclusion</h3><div>Sufentanil delays the time to tracheal extubation compared with remifentanil but is associated with a reduced need for postoperative rescue analgesia. No significant differences were observed between the two opioids in terms of postoperative respiratory depression or PONV.</div></div>","PeriodicalId":32356,"journal":{"name":"Brazilian Journal of Anesthesiology","volume":"75 1","pages":"Article 844558"},"PeriodicalIF":1.7,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Hybrid ultrasound and landmark technique for thoracic paravertebral block: a clinical image 胸椎旁阻滞的混合超声和地标技术:临床图像。
IF 1.7 4区 医学
Brazilian Journal of Anesthesiology Pub Date : 2024-09-06 DOI: 10.1016/j.bjane.2024.844555
Anthony M.-H. Ho, Glenio B. Mizubuti, Gregory Klar, Rachel Rooney
{"title":"Hybrid ultrasound and landmark technique for thoracic paravertebral block: a clinical image","authors":"Anthony M.-H. Ho,&nbsp;Glenio B. Mizubuti,&nbsp;Gregory Klar,&nbsp;Rachel Rooney","doi":"10.1016/j.bjane.2024.844555","DOIUrl":"10.1016/j.bjane.2024.844555","url":null,"abstract":"","PeriodicalId":32356,"journal":{"name":"Brazilian Journal of Anesthesiology","volume":"74 6","pages":"Article 844555"},"PeriodicalIF":1.7,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0104001424000770/pdfft?md5=6ee8e305f28ea43912e04f21745809ae&pid=1-s2.0-S0104001424000770-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142147029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Kidney transplantation and perioperative complications: a prospective cohort study 肾移植与围手术期并发症:一项前瞻性队列研究。
IF 1.7 4区 医学
Brazilian Journal of Anesthesiology Pub Date : 2024-09-05 DOI: 10.1016/j.bjane.2024.844556
Priscila Sartoretto Dal Magro , Gisele Meinerz , Valter Duro Garcia , Florentino Fernandes Mendes , Maria Eugenia Cavalheiro Marques , Elizete Keitel
{"title":"Kidney transplantation and perioperative complications: a prospective cohort study","authors":"Priscila Sartoretto Dal Magro ,&nbsp;Gisele Meinerz ,&nbsp;Valter Duro Garcia ,&nbsp;Florentino Fernandes Mendes ,&nbsp;Maria Eugenia Cavalheiro Marques ,&nbsp;Elizete Keitel","doi":"10.1016/j.bjane.2024.844556","DOIUrl":"10.1016/j.bjane.2024.844556","url":null,"abstract":"<div><h3>Background</h3><p>Kidney transplant recipients face complex perioperative challenges due to comorbidities from chronic kidney disease. This study aimed to assess perioperative complications in kidney transplant recipients and evaluate the association between the Charlson Comorbidity Index (CCI) and complication severity using the Clavien-Dindo (CD) classification.</p></div><div><h3>Methods</h3><p>A prospective cohort study conducted at a tertiary hospital in South Brazil from September 2020 to March 2022, including 230 adult kidney transplant recipients. Data on demographics, comorbidities, and complications were collected. Complications were categorized using the CD scale, and their relationship with CCI was analyzed using univariate and multivariate Cox regression.</p></div><div><h3>Results</h3><p>Mean age was 49.2 ± 12.7 years, with 58.7% male recipients. The mean CCI score was 3.65 ± 1.5 points. Intraoperative complications occurred in 10.9% of patients, with notable issues including bleeding and airway difficulties. In the immediate postoperative period, 9.1% required urgent dialysis. In the 30-day follow-up, 57.8% had delayed graft function, 21.7% infections, 11.3% had vascular complications, and the mortality was 1.7%. CCI was not a significant predictor of severe complications; however, congestive heart failure was strongly associated with severe complications (HR = 6.6 95% CI 2.6–6.7, <em>p</em> &lt; 0.001).</p></div><div><h3>Conclusions</h3><p>Despite a low overall comorbidity profile, kidney transplant recipients faced significant perioperative challenges. The lack of a significant association between the CCI score and severe complications suggests that traditional risk assessment tools may not fully capture the risks specific to the early postoperative period in kidney transplantation, and future research should focus on developing more refined risk assessment models for chronic kidney disease patients.</p></div>","PeriodicalId":32356,"journal":{"name":"Brazilian Journal of Anesthesiology","volume":"74 6","pages":"Article 844556"},"PeriodicalIF":1.7,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0104001424000782/pdfft?md5=c02f905cdccd68337a3649519f01c0f2&pid=1-s2.0-S0104001424000782-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142147030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pediatric emergence delirium is linked to increased early postoperative negative behavior within two weeks after adenoidectomy: an observational study 一项观察性研究:腺样体切除术后两周内小儿出现谵妄与术后早期消极行为增加有关。
IF 1.7 4区 医学
Brazilian Journal of Anesthesiology Pub Date : 2024-09-01 DOI: 10.1016/j.bjane.2021.03.008
{"title":"Pediatric emergence delirium is linked to increased early postoperative negative behavior within two weeks after adenoidectomy: an observational study","authors":"","doi":"10.1016/j.bjane.2021.03.008","DOIUrl":"10.1016/j.bjane.2021.03.008","url":null,"abstract":"<div><h3>Background</h3><p>The aim of this prospective multicenter observational study was to measure the incidence of postoperative pediatric emergence delirium and to investigate the occurrence of early postoperative negative behavior within two weeks after outpatient adenoidectomy in preschool children.</p></div><div><h3>Methods</h3><p>The study comprised 222 patients (1...7 years of age). All children received a multimodal anesthesia based on total intravenous anesthesia with propofol and remifentanil in combination with piritramid (0.1 mg.kg<sup>-1</sup>), ibuprofen (10 mg.kg<sup>-1</sup>), dexamethason (0.15 mg.kg<sup>-1</sup>), and ketanest S (0.1 mg.kg<sup>-1</sup>). We evaluated emergence delirium using the Pediatric Anesthesia Emergence Delirium Scale (PAED) at different predefined time points during the recovery period. Emergence delirium was defined as a PAED score ... 9 for the first three criteria. Additionally, we defined early postoperative negative behavior to be present when at least 5 of 27 criteria of the post hospitalization behavior questionnaire were positive.</p></div><div><h3>Results</h3><p>The incidence of emergence delirium following our anesthetic regime was 23%. The incidence of early postoperative negative behavior was significantly higher among patients with emergence delirium (24% vs. 11%, <em>p</em> = 0.04). The two categories, ..úsleep disturbance..Ñ and ..úseparation anxiety..Ñ, tested within the questionnaire for early postoperative negative behavior, were identified as the most common postoperative negative behavioral changes.</p></div><div><h3>Conclusion</h3><p>Emergence delirium not only plays a role immediately after surgery but is also linked to early postoperative negative behavior within two weeks after outpatient adenoidectomy. Parents should be informed that early postoperative negative behavior may occur in 1 out of 4 patients if emergence delirium was present postoperatively.</p></div><div><h3>Trial Registration</h3><p>DRKS ... German Clinical Trial Register ID: DRKS00013121</p></div>","PeriodicalId":32356,"journal":{"name":"Brazilian Journal of Anesthesiology","volume":"74 5","pages":"Article 744114"},"PeriodicalIF":1.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S010400142100138X/pdfft?md5=6953b6644c112b2f5ac2b05efaf3561f&pid=1-s2.0-S010400142100138X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38899478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Efficacy of dexmedetomidine versus magnesium sulfate as an adjuvant to intraperitoneal bupivacaine in pediatric laparoscopic surgery: a randomized clinical trial 右美托咪定与硫酸镁作为腹膜内布比卡因辅助剂在小儿腹腔镜手术中的疗效:一项随机临床试验。
IF 1.7 4区 医学
Brazilian Journal of Anesthesiology Pub Date : 2024-09-01 DOI: 10.1016/j.bjane.2022.05.003
{"title":"Efficacy of dexmedetomidine versus magnesium sulfate as an adjuvant to intraperitoneal bupivacaine in pediatric laparoscopic surgery: a randomized clinical trial","authors":"","doi":"10.1016/j.bjane.2022.05.003","DOIUrl":"10.1016/j.bjane.2022.05.003","url":null,"abstract":"<div><h3>Background</h3><p>We evaluated the efficacy of dexmedetomidine versus magnesium sulfate as an adjuvant to intraperitoneal (IP) bupivacaine in pediatric laparoscopic inguinal herniorrhaphy.</p></div><div><h3>Methods</h3><p>Ninety-seven male children, ASA I–II, 1–6 years old, undergoing laparoscopic inguinal herniorrhaphy, were randomized to receive before peritoneal insufflation, IP 2 mg.kg<sup>−1</sup> bupivacaine 0.5% combined with either 1 μg.kg<sup>−1</sup> of dexmedetomidine (Group D), 30 mg.kg<sup>−1</sup> of magnesium sulfate (Group M), or normal saline (Group C). All tested drugs were diluted to the volume of 10 mL with normal saline. FLACC pain scores, need for rescue analgesics, time to flatus and first stool, emetic events, adverse effects, functional recovery, and parents’ satisfaction were recorded for the first 48 h postoperatively.</p></div><div><h3>Results</h3><p>FLACC scores were significantly higher in Group C than in the other two groups at 6, 8, 12, 18, 24, and 48 hours after surgery with no differences between Groups D and M. Rescue analgesia was significantly higher in Group C with none of the children in Groups D and M requiring rescue analgesia (<em>p</em> = 0.001). Times to first flatus and stool, emetic events, and adverse effects did not differ among groups. Times to return to normal functional activity were comparable in all groups. Parents’ satisfaction was greater in Groups D and M than in Group C (<em>p</em> = 0.026).</p></div><div><h3>Conclusion</h3><p>Dexmedetomidine and magnesium sulfate added to IP bupivacaine improved the analgesia afforded by bupivacaine in the first two postoperative days in children scheduled for laparoscopic herniorrhaphy.</p></div>","PeriodicalId":32356,"journal":{"name":"Brazilian Journal of Anesthesiology","volume":"74 5","pages":"Article 744380"},"PeriodicalIF":1.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0104001422000677/pdfft?md5=3869f3145b01b20c1be54cacf191ee72&pid=1-s2.0-S0104001422000677-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44925097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Using the Perfusion Index to predict changes in the depth of anesthesia in children compared with the A-line Autoregression Index: an observational study 与 A 线自回归指数相比,使用灌注指数预测儿童麻醉深度的变化:一项观察性研究。
IF 1.7 4区 医学
Brazilian Journal of Anesthesiology Pub Date : 2024-09-01 DOI: 10.1016/j.bjane.2021.04.030
{"title":"Using the Perfusion Index to predict changes in the depth of anesthesia in children compared with the A-line Autoregression Index: an observational study","authors":"","doi":"10.1016/j.bjane.2021.04.030","DOIUrl":"10.1016/j.bjane.2021.04.030","url":null,"abstract":"<div><h3>Background</h3><p>We investigated the performance of the Perfusion Index (PI) derived from pulse oximetry waveform as a tool for assessment of anesthetic depth in comparison with A-line Autoregression Index (AAI) derived from analysis of Middle-Latency Auditory Evoked Potentials (MLAEP) waveform integrated by aepEXplus monitor in children receiving sevoflurane anesthesia for tonsillectomy.</p></div><div><h3>Methods</h3><p>Forty-one patients (4...12 years old) were included in this study. The PI and AAI were recorded simultaneously every minute during different stages of anesthesia delivery. The statistical tests included descriptive analysis, significance tests, correlation tests, and Receiver Operating Characteristic (ROC) curve. The AAI served as a reference.</p></div><div><h3>Results</h3><p>The PI significantly decreased during light anesthesia and recovery, and significantly increased during deeper planes of anesthesia, with an inverse mirror-image relationship with the AAI. A negative correlation of low to moderate degree was detected between PI and AAI during the study (<em>p</em>.ß&gt;.ß0.05), that reached a statistical significance at the 5th minute during sevoflurane mask induction (r.ß=.ß...0.457, <em>p</em>.ß=.ß0.008). ROC analysis at an AAI &lt; 25 extracted the best cut-off value for PI before intubation as 1.48 (AUC.ß=.ß0.698 [0.537...0.859], 94.4% sensitivity, 44.5% specificity) and at 10-minute intraoperatively as 2.4 (AUC.ß=.ß0.537 [0.354...0.721], 91.7% sensitivity, 31% specificity). During recovery, at an AAI.ß....ß50, the best cutoff was 1.82 (AUC.ß=.ß0.661 [0.46...0.863], 100% sensitivity and 50% specificity) 2 minutes before spontaneous eye opening.</p></div><div><h3>Conclusions</h3><p>Compared with the AAI, the PI can track changes in depth of anesthesia in pediatric patients undergoing tonsillectomy under sevoflurane anesthesia.</p></div><div><h3>Trial registration</h3><p>Clinical Trials. Gov. Identifier: NCT03412214.</p></div>","PeriodicalId":32356,"journal":{"name":"Brazilian Journal of Anesthesiology","volume":"74 5","pages":"Article 744169"},"PeriodicalIF":1.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0104001421001986/pdfft?md5=9d7ab6c18e2820e353ea18a452343e65&pid=1-s2.0-S0104001421001986-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38984943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Ultrasound-guided popliteal sciatic nerve block in a pediatric patient with complex regional pain syndrome: a case report 超声引导下腘坐骨神经阻滞治疗复杂区域疼痛综合征儿科患者:病例报告。
IF 1.7 4区 医学
Brazilian Journal of Anesthesiology Pub Date : 2024-09-01 DOI: 10.1016/j.bjane.2021.07.012
{"title":"Ultrasound-guided popliteal sciatic nerve block in a pediatric patient with complex regional pain syndrome: a case report","authors":"","doi":"10.1016/j.bjane.2021.07.012","DOIUrl":"10.1016/j.bjane.2021.07.012","url":null,"abstract":"<div><p>In the pediatric population, complex regional pain syndrome (CRPS) is a challenging condition that leads to chronic psychosocial dysfunction. This case is of a 12-year-old male patient, 50.ßkg, who, after twisting his right ankle, started to present intense pain. Without adequate diagnosis and treatment, his family sought a pain specialist. During the evaluation, a change in sensitivity and temperature was observed, besides hyperalgesia, allodynia, redness, edema, and motor dysfunction, being diagnosed with CRPS. Ultrasound-guided sciatic blocks were performed on the affected limb, increasing the interval between crises, reducing pain intensity, and promoting a return to daily activities.</p></div>","PeriodicalId":32356,"journal":{"name":"Brazilian Journal of Anesthesiology","volume":"74 5","pages":"Article 744233"},"PeriodicalIF":1.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0104001421002931/pdfft?md5=86cf25e69c6d20900f96bcf130947d55&pid=1-s2.0-S0104001421002931-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39255873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Transfusion-related acute lung injury and treatment with high-flow oxygen therapy in a pediatric patient: a case report 一名儿科患者输血相关急性肺损伤及高流量氧气疗法:病例报告。
IF 1.7 4区 医学
Brazilian Journal of Anesthesiology Pub Date : 2024-09-01 DOI: 10.1016/j.bjane.2021.12.001
{"title":"Transfusion-related acute lung injury and treatment with high-flow oxygen therapy in a pediatric patient: a case report","authors":"","doi":"10.1016/j.bjane.2021.12.001","DOIUrl":"10.1016/j.bjane.2021.12.001","url":null,"abstract":"<div><p>Transfusion-Related Acute Lung Injury (TRALI) is an immune-inflammatory lung pathology that manifests within the first 6–72 hours after administration of blood products. However, due to reduced awareness of TRALI, it continues to be an underreported and often underdiagnosed complication of transfusion therapy. We report a case of a 6-year-old girl with myelodysplastic syndrome and TRALI developed in the first hour after platelet transfusion. Diagnosis of TRALI is based on the exclusion of etiologic factors such as volume overload and cardiogenic pulmonary edema following transfusion. Symptoms responded to high-flow oxygen therapy, so intubation was not attempted and full recovery was achieved.</p></div>","PeriodicalId":32356,"journal":{"name":"Brazilian Journal of Anesthesiology","volume":"74 5","pages":"Article 744339"},"PeriodicalIF":1.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0104001421004164/pdfft?md5=6368f734660c1ed74db8af6ffc38435d&pid=1-s2.0-S0104001421004164-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39743519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Posterior transversus abdominis plane block versus lateral quadratus lumborum block in children undergoing open orchiopexy: a randomized clinical trial☆ 在接受开放式肛门成形术的儿童中使用腹横肌后方平面阻滞与腰方肌外侧阻滞:一项随机临床试验☆。
IF 1.7 4区 医学
Brazilian Journal of Anesthesiology Pub Date : 2024-09-01 DOI: 10.1016/j.bjane.2023.06.004
{"title":"Posterior transversus abdominis plane block versus lateral quadratus lumborum block in children undergoing open orchiopexy: a randomized clinical trial☆","authors":"","doi":"10.1016/j.bjane.2023.06.004","DOIUrl":"10.1016/j.bjane.2023.06.004","url":null,"abstract":"<div><h3>Background</h3><p>Due to the complex innervation of the testicle and spermatic cord, analgesic management can be challenging in orchiopexy. We aimed to compare the effects of posterior Transversus Abdominis Plane (TAP) and lateral Quadratus Lumborum Block (QLB) on analgesic use, pain, and parent satisfaction in unilateral orchiopexy.</p></div><div><h3>Methods</h3><p>ASA I–III, aged 6 months –to 12 years children undergoing unilateral orchiopexy were included to this double-blinded randomized trial. Patients were randomized into two groups with the closed envelope method before the surgery. Lateral QLB or posterior TAP block was applied under ultrasonography with 0.4 ml.kg<sup>−1</sup> 0.25% bupivacaine for both groups. The primary outcome was the assessment of additional analgesic usage in the peri-postoperative period. Evaluation of postoperative pain until 24 hours after surgery and parental satisfaction were also assessed as secondary outcomes.</p></div><div><h3>Results</h3><p>A total of 90 patients were included in the analysis (45 patients in each group). The number of patients needing remifentanil was significantly higher in the TAP group (<em>p</em> &lt; 0.001). The average FLACC (TAP: 2.74 ± 1.8, QLB: 0.7 ± 0.84) and Wong-Baker scores (TAP: 3.13 ± 2.42, QLB: 0.53 ± 1.12) were significantly higher for TAP (<em>p</em> &lt; 0.001). Additional analgesic consumption at the 10<sup>th</sup>, 20<sup>th</sup> minutes, 6<sup>th</sup>, 16<sup>th</sup>, and 24<sup>th</sup> hours, especially after the 6<sup>th</sup> hour, were significantly higher for TAP. Parent satisfaction was significantly higher in the QLB group (<em>p</em> &lt; 0.001).</p></div><div><h3>Conclusion</h3><p>Lateral QLB provided more effective analgesia than posterior TAP block in children undergoing elective open unilateral orchiopexy.</p></div><div><h3>Clinical Trials Registry</h3><p>NCT03969316.</p></div>","PeriodicalId":32356,"journal":{"name":"Brazilian Journal of Anesthesiology","volume":"74 5","pages":"Article 744443"},"PeriodicalIF":1.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0104001423000684/pdfft?md5=d67db9747360f1a70caa50f2df9eaf3d&pid=1-s2.0-S0104001423000684-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9867788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comparison of the lateral sagittal and costoclavicular approaches for ultrasound-guided infraclavicular block in pediatric patients: a prospective randomized study 在超声引导下对儿科患者进行锁骨下阻滞的外侧矢状切口和肋锁切口的比较:一项前瞻性随机研究。
IF 1.7 4区 医学
Brazilian Journal of Anesthesiology Pub Date : 2024-09-01 DOI: 10.1016/j.bjane.2021.05.005
{"title":"Comparison of the lateral sagittal and costoclavicular approaches for ultrasound-guided infraclavicular block in pediatric patients: a prospective randomized study","authors":"","doi":"10.1016/j.bjane.2021.05.005","DOIUrl":"10.1016/j.bjane.2021.05.005","url":null,"abstract":"<div><h3>Background</h3><p>The lateral sagittal brachial plexus block is the most used method for pediatric upper extremity surgery, whereas the applications of costoclavicular brachial plexus block are limited. This study aimed to compare the lateral sagittal and costoclavicular approaches for the ultrasound-guided infraclavicular block in pediatric patients.</p></div><div><h3>Methods</h3><p>Sixty pediatric patients aged 5...15 years undergoing hand or forearm surgery were randomly assigned to two groups. Group LS (n.ß=.ß30) received ultrasound-guided lateral sagittal block, and Group CC (n.ß=.ß30) received ultrasound-guided costoclavicular block. The block performing time, needling time, imaging time, needle visibility, number of passes, sensorial/motor block time, and postoperative pain scores were evaluated.</p></div><div><h3>Results</h3><p>The needling time (82.90.ß...ß28.17 seconds vs. 64.77.ß...ß28.11 seconds respectively, <em>p</em>.ß=.ß0.004) and total block performance time (109.53 .. 29.75 seconds vs. 89.70 .. 29.98 seconds respectively, <em>p</em>.ß=.ß0.005) were significantly longer in Group LS than in Group CC. However, there was no significant difference between the groups in imaging time, needle visibility, number of passes, sensorial/motor block time, and postoperative pain scores (<em>p</em> &gt; 0.05).</p></div><div><h3>Conclusions</h3><p>Costoclavicular and lateral sagittal brachial plexus blocks resulted in similar anesthetics effects. Moreover, the costoclavicular method can be a better alternative to lateral sagittal as it has a shorter block performance time.</p></div>","PeriodicalId":32356,"journal":{"name":"Brazilian Journal of Anesthesiology","volume":"74 5","pages":"Article 744178"},"PeriodicalIF":1.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0104001421002244/pdfft?md5=2c68b4333e22619d07296d191bd64f32&pid=1-s2.0-S0104001421002244-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39064545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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