Navegando por Palavras-chave "Anestesia geral"
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- ItemSomente MetadadadosAnestesia geral nos transplantes renais realizados entre janeiro de 1983 e julho de 1987, na Escola Paulista de Medicina(Universidade Federal de São Paulo (UNIFESP), 1992) Munechika, Masashi [UNIFESP]; Tardelli, Maria Angela [UNIFESP]
- ItemAcesso aberto (Open Access)Efeito do modo ventilatório na cinética do desflurano(Universidade Federal de São Paulo (UNIFESP), 2017-09-28) Fabri, Daniel Capucci [UNIFESP]; Oliveira, Itamar Souza de [UNIFESP]; Tardelli, Maria Angela [UNIFESP]; http://lattes.cnpq.br/9044839480768622; http://lattes.cnpq.br/0568989035666759; http://lattes.cnpq.br/1102159872135588; Universidade Federal de São Paulo (UNIFESP)This study analyzed the pharmacokinetics of desflurane inhalatory anesthetic under pressure controlled ventilation (PCV) and volume controlled ventilation (VCV). The aim of this study was to determine if ventilatory modes (PCV and VCV) interfere with the wash in and wash out of desflurane, since PCV could improve gas exchange, optimizing ventilation perfusion ratio. To achieve this purpose, 33 adults ASA I physical status, were randomly assigned to general anesthesia, with induction of propofol, fentanyl and rocuronium as a neuromuscular blocker. The anesthesia was maintained with a continuous infusion pump of propofol and remifentanil. All patients were ventilated with air and oxygen at 60%, with a flow rate of 6 L/min, in a non-rebreathing system. VCV and PCV were performed with VT of 8 mL/kg, peak inspiratory pressure of 30 cmH2O, inspiratory and expiratory time ratio was 1:2, without PEEP. Respiratory rate was adjusted to maintain EtCO2 between 25 and 40 mmHg. After induction, desflurane at 6% concentration was given for 30 minutes. The patients were ventilated with both PCV and VCV, initiating with one of two modes chosen at random. Desflurane kinetics were determined by recording Fi and FA every 10 seconds in the first minute and at times 5, 10, 15, 20, 25 and 30 minutes. After this period, the vaporizer was turned off and the FA values were recorded at this time and also every 30 seconds on the first 5 minutes. The 33 patients had a mean age of 38.4 ± 6.8 years, mean body weight of 63.3 ± 8.4kg and mean height of 1.60 ± 0.1m. During the induction of anesthesia, uptake and elimination of desflurane did not change the heart rate and mean arterial pressure in both VCV and PCV. During the capture and elimination of desflurane, the VM parameters and BIS readings did not present a statistically significant difference between the two groups. At the elimination of desflurane, there was a statistical difference in the EtCO2 values when the vaporizer was turned off. During wash in of desflurane there was no significant difference in the FA/Fi. During the wash out of this anesthetic, there were statistical differences in two moments, at the first and third minutes. In the conditions of this study, desflurane uptake was similar in both ventilatory modes, however its elimination presented a difference in two moments.
- ItemAcesso aberto (Open Access)Estudo clínico prospectivo aleatório sobre o uso da máscara laríngea Supreme® em pacientes submetidos a anestesia geral(Sociedade Brasileira de Anestesiologia, 2013-12-01) Barreira, Sara Rocha [UNIFESP]; Souza, Camila Machado [UNIFESP]; Fabrizia, Fernanda [UNIFESP]; Azevedo, Ana Bárbara G. [UNIFESP]; Lelis, Talitha G. [UNIFESP]; Lutke, Claudia [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)BACKGROUND AND OBJECTIVES: Supraglottic airway devices are increasingly used as an option to tracheal intubation for elective procedures of varying complexity. The aim of this study was to prospectively evaluate the clinical use of the laryngeal mask airway Supreme® (LMAS) in patients undergoing elective breast surgery and compare it with endotracheal tube (ETT). METHODS: Sixty patients undergoing breast procedures under general anesthesia were randomly divided into two groups according to the device used (LMAS or ETT). Time of insertion, number of insertion attempts, hemodynamic response to insertion, presence of blood on the device used; and incidence of sore throat, dysphagia, nausea and vomiting were assessed postoperatively. RESULTS: There was no difference between groups regarding time of insertion, number of attempts for successful insertion, and presence of blood on the device. Heart rate and blood pressure after insertion were higher in ETT group. Incidence of sore throat and dysphagia was also higher in ETT group after two hours in the postoperative period. There was no difference regarding incidence and severity of complications evaluated after six hours postoperatively. CONCLUSIONS: The use of the LMAS technique to access airway during general anesthesia for elective breast surgery is as safe and effective as tracheal intubation, with the advantage of promoting smaller hemodynamic response during its management and lower incidence of sore throat and dysphagia in the first hours after surgery.
- ItemAcesso aberto (Open Access)Intubação orotraqueal e disfunção temporomandibular: estudo longitudinal controlado(Elsevier Science Inc, 2016) Battistella, Claudia Branco [UNIFESP]; Machado, Flavia Ribeiro [UNIFESP]; Juliano, Yara; Guimaraes, Antonio Sergio [UNIFESP]; Tanaka, Cassia Emi [UNIFESP]; de Souza Garbim, Cristina Tala [UNIFESP]; da Rocha Fonseca, Paula de Maria [UNIFESP]; Sanches, Monique Lalue [UNIFESP]Background and objectives: To determine the incidence of signs and symptoms of temporomandibular disorder in elective surgery patients who underwent orotracheal intubation. Methods: This was a longitudinal controlled study with two groups. The study group included patients who underwent orotracheal intubation and a control group. We used the American Academy of Orofacial Pain questionnaire to assess the temporomandibular disorder signs and symptoms one-day postoperatively (T1), and the patients' baseline status prior to surgery (TO) was also recorded. The same questionnaire was used after three months (T2). The mouth opening amplitude was measured at T1 and T2. We considered a p value of less than 0.05 to be significant. Results: We included 71 patients, with 38 in the study group and 33 in the control. There was no significant difference between the groups in age (study group: 66 [52.5-72]; control group: 54 [47-68]; p=0.117) or in their belonging to the female gender (study group: 57.9%; control group: 63.6%; p = 0.621). At T1, there were no statistically significant differences between the groups in the incidence of mouth opening limitation (study group: 23.7% vs. control group: 18.2%; p=0.570) or in the mouth opening amplitude (study group: 45 [40-47] vs. control group: 46 [40-51]; p = 0.278). At T2 we obtained similar findings. There was no significant difference in the affirmative response to all the individual questions in the American Academy of Orofacial Pain questionnaire. Conclusions: In our population, the incidence of signs and symptoms of temporomandibular disorder of muscular origin was not different between the groups. (C) 2014 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.