Navegando por Palavras-chave "Procedimentos cirúrgicos cardiovasculares"

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    Comparison study of two different patient-controlled anesthesia regiments after cardiac surgery
    (Sociedade Brasileira de Cirurgia Cardiovascular, 2010-03-01) Mota, Fabiane de Almeida [UNIFESP]; Marcolan, Joao Fernando [UNIFESP]; Pereira, Mara Helena Corso; Milanez, Adriano Márcio de Melo; Dallan, Luis Alberto Oliveira; Diccini, Solange [UNIFESP]; Clinics Hospital; Universidade Federal de São Paulo (UNIFESP); Heart Institute; Heart Institute Heart Surgical Diseases Group
    INTRODUCTION: Acute and severe pain is frequent in patients who undergo cardiothoracic surgery. Patient controlled analgesia (PCA) can be used to manage postoperative pain. OBJECTIVE: To compare analgesia of morphine PCA alone (without continous infusion) with morphine PCA plus a continuous infusion on postoperative period after cardiac surgery and to evaluate pain scores, morphine consumption, number of demand, patient satisfaction and side effects. METHODS: Randomized trial was conducted to assess patients who underwent cardiac surgery receiving either morphine PCA alone or morphine PCA plus continous infusion. In the post operative period, PCA was started at extubation in both regiments according to randomization. Pain intensity, morphine consumption, number of demand, satisfaction and side effects were assessed at zero, six, twelve, eighteen, twenty four and thirty hours after patients' extubation. RESULTS: The study enrolled 100 patients. 50 patients received morphine PCA alone, (Group A) and 50 patients received morphine PCA plus a background infusion, (Group B). Group B patients had less demand, consumed more morphine and were more satisfied regarding analgesia. No statistical differences were shown between groups related to pain intensity, and side effects. CONCLUSIONS: Pain control was effective and similar in both groups. Morphine PCA alone seems to be better for postoperative pain manage in cardiac surgery, due to its less morphine expense with the same effectiveness.
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    Estudo angiográfico comparativo da artéria pulmonar no pré e pós-operatório de pacientes submetidos a operação de derivação cavopulmonar bidirecional
    (Sociedade Brasileira de Cirurgia Cardiovascular, 2001-12-01) Westphal, Fernando Luiz [UNIFESP]; Maluf, Miguel Angel [UNIFESP]; Silva, Célia Maria Camelo da [UNIFESP]; Carvalho, Antonio Carlos [UNIFESP]; Buffolo, Enio [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    INTRODUCTION: This study analyzed the alterations in the pulmonary artery (PA) diameters after bilateral cavopulmonary derivation (BCPD). MATERIAL AND METHODS: Eighteen patients submitted to BCPD in the period from March 1990 to January 1997, with available cineangiographic examinations in the pre- and postoperative period, were included. Measurements in right pulmonary artery (RPA) and left pulmonary artery (LPA) were performed at three sites: at the origin, immediately before bifurcation and at the beginning of the inferior lobe artery. The diameters of each site were indexed with respect to body surface or diameter of the aorta at the level of the diaphragm. Angiographic and oximetric data were submitted to statistical analysis. RESULTS: On analyzing absolute diameters, it was observed that most suffered a non-significant increase in the postoperative period, while the LPA diameter presented a decrease. The total indexes I e III presented a significant decrease in the postoperative period, this reduction of the total index II being non-significant. Analysis of the postoperative follow-up variable showed a significant reduction in the total indexes in patients with a postoperative follow-up less than 23,6 months. Presence of additional blood flow elicited an increase in RPA I and III indexes and a small reduction in the other. The PA measurements indexed with respect to the diameter of the aorta showed a behavior similar to those with respect to body surface. In the absence of collateral venous circulation (CVC) a significant increase in O2 saturation was observed. On the other hand, its presence elicited a non-significant increase during the period of observation.