Brazilian Journal of Anesthesiology最新文献

{"title":"Influence of exogenous opioids on the acute inflammatory response in the perioperative period of oncological surgery: a clinical study","authors":"Odirlei Jo.·o Titon,&nbsp;Joana Perotta Titon,&nbsp;Jana.ína Carla da Silva,&nbsp;Mariane Okamoto Ferreira,&nbsp;Matheus Ricrado Garbim,&nbsp;Daniel Rech,&nbsp;Jano..rio Athanazio de Souza,&nbsp;Carolina Panis","doi":"10.1016/j.bjane.2021.09.011","DOIUrl":"10.1016/j.bjane.2021.09.011","url":null,"abstract":"<div><h3>Background</h3><p>Recently, opioids have been related to trigger changes in cytokine release and tumor angiogenesis processes, influencing tumor growth, metastasis, and recurrence.</p></div><div><h3>Methods</h3><p>This is a prospective randomized clinical study to test whether if exogenous opioids used in the anesthesia during cancer surgery can affect the systemic inflammatory and immunological patterns. Patients were randomly allocated to the OP (opioid...inclusive) or OF (opioid-free) anesthesia group. A total of 45 patients were selected, being carriers of prostate, stomach, pancreas, bile ducts, breast, colon, lung, uterus, kidneys, or retroperitoneum tumors. Plasma levels of IL-4, IL-12, IL-17A, and TNF-.., and their oxidative stress profile before and after surgery were evaluated in both groups. In vitro tests were performed by using healthy donor blood incubated with each isolated drug used in patients... anesthesia for 1...hour, the same cytokines were measured in plasma.</p></div><div><h3>Results</h3><p>There was a significant reduction in lipid peroxidation in both groups. Patients from OF group had a significant consumption of IL-12 in the perioperative period. The other cytokines evaluated did not vary. It was also observed a significant correlation between IL-12 and TNF-.. levels in the OF-post group. Except for atracurium, all tested drugs led to a reduction in IL-12 levels.</p></div><div><h3>Conclusions</h3><p>This study demonstrated that there is a reduction of IL-12 in the OF-post patients, suggesting acute consumption and that this seems to be a general mechanism of anesthetic drugs, as demonstrated <em>in vitro</em>. Also, these findings bring us to reflect if IL-12 changes may influence the disease progression and recurrence.</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/S0104001421003626/pdfft?md5=4ee6dde15c9767400f4c7e47f9ccc6e2&pid=1-s2.0-S0104001421003626-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39500473","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":"Exploring the analgesic effects of pregabalin for post-chikungunya arthralgia: a comparative double-blind study","authors":"Rodrigo Souza Rodrigues ,&nbsp;Rioko Kimiko Sakata ,&nbsp;William Vinicius da Silva ,&nbsp;Camila Roberta Raimundo ,&nbsp;Camila Fecury Cerqueira ,&nbsp;Plinio da Cunha Leal","doi":"10.1016/j.bjane.2023.09.002","DOIUrl":"10.1016/j.bjane.2023.09.002","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/S0104001423000970/pdfft?md5=8e42808e48e09897aaaa3669da6887d5&pid=1-s2.0-S0104001423000970-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10286450","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":"Platypnea-orthodeoxia syndrome: an intriguing perioperative hypoxemia case report","authors":"Eunice Mendes,&nbsp;Mariana Vaz Gomes,&nbsp;Cl..udia Carreira,&nbsp;N.ídia Gon..alves,&nbsp;Ana Filipa Ribeiro","doi":"10.1016/j.bjane.2021.05.015","DOIUrl":"10.1016/j.bjane.2021.05.015","url":null,"abstract":"<div><p>Platypnea-orthodeoxia syndrome (POS) is a rare condition of positional hypoxemia and dyspnea. The following is a case of hypoxemia for no obvious reason in the perioperative scenario. A 70-year-old male patient was submitted to a radical prostatectomy. On several occasions after anesthetic induction, peripheral oxygen saturation decreased without any understandable cause. In the postanesthesia care unit, severe hypoxemia occurred in the upright position, oddly correcting with recumbency. An echocardiography showed a right-to-left intracardiac shunt through a patent <em>foramen ovale</em> with no pulmonary hypertension, establishing POS. Achieving this diagnosis required a broad workup with a high degree of suspicion.</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/S0104001421002384/pdfft?md5=ede0b66d10cec1272a138b01617de2ec&pid=1-s2.0-S0104001421002384-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39018514","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":"Continuous erector spinae plane block for analgesia and better pulmonary functions in patients with multiple rib fractures: a prospective descriptive study","authors":"Rashmi Syal,&nbsp;Sadik Mohammed,&nbsp;Rakesh Kumar,&nbsp;Nidhi Jain,&nbsp;Pradeep Bhatia","doi":"10.1016/j.bjane.2021.09.010","DOIUrl":"10.1016/j.bjane.2021.09.010","url":null,"abstract":"<div><h3>Background</h3><p>The present study explored the role of continuous erector spinae plane (ESP) block for analgesia as well as its impact on pulmonary functions in patients with multiple rib fractures.</p></div><div><h3>Methods</h3><p>Ten patients with multiple rib fractures were enrolled after getting informed and written consent. Ultrasound-guided ESP block was performed at the level midway between the fractured ribs followed by the insertion of the catheter. Pre- and post-block VAS score, hemodynamics, respiratory rate (RR), peripheral oxygen saturation (SpO₂), inspiratory capacity (IC), blood gases (PaO₂ and PCO₂), and complications were compared.</p></div><div><h3>Results</h3><p>Pain scores at rest as well as on movement showed a significant reduction from 5.9 and 7.5 pre block to 1.6 and 2.5 respectively at 96.ßhours (<em>p</em>.ß&lt;.ß0.0001). Similarly, RR, SpO₂, IC, and PaO₂ were significantly better after the block placement (<em>p</em>.ß&lt;.ß0.001).</p></div><div><h3>Conclusion</h3><p>Continuous ESP block provide adequate analgesia with better respiratory functions in patients with multiple rib fractures.</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/S0104001421003614/pdfft?md5=ff56d4a2702ff9f21753b9add677f53a&pid=1-s2.0-S0104001421003614-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39500475","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":"Comparison of the effect of adding midazolam versus fentanyl to intrathecal levobupivacaine in patients undergoing cesarean section: double-blind, randomized clinical trial","authors":"Marwa Mahmoud Abdelrady,&nbsp;Golnar Mohammed Fathy,&nbsp;Mohamed Abdelrady Mohamed Abdallah,&nbsp;Wesam Nashat Ali","doi":"10.1016/j.bjane.2022.06.001","DOIUrl":"10.1016/j.bjane.2022.06.001","url":null,"abstract":"<div><h3>Background</h3><p>Many adjuvants are added to prolong the effects of spinal analgesia. We investigated the postoperative analgesic efficacy of the addition of midazolam or fentanyl to intrathecal levobupivacaine in women undergoing cesarean delivery.</p></div><div><h3>Methods</h3><p>Eighty patients were randomly assigned to two groups (n = 40). Group M received 10 mg of 0.5% levobupivacaine plus 2 mg of midazolam. Group F received 10 mg of 0.5% levobupivacaine plus 25 μg of fentanyl. Assessments included motor and sensory block, APGAR score, time to first request for analgesia, postoperative pain score, total consumption of rescue analgesics, and adverse effects.</p></div><div><h3>Results</h3><p>Sensory blockade was prolonged in Group M compared with Group F (215.58 ± 27.94 vs. 199.43 ± 19.77 min; <em>p</em> = 0.004), with no differences in other characteristics of the spinal block in intraoperative hemodynamics or APGAR score. The mean time to first request for rescue analgesia was longer in Group M (351.45 ± 11.05 min) than in Group F (268.83 ± 10.35 min; <em>p</em> = 0.000). The median total consumption of rescue analgesics in the first 24 hours postoperatively was 30 mg in Group M vs. 60 mg in Group F (<em>p</em> = 0.003). The median Visual Analog Scale (VAS) scores were lower in Group Ethan in Group F from the 8^th to the 12^th hour postoperatively, with no differences between the groups at other time points. The incidence of adverse effects was higher in Group F than in Group M.</p></div><div><h3>Conclusion</h3><p>Intrathecal midazolam (2 mg) was superior to intrathecal fentanyl (25 μg) in increasing the duration of the sensory blockade and postoperative analgesia with lower postoperative pain scores and decreasing the incidence of adverse effects.</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/S0104001422000720/pdfft?md5=2a9ed24d91881925c7c1ec70234bc40d&pid=1-s2.0-S0104001422000720-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48537335","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":"Staff","authors":"","doi":"10.1016/S0104-0014(24)00009-5","DOIUrl":"https://doi.org/10.1016/S0104-0014(24)00009-5","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/S0104001424000095/pdfft?md5=18d9714e470e294f1e4bab957d5e186f&pid=1-s2.0-S0104001424000095-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139731557","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":"Palonosetron versus ondansetron for prophylaxis of postoperative nausea and vomiting in laparoscopic cholecystectomy: a non-inferiority randomized controlled trial","authors":"Francisco Jos.. Chiaradia Davolos,&nbsp;Norma S. Modolo,&nbsp;Leandro G. Braz,&nbsp;Paulo do Nascimento Junior","doi":"10.1016/j.bjane.2021.06.020","DOIUrl":"10.1016/j.bjane.2021.06.020","url":null,"abstract":"<div><h3>Background</h3><p>We tested the hypothesis that, within the margin of 15% of risk difference, palonosetron is not inferior to ondansetron in reducing the incidence of postoperative nausea and vomiting (PONV) in laparoscopic cholecystectomy.</p></div><div><h3>Methods</h3><p>We conducted a double-blind, non-inferiority, randomized, controlled trial of 212 patients aged 18 to 65 years undergoing laparoscopic cholecystectomy under general anesthesia in two secondary care hospitals. Patients were randomly assigned to receive either palonosetron (0.075.ßmg) or ondansetron (8.ßmg) intravenously at induction of anesthesia. Ondansetron (8.ßmg) was also administered 8 and 16.ßhours postoperatively. All anesthetic and surgical procedures were standardized. Patients were evaluated for 24.ßhours postoperatively for the occurrence of PONV.</p></div><div><h3>Results</h3><p>A high incidence of PONV was observed at 2...6.ßhours postoperatively, with a rate of 36.8% (95% confidence interval [CI] 28.2...46.3) in the palonosetron group, as compared to 43.4% (95% CI 34.4...52.9) in the ondansetron group. The risk difference (95% CI) between palonosetron and ondansetron for PONV was 0 (-10.9 to 10.9) at 0...2.ßhours, -6.6 (-19.4 to 6.5) at 2...6.ßhours, -0.9 (-11.0 to 9.2) at 6...12.ßhours, and -2.8 (-9.6 to 3.6) at 12...24.ßhours. There was no statistically significant difference between the palonosetron and ondansetron groups in the use of rescue medication (dimenhydrinate). There were no adverse events associated with the medications under study.</p></div><div><h3>Conclusion</h3><p>Palonosetron is not inferior to ondansetron in patients at risk of PONV undergoing laparoscopic cholecystectomy, providing a good option for PONV prophylaxis, as it can be administered in a single dose.</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/S0104001421002761/pdfft?md5=c2516a80cab48c5ed2f369e28bc8dafe&pid=1-s2.0-S0104001421002761-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39199035","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":"Comparison of palonosetron and ondansetron in preventing postoperative nausea and vomiting in renal transplantation recipients: a randomized clinical trial","authors":"Tanvi Bhargava ,&nbsp;Sandeep Sahu ,&nbsp;Tapas Kumar Singh ,&nbsp;Divya Srivastava ,&nbsp;Abhishek Kumar ,&nbsp;Danish Mohammad ,&nbsp;Aneesh Srivastava","doi":"10.1016/j.bjane.2021.07.027","DOIUrl":"10.1016/j.bjane.2021.07.027","url":null,"abstract":"<div><h3>Background</h3><p>End-stage renal diseases patients have a high risk of postoperative nausea and vomiting (PONV), which is multifactorial and need acute attention after renal transplantation for a successful outcome in term of an uneventful postoperative period. The study was done to compare the efficacy of palonosetron and ondansetron in preventing early and late-onset PONV in live donor renal transplantation recipients (LDRT).</p></div><div><h3>Methods</h3><p>The prospective randomized double-blinded study was done on 112 consecutive patients planned for live donor renal transplantation. Patients of both sexes in the age group of 18...60 years were randomly divided into two groups: Group O (Ondansetron) and Group P (Palonosetron) with 56 patients in each group by computer-generated randomization. The study drug was administered intravenously (IV) slowly over 30.ßseconds, one hour before extubation. Postoperatively, the patients were accessed for PONV at 6, 24, and 72.ßhours using the Visual Analogue Scale (VAS) nausea score and PONV intensity scale.</p></div><div><h3>Results</h3><p>The incidence of PONV in the study was found to be 30.35%. There was significant difference in incidence of PONV between Group P and Group O at 6.ßhours (12.5% vs. 32.1%, <em>p</em>.ß=.ß0.013) and 72.ßhours (1.8% vs. 33.9%, <em>p</em>.ß&lt;.ß0.001), but insignificant difference at 24.ßhours (1.8% vs. 10.7%, <em>p</em>.ß=.ß0.113). VAS-nausea score was significantly lower in Group P as compared to Group O at a time point of 24.ßhours (45.54.ß...ß12.64 vs. 51.96.ß...ß14.70, <em>p</em>.ß=.ß0.015) and 72.ßhours (39.11.ß...ß10.32 vs. 45.7.ß...ß15.12, <em>p</em>.ß=.ß0.015).</p></div><div><h3>Conclusion</h3><p>Palonosetron is clinically superior to ondansetron in preventing early and delayed onset postoperative nausea and vomiting in live-related renal transplant recipients.</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/S010400142100316X/pdfft?md5=72426e87a387fa71affb8ae7637010e0&pid=1-s2.0-S010400142100316X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39327064","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 pericapsular nerve group and obturator nerve phenol neurolysis for refractory inpatient hip cancer metastasis pain: a case report","authors":"Marcio V. Pimenta,&nbsp;Amanda T. Nakamura,&nbsp;Hazem A. Ashmawi,&nbsp;Joaquim E. Vieira,&nbsp;Hermann dos Santos Fernandes","doi":"10.1016/j.bjane.2021.02.037","DOIUrl":"10.1016/j.bjane.2021.02.037","url":null,"abstract":"<div><h3>Introduction</h3><p>Bone cancer metastasis may produce severe and refractory pain. It is often difficult to manage with systemic analgesics. Chemical neurolysis may be an effective alternative in terminally ill patients.</p></div><div><h3>Case report</h3><p>Female terminally ill patient with hip metastasis of gastric cancer in severe pain. Neurolytic ultrasound-guided blocks of the pericapsular nerve group and obturator nerve were performed with 5% phenol. This led to satisfactory pain relief for 10 days, until the patient's death.</p></div><div><h3>Discussion</h3><p>This approach may be effective and safe as an analgesic option for refractory hip pain due to metastasis or pathologic fracture in terminally ill patients.</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/S0104001421001056/pdfft?md5=252a5f98567c462f4fa2d0ca7360180a&pid=1-s2.0-S0104001421001056-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25517020","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":"Expert recommendations for managing difficult airways in adults and children: insights from the Brazilian Society of Anesthesiology (SBA)","authors":"André P. Schmidt","doi":"10.1016/j.bjane.2024.844479","DOIUrl":"10.1016/j.bjane.2024.844479","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/S0104001424000010/pdfft?md5=35151d51856a17f4b1bf9f67b1f17f2a&pid=1-s2.0-S0104001424000010-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139572403","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}