Brazilian Journal of Anesthesiology最新文献

{"title":"The brief measure of preoperative emotional stress screens preoperative maladaptive psychological features and predicts postoperative opioid use: an observational study","authors":"Rogério Boff Borges ,&nbsp;Wolnei Caumo ,&nbsp;Caroline Bavaresco ,&nbsp;Luciana Paula Cadore Stefani ,&nbsp;Vinicius Souza dos Santos ,&nbsp;Stela Maris de Jezus Castro","doi":"10.1016/j.bjane.2023.02.004","DOIUrl":"10.1016/j.bjane.2023.02.004","url":null,"abstract":"<div><h3>Background</h3><p>The Brief Measure of Preoperative Emotional Stress (B-MEPS) is a suitable screening tool for Preoperative Emotional Stress (PES). However, personalized decision-making demands practical interpretation of the refined version of B-MEPS. Thus, we propose and validate cut-off points on the B-MEPS to classify PES. Also, we assessed if the cut-off points screened preoperative maladaptive psychological features and predicted postoperative opioid use.</p></div><div><h3>Methods</h3><p>This observational study comprises samples of two other primary studies, with 1009 and 233 individuals, respectively. The latent class analysis derived emotional stress subgroups using B-MEPS items. We compared membership with the B-MEPS score through the Youden index. Concurrent criterion validity of the cut-off points was performed with the severity of preoperative depressive symptoms, pain catastrophizing, central sensitization, and sleep quality. Predictive criterion validity was performed with opioid use after surgery.</p></div><div><h3>Results</h3><p>We chose a model with three classes labeled mild, moderate, and severe. The Youden index points -0.1663 and 0.7614 of the B-MEPS score classify individuals, in the severe class, with a sensitivity of 85.7% (80.1%–90.3%) and specificity of 93.5% (91.5–95.1%). The cut-off points of the B-MEPS score have satisfactory concurrent and predictive criterion validity.</p></div><div><h3>Conclusions</h3><p>These findings showed that the preoperative emotional stress index on the B-MEPS offers suitable sensitivity and specificity for discriminating the severity of preoperative psychological stress. They provide a simple tool to identify patients prone to severe PES related to maladaptive psychological features, which might influence the perception of pain and analgesic opioid use in the postoperative period.</p></div>","PeriodicalId":32356,"journal":{"name":"Brazilian Journal of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0104001423000192/pdfft?md5=5d7ec076c342ba6251ae81d3508e18af&pid=1-s2.0-S0104001423000192-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9497262","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}

{"title":"Accuracy of closed-loop and open-loop propofol delivery systems by bispectral index monitoring in breast surgery patients: a prospective randomized trial","authors":"Tian Xie,&nbsp;Yong Wang,&nbsp;Yuhua Liu,&nbsp;Junjie Li,&nbsp;Weijing Li,&nbsp;Hongmeng Xu","doi":"10.1016/j.bjane.2023.05.003","DOIUrl":"10.1016/j.bjane.2023.05.003","url":null,"abstract":"<div><h3>Background</h3><p>This randomized and controlled prospective study tested the hypothesis that closed-loop Target-Controlled Infusion (TCI) of propofol would be associated with better system performance when compared with open-loop controlled delivery of propofol.</p></div><div><h3>Methods</h3><p>Patients scheduled for elective breast surgery were randomly assigned to two groups: a closed-loop group, in which propofol infusion was performed by a closed-loop TCI system that used the Bispectral Index (BIS) as a feedback parameter to titrate the rate of propofol infusion, and an open-loop group, in which propofol infusion was performed manually and guided by the bispectral index.</p></div><div><h3>Results</h3><p>A total of 156 patients were recruited for this study (closed-loop group n = 79; open-loop group n = 77). The Global Score (GS) of the closed-loop group was lower than that of the open-loop group (34.3 and 42.2) (<em>p</em> = 0.044). The proportions of time with a BIS value between 40 and 60 were almost identical in the closed-loop group and the open-loop group (68.7 ± 10.6% and 66.7 ± 13.3%) (<em>p</em> = 0.318). The individuals in the closed-loop group consumed more propofol compared with those in the open-loop group (7.20 ± 1.65 mg.kg⁻¹.h⁻¹ vs. 6.03 ± 1.31 mg.kg⁻¹.h⁻¹, <em>p &lt;</em> 0.001). No intraoperative recall, somatic events or adverse events occurred. No significant difference in heart rate was observed between the two groups (<em>p</em> = 0.169).</p></div><div><h3>Conclusion</h3><p>The closed-loop protocol was associated with lower BIS variability and lower out-of-range BIS values, at the cost of a greater consumption of propofol when compared to the open loop group.</p></div><div><h3>Register number</h3><p>ChiCTR-INR-17010399.</p></div>","PeriodicalId":32356,"journal":{"name":"Brazilian Journal of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0104001423000489/pdfft?md5=d6604bc9cd9506163b50492fcb955eb8&pid=1-s2.0-S0104001423000489-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9745483","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}

{"title":"Minimum effective concentration of ropivacaine for ultrasound-guided transmuscular quadratus lumborum block in total hip arthroplasty: a randomized clinical trial☆","authors":"Jian Hu ,&nbsp;Xingcheng Li ,&nbsp;Qiuru Wang ,&nbsp;Jing Yang","doi":"10.1016/j.bjane.2023.08.005","DOIUrl":"10.1016/j.bjane.2023.08.005","url":null,"abstract":"<div><h3>Objective</h3><p>This trial aimed to identify the Minimum Effective Concentration (MEC₉₀, defined as the concentration which can provide successful block in 90% of patients) of 30 mL ropivacaine for single-shot ultrasound-guided transmuscular Quadratus Lumborum Block (QLB) in patients undergoing Total Hip Arthroplasty (THA).</p></div><div><h3>Methods</h3><p>A double-blind, randomized dose-finding study using the biased coin design up-and-down sequential method, where the concentration of local anesthetic administered to each patient depended on the response from the previous one. Block success was defined as a Numeric Rating Scale (NRS) score during motion ≤ 3 at 6 hours after arrival in the ward. If the block was successful, the next subject received either a 0.025% smaller dose (probability of 0.11) or the same dose (probability of 0.89); otherwise, the next subject received a 0.025% higher ropivacaine concentration. MEC₉₀, MEC₉₅ and MEC₉₉ were estimated by isotonic regression, and the corresponding 95% Confidence Intervals (95% CIs) were calculated by the bootstrapping method.</p></div><div><h3>Results</h3><p>Based on the analysis of 52 patients, MEC₉₀, MEC₉₅, and MEC₉₉ of ropivacaine for QLB were estimated to be 0.352% (95% CI 0.334–0.372%), 0.363% (95% CI 0.351–0.383%), and 0.373% (95% CI 0.363–0.386%). The concentration of ropivacaine at 0.352% in a volume of 30 ml can provide a successful block in 90% of patients.</p></div><div><h3>Conclusions</h3><p>For ultrasound-guided transmuscular QLB in patients undergoing THA, 0.352% ropivacaine in a volume of 30 ml can provide a successful block in 90% of patients. Further dose-finding studies and large sample size are required to verify the concentration.</p></div>","PeriodicalId":32356,"journal":{"name":"Brazilian Journal of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0104001423000957/pdfft?md5=80467da0e0ce700d683e7b363ddc677a&pid=1-s2.0-S0104001423000957-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10207160","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}

{"title":"Metoprolol for prevention of bucking at orotracheal extubation: a double-blind, placebo-controlled randomised trial","authors":"Murilo Neves de Queiroz ,&nbsp;Fabrício Tavares Mendonça ,&nbsp;Maurício Vargas de Matos ,&nbsp;Rafael Santos Lino ,&nbsp;Luiz Sérgio Fernandes de Carvalho","doi":"10.1016/j.bjane.2023.07.012","DOIUrl":"10.1016/j.bjane.2023.07.012","url":null,"abstract":"<div><h3>Background</h3><p>Respiratory responses to extubation can cause serious postoperative complications. Beta-blockers, such as metoprolol, can interfere with the cough pathway. However, whether metoprolol can effectively control respiratory reflexes during extubation remains unclear. The objective of this study is to evaluate the efficacy of intravenous metoprolol in attenuating respiratory responses to tracheal extubation.</p></div><div><h3>Methods</h3><p>Randomized, double-blinded, placebo-controlled trial. Setting: Tertiary referral center located in Brasília, Brazil. Recruitment: June 2021 to December 2021. Sample: 222 patients of both sexes with an American Society of Anesthesiologists (ASA) physical status I–III aged 18–80 years. Patients were randomly assigned to receive intravenous metoprolol 5 mg IV or placebo at the end of surgery. The primary outcome was the proportion of patients who developed bucking secondary to endotracheal tube stimulation of the tracheal mucosa during extubation. Secondary outcomes included coughing, bronchospasm, laryngospasm, Mean Blood Pressure (MAP), and Heart Rate (HR) levels.</p></div><div><h3>Results</h3><p>Two hundred and seven participants were included in the final analysis: 102 in the metoprolol group and 105 in the placebo group. Patients who received metoprolol had a significantly lower risk of bucking (43.1% vs. 64.8%, Relative Risk [RR = 0.66], 95% Confidence Interval [95% CI 0.51–0.87], <em>p</em> = 0.003). In the metoprolol group, 6 (5.9%) patients had moderate/severe coughing compared with 33 (31.4%) in the placebo group (RR = 0.19; 95% CI 0.08–0.43, <em>p</em> &lt; 0.001).</p></div><div><h3>Conclusion</h3><p>Metoprolol reduced the risk of bucking at extubation in patients undergoing general anesthesia compared to placebo.</p></div>","PeriodicalId":32356,"journal":{"name":"Brazilian Journal of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0104001423000805/pdfft?md5=0f5cebf8c567e92b9a10320535d14e12&pid=1-s2.0-S0104001423000805-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10025256","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}

{"title":"Retrospective analysis of 20 years of activity of the Brazilian malignant hyperthermia hotline service","authors":"Cezar D.S. Souza,&nbsp;Clea S. Almeida,&nbsp;Pamela V. Andrade,&nbsp;Joilson M. Santos,&nbsp;José L.G. Amaral,&nbsp;Helga C.A. Silva","doi":"10.1016/j.bjane.2024.844482","DOIUrl":"10.1016/j.bjane.2024.844482","url":null,"abstract":"","PeriodicalId":32356,"journal":{"name":"Brazilian Journal of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0104001424000046/pdfft?md5=e4bcf3f5881644acab4a0eaef92d7330&pid=1-s2.0-S0104001424000046-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139716733","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}

{"title":"Sizing double-lumen tubes by direct measurement of the mainstem bronchus","authors":"Anthony M.-H. Ho ,&nbsp;Gregory Klar ,&nbsp;Andrew D. Chung ,&nbsp;Glenio B. Mizubuti","doi":"10.1016/j.bjane.2024.844481","DOIUrl":"10.1016/j.bjane.2024.844481","url":null,"abstract":"","PeriodicalId":32356,"journal":{"name":"Brazilian Journal of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0104001424000034/pdfft?md5=7a97ef05752223b705593443b45e71d7&pid=1-s2.0-S0104001424000034-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139725183","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}

{"title":"Perioperative organ dysfunction: a burden to be countered","authors":"Ricardo Esper Treml ,&nbsp;Henrique Tadashi Katayama ,&nbsp;Tulio Caldonazo ,&nbsp;Talison Silas Pereira ,&nbsp;Luiz M. Sá Malbouisson ,&nbsp;Maria José C. Carmona ,&nbsp;Pedro Tanaka ,&nbsp;João Manoel Silva Jr.","doi":"10.1016/j.bjane.2024.844480","DOIUrl":"10.1016/j.bjane.2024.844480","url":null,"abstract":"","PeriodicalId":32356,"journal":{"name":"Brazilian Journal of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0104001424000022/pdfft?md5=474024aaedf2cb579397ca3e617d6719&pid=1-s2.0-S0104001424000022-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139673771","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}

{"title":"Ultrasound-guided pulsed radiofrequency for chronic shoulder pain: a prospective study","authors":"Rita Diogo Torgal Pinto ,&nbsp;Joana Manuela Tenreiro Pinto ,&nbsp;Maria C..u Loureiro ,&nbsp;Cristina Cardoso ,&nbsp;Jos.. Pedro Assun...·o","doi":"10.1016/j.bjane.2021.08.006","DOIUrl":"10.1016/j.bjane.2021.08.006","url":null,"abstract":"<div><h3>Background and objectives</h3><p>Chronic shoulder pain is a frequent cause of suffering and impaired quality of life. Treatment includes non-pharmacological and pharmacological therapies, and interventional procedures such as suprascapular nerve blocks and radiofrequency. This prospective study aims to evaluate the efficacy of ultrasound-guided pulsed radiofrequency of suprascapular nerve for chronic shoulder pain in a clinical setting.</p></div><div><h3>Methods</h3><p>Therapeutic efficacy was evaluated through pain intensity using numeric pain rating scale at baseline, immediately, 3, and 6 months after, and patient...s motor function improvement. The secondary outcome was patient satisfaction.</p></div><div><h3>Results</h3><p>A total of 34 patients were enrolled and all patients presented a reduction in the numeric pain rating scale immediately after treatment. Pain reduction from baseline to 6 months after the procedure was 34.4% and 36.9% static and dynamic, respectively. The median percentage reduction was statistically significant immediately, 3 and 6 months after. There was also an improvement in range of motion, 39.6% in abduction, 24.1% in flexion, and 29.5% in extension. Ninety percent of patients reported patient...s global impression of change superior to six.</p></div><div><h3>Conclusion</h3><p>This study concludes that ultrasound-guided pulsed radiofrequency of suprascapular nerve reduces pain intensity for at least 6 months, accompanied by improvement of motor function and higher levels of patients... satisfaction. Therefore, this technique represents a valid analgesic approach to chronic shoulder pain.</p></div>","PeriodicalId":32356,"journal":{"name":"Brazilian Journal of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0104001421003341/pdfft?md5=3f0e154166b9ba77377cdc5033e89771&pid=1-s2.0-S0104001421003341-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39455170","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}

{"title":"How would a completely homogeneous malignant hyperthermia susceptible sample be?","authors":"Pamela Vieira de Andrade,&nbsp;Lívia Maria Valim,&nbsp;Joilson Moura Santos,&nbsp;Isac de Castro,&nbsp;José Luiz Gomes do Amaral,&nbsp;Helga Cristina Almeida da Silva","doi":"10.1016/j.bjane.2023.10.001","DOIUrl":"10.1016/j.bjane.2023.10.001","url":null,"abstract":"","PeriodicalId":32356,"journal":{"name":"Brazilian Journal of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0104001423001136/pdfft?md5=f04858218ed28fa94c01b250ec3e16a4&pid=1-s2.0-S0104001423001136-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41221747","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}

{"title":"Fatigue in anesthesia workers","authors":"Nancy Redfern ,&nbsp;Federico Bilotta","doi":"10.1016/j.bjane.2023.09.001","DOIUrl":"10.1016/j.bjane.2023.09.001","url":null,"abstract":"","PeriodicalId":32356,"journal":{"name":"Brazilian Journal of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0104001423000969/pdfft?md5=0230aeade7d1c37bb5fd5fa5433109ae&pid=1-s2.0-S0104001423000969-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10241371","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}