Brazilian journal of anesthesiology (Elsevier)最新文献

{"title":"Health-related quality of life after ketamine or esketamine treatment for chronic pain: a review of randomized controlled trials.","authors":"Alexandre Vieira Figueiredo, Stefania Lacerda Garcia, Isabel Lima Araújo, Liliane Else Falcão Lins Kusterer, Lucas de Castro Quarantini","doi":"10.1016/j.bjane.2026.844838","DOIUrl":"https://doi.org/10.1016/j.bjane.2026.844838","url":null,"abstract":"<p><p>Chronic pain, lasting over three months, significantly impairs patients' health-related quality of life (HRQoL) due to its impact on physical, psychological, and social well being. Given the limitations and risks associated with opioid use, there is growing interest in alternative analgesics. Ketamine and its S-enantiomer, esketamine, as NMDA receptor antagonists, are becoming important treatments for central sensitization. However, evidence regarding their direct positive effect on HRQoL in chronic pain patients remains sparse. This systematic review was conducted following Cochrane standards and the PRISMA framework. The search included only randomized clinical trials (RCTs) in adult patients focusing on HRQoL measures following ketamine or esketamine treatment for chronic pain. Methodological bias was assessed using the Cochrane RoB2 tool. Results: The systematic search yielded five eligible RCTs involving 405 patients with diverse chronic pain conditions. The studies were mixed and heterogeneous due to various routes of administration and different HRQoL instruments. Two studies reported a significant improvement in HRQoL (for central pain/low back pain); two found no difference (oncological/neuropathic pain); and one reported a worsening of HRQoL in palliative care cancer patients, linked to adverse events. Conclusion: The significant heterogeneity across the selected RCTs (pain types, regimens, routes, and HRQoL tools) makes meta-analytic synthesis unfeasible. The results on the impact of ketamine and esketamine on HRQoL in chronic pain patients are inconsistent, ranging from improvement to worsening. Future research must prioritize HRQoL as a primary outcome and standardize protocols to establish stronger, generalizable evidence.</p>","PeriodicalId":72456,"journal":{"name":"Brazilian journal of anesthesiology (Elsevier)","volume":" ","pages":"844838"},"PeriodicalIF":1.9,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149129437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementing patient blood management in a Brazilian public women's hospital: a pre-post implementation study.","authors":"Lorena Costa Corrêa, Nataly Andrade Alves de Paiva, Ana Carolina Dias Almeida, Ulisses Montarroyos, Cesar de Almeida-Neto","doi":"10.1016/j.bjane.2026.844839","DOIUrl":"10.1016/j.bjane.2026.844839","url":null,"abstract":"<p><strong>Background: </strong>Patient Blood Management (PBM) is a personalized, evidence-based, and cost-effective approach. In surgery, the objective is to detect and treat anemia, minimal perioperative blood loss, and promote restrictive transfusion practices. It improves clinical outcomes, patient engagement, and reduces costs. We evaluated the effect of PBM on preoperative management of hysterectomies for uterine fibroids and Postpartum Hemorrhage (PPH) in a Brazilian public hospital.</p><p><strong>Methods: </strong>In this pre-post intervention study, a PBM outpatient clinic was established, a Hemorrhage Management Protocol (HMP) was implemented, and low-cost educational initiatives were used. The study period was from 2016 to 2023.</p><p><strong>Results: </strong>Overall, 36 patients were included; twenty-two returned to a 30-day appointment and had a mean preoperative hemoglobin increase of 2.48 g.dL^-1 (95% Confidence Interval: 1.8-3.16; p < 0.001). Twenty-five underwent surgery. No preoperative prophylactic transfusions were administered. Transfusions of Packed Red Blood Cells (PRBC) had a mean reduction of -77.4 (p = 0.253) before January 2020 and maintained its behavior until 2023 (1.9; p = 0.686). The HMP was activated in five cases for PPH and 23 units of PRBCs and 11 units of Fresh Frozen Plasma (FFP) were transfused (mean of 4.6 PRBC units and 2.2 FFP units per patient). Additionally, 546 healthcare professionals accessed the PBM guidelines via instant messaging during the study period.</p><p><strong>Conclusion: </strong>The implementation of PBM by leveraging existing resources led to appropriate treatment of iron deficiency anemia before hysterectomies; systematic use of hemocomponents for PPH and sustained reduction on PRBC transfusions.</p>","PeriodicalId":72456,"journal":{"name":"Brazilian journal of anesthesiology (Elsevier)","volume":" ","pages":"844839"},"PeriodicalIF":1.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to the Letter to the Editor: \"Impact of mannitol on intracranial pressure assessed by optic nerve sheath ultrasonography during video-laparoscopic prostatectomy: a randomized clinical trial\".","authors":"George Pereira Barreto, Wallace Andrino da Silva","doi":"10.1016/j.bjane.2026.844794","DOIUrl":"10.1016/j.bjane.2026.844794","url":null,"abstract":"","PeriodicalId":72456,"journal":{"name":"Brazilian journal of anesthesiology (Elsevier)","volume":" ","pages":"844794"},"PeriodicalIF":1.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13487293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148474403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pillar Zero: a temporal anchor for patient-centered Patient Blood Management (PBM).","authors":"Flávio Takaoka, Maria José Carvalho Carmona, Renato Carneiro de Freitas Chaves, Paulo Roberto Silva Garcez Dos Santos","doi":"10.1016/j.bjane.2026.844801","DOIUrl":"10.1016/j.bjane.2026.844801","url":null,"abstract":"","PeriodicalId":72456,"journal":{"name":"Brazilian journal of anesthesiology (Elsevier)","volume":" ","pages":"844801"},"PeriodicalIF":1.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13487292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148564001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of GLP-1 agonists in perioperative care: a suspension dilemma.","authors":"Maisa Ribeiro Araújo, Marcelo Fouad Rabahi, Fabiana Aparecida Penachi Bosco Ferreira","doi":"10.1016/j.bjane.2025.844668","DOIUrl":"10.1016/j.bjane.2025.844668","url":null,"abstract":"","PeriodicalId":72456,"journal":{"name":"Brazilian journal of anesthesiology (Elsevier)","volume":" ","pages":"844668"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12357290/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144777046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"WITHDRAWN: Prophylactic use of platelet-rich plasma for post-spinal low back pain following gynecological surgery: a randomized clinical trial.","authors":"Ghada Mohammad Abo Elfadl, Abdelraheem Mahmoud Elawamy, Abualauon Mohamed Abedalmohsen, Azza Abo Elfadl El Sayed, Mustafa Bahloul, Eman Ahmed Ismail","doi":"10.1016/j.bjane.2021.09.009","DOIUrl":"10.1016/j.bjane.2021.09.009","url":null,"abstract":"<p><strong>Background: </strong>Post-spinal back pain is suggested to occur as a result of a localized inflammatory response that is often associated with some degree of muscle spasm. We aimed to evaluate the effect of platelet-rich plasma (PRP) in reducing the incidence of post-spinal back pain.</p><p><strong>Methods: </strong>One hundred patients were randomly enrolled and scheduled for elective gynecological surgery under spinal anesthesia. After the subarachnoid block, group A (placebo) received 2 mL of sodium chloride 0.9% injected into the track of spinal needle during its withdrawal (2 mm after outward withdrawal in muscles and subcutaneous tissues). While patients in group B (PRP); received 2 ml of PRP injected into the track of the spinal needle during its withdrawal. The primary outcome was the number of patients who developed post-spinal low back pain within the first week following the subarachnoid block. Secondary outcomes included the time of the first analgesic request and total meperidine consumption during the first 24 h postoperatively.</p><p><strong>Results: </strong>Fifteen patients in the PRP group developed low back pain during the first week following subarachnoid block compared to 26 patients in the placebo group (p = 0.037). There was a significant decrease in the mean meperidine consumption during first 24 h postoperatively in PRP group (174 ± 14 mg) compared to placebo group (210 ± 22 mg) (p < 0.0001). Also, the first analgesic request was significantly delayed in PRP group (243 ± 21 min.) compared to placebo group (185 ± 31 min.) (p < 0.0001).</p><p><strong>Conclusion: </strong>This study demonstrated the positive effects of platelet-rich plasma on the prevention of post-spinal backache.</p>","PeriodicalId":72456,"journal":{"name":"Brazilian journal of anesthesiology (Elsevier)","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2021-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39500474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"WITHDRAWN: Preoperative duloxetine to prevent postoperative shoulder pain after gynecologic laparoscopy: a randomized controlled trial.","authors":"Ghada Mohammad Abo Elfadl, Ayman Mamdouh Osman, Mina Fayez Ghalyoom, Nawal Abdel-Aziz Gad Al-Rab, Mustafa Bahloul","doi":"10.1016/j.bjane.2021.07.035","DOIUrl":"10.1016/j.bjane.2021.07.035","url":null,"abstract":"<p><p>This article has been withdrawn at the request of the editor. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal.</p>","PeriodicalId":72456,"journal":{"name":"Brazilian journal of anesthesiology (Elsevier)","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2021-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10773488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"WITHDRAWN: Recommendations for Cardiopulmonary Resuscitation (CPR) of patients with suspected or confirmed COVID-19.","authors":"Sérgio Timerman, Hélio Penna Guimarães, Roseny Dos Reis Rodrigues, Thiago Domingos Corrêa, Daniel Ujakow Correa Schubert, Ana Paula Freitas, Álvaro Rea Neto, Thatiane Facholi Polastri, Matheus Fachini Vane, Thomaz Bittencourt Couto, Antonio Carlos Aguiar Brandão, Natali Schiavo Giannetti, Maria José Carvalho Carmona, Thiago Timerman, Ludhmila Abrahão Hajjar, Fernando Bacal, Marcelo Queiroga","doi":"10.1016/j.bjane.2020.06.007","DOIUrl":"10.1016/j.bjane.2020.06.007","url":null,"abstract":"<p><p>The care for patients suffering from cardiopulmonary arrest in a context of a COVID-19 pandemic has particularities that should be highlighted. The following recommendations from the Brazilian Association of Emergency Medicine (ABRAMEDE), the Brazilian Society of Cardiology (SBC) and the Brazilian Association of Intensive Medicine (AMIB) and the Brazilian Society of Anesthesiology (SBA), associations and societies official representatives of specialties affiliated to the Brazilian Medical Association (AMB), aim to guide the various assistant teams, in a context of little solid evidence, maximizing the protection of teams and patients. It is essential to wear full Personal Protective Equipment (PPE) for aerosols during the care of Cardiopulmonary Resuscitation (CPR) and it is imperative to consider and treat the potential causes in these patients, especially hypoxia and arrhythmias caused by changes in the QT interval or myocarditis. The installation of an advanced invasive airway must be obtained early and the use of High Efficiency Particulate Arrestance (HEPA) filters at the interface with the valve bag is mandatory; situations of occurrence of CPR during mechanical ventilation and in a prone position demand peculiarities that are different from the conventional CPR pattern. Faced with the care of a patient diagnosed or suspected of COVID-19, the care follows the national and international protocols and guidelines 2015 ILCOR (International Alliance of Resuscitation Committees), AHA 2019 Guidelines (American Heart Association) and the Update of the Cardiopulmonary Resuscitation and Emergency Care Directive of the Brazilian Society of Cardiology 2019.</p>","PeriodicalId":72456,"journal":{"name":"Brazilian journal of anesthesiology (Elsevier)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7293473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38302110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"There is high incidence of skin cells in the first and third drops of cerebrospinal fluid in spinal anesthesia.","authors":"Mário Humberto Curado Taveira,&nbsp;Antonio Fernando Carneiro,&nbsp;Gustavo Gabriel Rassi,&nbsp;Marise Amaral Rebouças Moreira,&nbsp;Simone de Andrade Curado Taveira","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background and objectives: </strong>Skin fragments during lumbar punctures may develop intraspinal epidermoid tumors. The aim of this study was to determine the incidence of epithelial cells that reflow along with the fi rst and third drops of CSF of patients undergoing spinal anesthesia.</p><p><strong>Methods: </strong>Samples of the fi rst and third drops of cerebrospinal fluid were collected from 39 adult patients undergoing spinal anesthesia with a 25G Quincke needle. Four microscope slides were prepared: one for the fi rst drop, one for third drop, one for the needle, and one with a drop of saline for control. A pathologist examined the slides randomly.</p><p><strong>Results: </strong>Squamous epithelial cells were identified in 35 (89.7%) samples from the fi rst drop, 34 (87.2%) from the third drop, and 24 (61.5%) from spinal needle. The third drop showed a mean number of cells larger than the fi rst drop (p = 0.046). Nucleated epithelial cells were found in a sample of the fi rst drop (2.56%), in four samples of third drop (10.25%), and in one spinal needle (2.56%). Third drop showed a mean number of nucleated cells higher than fi rst drop with no statistical difference (p = 0.257).</p><p><strong>Conclusions: </strong>High percentage of epithelial cells was found in the fi rst (89.7%) and third (87.2%) drops of CSF reflow and in used needles (61.5%). Skin cells were found even using small gauge disposable needles with well-adapted mandrel.</p>","PeriodicalId":72456,"journal":{"name":"Brazilian journal of anesthesiology (Elsevier)","volume":"63 2","pages":"193-6"},"PeriodicalIF":0.0,"publicationDate":"2013-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32237017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}