Brazilian Journal of Anesthesiology最新文献

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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":null,"pages":null},"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":null,"pages":null},"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
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":null,"pages":null},"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":null,"pages":null},"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":null,"pages":null},"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}
引用次数: 0
End-tidal carbon dioxide measurements as a surrogate to arterial carbon dioxide during pediatric laparoscopic surgeries: a prospective observational cohort study 将潮气末二氧化碳测量值作为小儿腹腔镜手术中动脉二氧化碳的替代值:一项前瞻性观察队列研究。
IF 1.7 4区 医学
Brazilian Journal of Anesthesiology Pub Date : 2024-09-01 DOI: 10.1016/j.bjane.2021.07.036
{"title":"End-tidal carbon dioxide measurements as a surrogate to arterial carbon dioxide during pediatric laparoscopic surgeries: a prospective observational cohort study","authors":"","doi":"10.1016/j.bjane.2021.07.036","DOIUrl":"10.1016/j.bjane.2021.07.036","url":null,"abstract":"<div><h3>Background</h3><p>Maintaining normocapnia during mechanical ventilation in anesthetized children during laparoscopic surgeries is highly recommended. There is a debate regarding the use of capnography (ETCO<sub>2</sub>) as a trend monitor for evaluation of arterial carbon dioxide levels (PaCO<sub>2</sub>). We analyzed the relationship between ETCO<sub>2</sub> and PaCO<sub>2</sub> with time in elective pediatric laparoscopic surgeries.</p></div><div><h3>Methods</h3><p>This study was a prospective observational cohort analysis of 116 paired comparisons between PaCO<sub>2</sub> and ETCO<sub>2</sub> computed from 29 children (ASA I, 12...72 months). Arterial blood samples were withdrawn before, at 15...minutes and 30...minutes during pneumoperitoneum and 1...minute after deflation. ETCO<sub>2</sub> value was recorded simultaneously, while arterial blood was withdrawn. PaCO<sub>2</sub>...ETCO<sub>2</sub> relationship was evaluated by Pearson's correlation coefficients and Bland Altman Method of agreement.</p></div><div><h3>Results</h3><p>Out of the 116 comparisons analyzed, a PaCO<sub>2</sub>...ETCO<sub>2</sub> difference beyond 0 to ..± 5...mmHg was recorded in 71 comparisons (61.2%) with negative difference in 34 comparisons (29.3%). A positive significant correlation between PaCO<sub>2</sub> and ETCO<sub>2</sub> was recorded before (<em>r</em>...=...0.617, <em>p</em>...=...0.000) and at 15...minutes (<em>r</em>...=...0.582, <em>p</em>...=...0.001), with no significant correlation at 30 minutes (<em>r</em>...=...0.142, <em>p</em>...=...0.461), either after deflation (<em>r</em>...=...0.108, <em>p</em>...=...0.577). Bland-Altman plots showed agreement between ETCO<sub>2</sub> and PaCO<sub>2</sub> before inflation with mean PaCO<sub>2</sub>-ETCO<sub>2</sub> difference 0.14........5.6...mmHg (limits of 95% agreement -10.84...11.2, simple linear regression testing <em>p</em>-value 0.971), with no agreement at 15...minutes (0.51........7.15, -13.5...14.5, <em>p</em>...=...0.000), 30...minutes. (2.62........7.83, -12.73...17.97, <em>p</em>...=...0.000), or after deflation (1.81........6.56, -10.93...14.55, <em>p</em>...=...0.015).</p></div><div><h3>Conclusion</h3><p>Usage of capnography as a trend monitor in pediatric laparoscopic surgeries may not be a reliable surrogate for PaCO<sub>2</sub> levels.</p></div><div><h3>Trial registration</h3><p>Clinical Trials. gov (Identifier: NCT03361657)</p></div>","PeriodicalId":32356,"journal":{"name":"Brazilian Journal of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0104001421003262/pdfft?md5=636d5b29ebde5bd37ff1f90ffe30c3fd&pid=1-s2.0-S0104001421003262-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39338934","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
Real-time ultrasound-guided epidural catheter placement in infants: a case series 实时超声引导婴儿硬膜外导管置入:病例系列。
IF 1.7 4区 医学
Brazilian Journal of Anesthesiology Pub Date : 2024-09-01 DOI: 10.1016/j.bjane.2022.03.004
{"title":"Real-time ultrasound-guided epidural catheter placement in infants: a case series","authors":"","doi":"10.1016/j.bjane.2022.03.004","DOIUrl":"10.1016/j.bjane.2022.03.004","url":null,"abstract":"<div><p>Although epidural catheter insertion under ultrasound (US) guidance in the pediatric age group has been reported in the literature, it is yet to be adopted widely in clinical practice. The incomplete fusion of bones in pediatric patients provides an acoustic window for the US. The epidural space in children is at shallow depth, hence a high-frequency probe, which provides better resolution can be used. We present a case series in which real-time US-guided epidural catheter placement was performed in 10 infants in lower thoracic and upper lumbar interspaces. We reiterate that the use of real-time US during epidural catheter placement in patients increases the success rate of epidural catheter placement while decreasing procedural complications.</p></div>","PeriodicalId":32356,"journal":{"name":"Brazilian Journal of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0104001422000343/pdfft?md5=091fc89b8e101618c2266c199c97219a&pid=1-s2.0-S0104001422000343-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40311662","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
Erratum to Estudo comparativo entre bupivacaína a 0,5% e mistura enantiomérica de bupivacaína (S75-R25) a 0,5% em anestesia peridural [Rev. Bras. Anestesiol. 53 (2003)169 -176] 0.5%布比卡因与0.5%布比卡因对映体混合物(S75-R25)在硬膜外麻醉中的比较研究[Rev. Bras. Anestesiol.
IF 1.7 4区 医学
Brazilian Journal of Anesthesiology Pub Date : 2024-08-30 DOI: 10.1016/j.bjane.2024.844549
{"title":"Erratum to Estudo comparativo entre bupivacaína a 0,5% e mistura enantiomérica de bupivacaína (S75-R25) a 0,5% em anestesia peridural [Rev. Bras. Anestesiol. 53 (2003)169 -176]","authors":"","doi":"10.1016/j.bjane.2024.844549","DOIUrl":"10.1016/j.bjane.2024.844549","url":null,"abstract":"","PeriodicalId":32356,"journal":{"name":"Brazilian Journal of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142115571","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
Use of the cardiac power index to predict fluid responsiveness in the prone position: a proof-of-concept study 使用心脏动力指数预测俯卧位的液体反应性:概念验证研究。
IF 1.7 4区 医学
Brazilian Journal of Anesthesiology Pub Date : 2024-08-06 DOI: 10.1016/j.bjane.2024.844545
{"title":"Use of the cardiac power index to predict fluid responsiveness in the prone position: a proof-of-concept study","authors":"","doi":"10.1016/j.bjane.2024.844545","DOIUrl":"10.1016/j.bjane.2024.844545","url":null,"abstract":"<div><h3>Background</h3><p>The primary aim of this proof-of-concept study was to investigate whether the Cardiac Power Index (CPI) could be a novel alternative method to assess fluid responsiveness in the prone position.</p></div><div><h3>Methods</h3><p>Patients undergoing scheduled elective lumbar spine surgery in the prone position under general anesthesia were enrolled in the criteria of patients aged 19–75 years with American Society of Anesthesiologists (ASA) physical status I–II. The hemodynamic variables were evaluated before and after changes in posture after administering a colloid bolus (5 mL.kg<sup>−1</sup>) in the prone position. Fluid responsiveness was defined as an increase in the Stroke Volume Index (SVI) ≥ 10%.</p></div><div><h3>Results</h3><p>A total of 28 patients were enrolled. In responders, the CPI (median [1/4Q–3/4Q]) decreased to 0.34 [0.28–0.39] W.m<sup>−2</sup> (<em>p</em> = 0.035) after the prone position. After following fluid loading, CPI increased to 0.48 [0.37–0.52] W.m<sup>−2</sup> (<em>p</em> &lt; 0.008), and decreased SVI (median [1/4Q–3/4Q]) after prone increased from 26.0 [24.5–28.0] mL.m<sup>−2</sup> to 33.0 [31.0–37.5] mL.m<sup>−2</sup> (<em>p</em> = 0.014). Among non-responders, CPI decreased to 0.43 [0.28–0.53] W.m<sup>−2</sup> (<em>p</em> = 0.011), and SVI decreased to 29.0 [23.5–34.8] mL.m<sup>−2</sup> (<em>p</em> &lt; 0.009). CPI exhibited predictive capabilities for fluid responsiveness as a receiver operating characteristic curve of 0.78 [95% Confidence Interval, 0.60–0.95; <em>p</em> = 0.025].</p></div><div><h3>Conclusion</h3><p>This study suggests the potential of CPI as an alternative method to existing preload indices in assessing fluid responsiveness in clinical scenarios, offering potential benefits for responders and non-responders.</p></div>","PeriodicalId":32356,"journal":{"name":"Brazilian Journal of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0104001424000678/pdfft?md5=d7625cbc8d82045ec94d11b5fa3f31e5&pid=1-s2.0-S0104001424000678-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141908435","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
Effectiveness of intracuff alkalinized lidocaine associated with intravenous dexamethasone in reducing laryngotracheal morbidity in children undergoing general anesthesia for tonsillectomy: a randomized controlled trial 对接受扁桃体切除术全身麻醉的儿童而言,袖带内碱化利多卡因与静脉注射地塞米松可有效降低喉气管发病率:随机对照试验。
IF 1.7 4区 医学
Brazilian Journal of Anesthesiology Pub Date : 2024-08-03 DOI: 10.1016/j.bjane.2024.844548
{"title":"Effectiveness of intracuff alkalinized lidocaine associated with intravenous dexamethasone in reducing laryngotracheal morbidity in children undergoing general anesthesia for tonsillectomy: a randomized controlled trial","authors":"","doi":"10.1016/j.bjane.2024.844548","DOIUrl":"10.1016/j.bjane.2024.844548","url":null,"abstract":"<div><h3>Background</h3><p>Postoperative sore throat is one of the main postoperative complaints in patients undergoing tonsillectomy. As the primary outcome, we aimed to determine whether endotracheal tube cuffs filled with alkalinized lidocaine are associated with a lower incidence of postoperative sore throat and anesthesia emergence phenomena in children undergoing tonsillectomy or adenotonsillectomy. We also assessed the potential additional benefits of IV dexamethasone in reducing postoperative laryngotracheal morbidity.</p></div><div><h3>Methods</h3><p>This is a clinical prospective, randomized, controlled trial. Patients were randomly allocated to one of four groups, as follows: air <strong>–</strong> endotracheal tube cuff filled with air; air/dex – endotracheal tube cuff filled with air and intravenous dexamethasone; lido – endotracheal tube cuff filled with alkalinized lidocaine; and lido/dex – endotracheal tube cuff filled with alkalinized lidocaine and intravenous dexamethasone. Perioperative hemodynamic parameters and the incidence of postoperative nausea and vomiting, coughing and hoarseness were recorded. Postoperative sore throat was assessed in the postanesthetic care unit and 24 hours post tracheal extubation.</p></div><div><h3>Results</h3><p>In total, 154 children aged 4–12 years, ASA physical status I or II, undergoing general anesthesia for elective tonsillectomy and adenotonsillectomy, were assessed for postoperative sore throat in this study. The incidence of postoperative sore throat 24 hours after tracheal extubation was significantly lower in the lido/dex group compared to groups air and air/dex (p = 0.01). However, no additional reduction in these symptoms was observed from the intravenous administration of dexamethasone when comparing the lido and lido/dex groups. Similarly, there were no differences among groups regarding perioperative hemodynamic variables or postoperative nausea and vomiting, coughing, and hoarseness during the study period.</p></div><div><h3>Conclusion</h3><p>Intracuff alkalinized lidocaine, associated with intravenous dexamethasone, might be effective in reducing sore throat 24 hours post-tonsillectomy or adenotonsillectomy in children when compared to the use of air as the cuff insufflation media.</p></div>","PeriodicalId":32356,"journal":{"name":"Brazilian Journal of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0104001424000708/pdfft?md5=501c0f906a3c2b40b5a492ea7a0821e5&pid=1-s2.0-S0104001424000708-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141895000","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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