Navegando por Palavras-chave "TÉCNICAS DE MEDIÇÃO"

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    Efeito analgésico residual do fentanil em pacientes submetidos a revascularização do miocárdio com circulação extracorpórea
    (Sociedade Brasileira de Anestesiologia, 2002-09-01) Issy, Adriana Machado [UNIFESP]; Espada, Eloísa Bonetti; Sakata, Rioko Kimiko [UNIFESP]; Lanchote, Vera Lúcia; Auler Júnior, José Otávio Costa; Santos, Silvia Regina C. J.; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP)
    BACKGROUND AND OBJECTIVES: In spite of the frequent use of high doses of fentanyl for major surgeries, the correlation of its residual plasma concentration to postoperative analgesia deserves further investigation. This study aimed at evaluating the residual analgesic effect of fentanyl in the first and second postoperative days of myocardial revascularization, as well as quantifying its concentration. METHODS: Participated in this study 11 patients undergoing myocardial revascularization with cardiopulmonary bypass under general anesthesia with 50 µg.kg-1 intravenous fentanyl. Analgesia was evaluated by a numeric verbal scale at moments zero (extubation), 70 min, 3, 5, 8 and 12 hours in the first day; and moments zero (24 h after extubation), 70 min, 3, 5, 8 and 12 hours in second post-operative day. Pain intensity to vigorous cough and respiratory physical therapy was evaluated. At every measurement, patients were asked about the need for analgesic complementation. Plasma samples were collected in moments zero (extubation), 70 min, 3, 5, 8 and 12 hours during the first and second postoperative days for fentanyl radioimmunoassay. RESULTS: Mean pain intensity varied from 1.9 to 3.7 in the first day and from 2.1 to 3.8 in the second postoperative day. Fentanyl plasma levels (> 1 ng/ml) evidenced its contribution to post-operative analgesia during the first postoperative day. CONCLUSIONS: In spite of the lack of correlation between residual fentanyl plasma concentration and pain intensity, patients referred only mild pain during the whole investigation period.
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    Estudo das pressões no interior dos balonetes de tubos traqueais
    (Sociedade Brasileira de Anestesiologia, 2003-12-01) Aranha, André Galante Alencar [UNIFESP]; Forte, Vicente [UNIFESP]; Perfeito, João Aléssio Juliano [UNIFESP]; Leao, Luiz Eduardo Villaca [UNIFESP]; Imaeda, Carlos Jogi [UNIFESP]; Juliano, Yara [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Sociedade Brasileira de Cirurgia Torácica
    BACKGROUND AND OBJECTIVES: Since controlling tracheal tube cuffs internal pressure is unusual and there is no detailed description in the literature on how to maintain it below 30 cmH2O without manometer, this study aimed at checking tracheal tube intra-cuff pressures in intensive care unit and operating room patients. A maneuver was tested to keep intra-cuff pressure below 30 cmH2O, but at minimum levels needed for ventilator cycling with no tidal volume leakage. METHODS: Tracheal tube intra-cuff pressures were evaluated in 50 intensive care unit intubated patients (Group I) and 72 intubated patients in the operating room (Group II). A maneuver was tested to obtain the minimum tracheal tube intra-cuff pressure to maintain adequate ventilation with no air leakage. Initial tracheal tube intra-cuff pressure (P1) was recorded using a gaged digital manometer (cmH2O) coupled to a 15-ml syringe. Oropharynx secretion was aspirated. With the investigator s external acoustic meatus positioned 10-20 cm apart from patient s mouth and cuff connected to the manometer, cuff was slowly deflated until a murmur sound was heard, determined by tidal volume leakage during the inspiratory period of artificial ventilation. At this moment, cuff was slowly inflated until murmur disappearance. Final intra-cuff pressure (P2) and the remaining air volume in the manometer syringe (V) were recorded. RESULTS: Mean P1 values in groups I and II were 85.3 and 56.2 cmH2O, respectively. Mean P2 values in groups I and II were 26.7 and 15.5 cmH2O, respectively. After the maneuver, standard deviation decreased from 56.3 to 8.2 in group I, and from 48 to 6.7 in group II. Maneuver has decreased cuff volume and pressure in 100% of group I patients, and in 97.3% of group II patients. CONCLUSIONS: Both groups had intra-cuff pressures higher than necessary to keep ventilator cycling with no tidal volume leakage. Maneuver to keep intra-cuff pressure below 30 cmH2O was simple and cheap.
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    Neuropatias periféricas dolorosas
    (Sociedade Brasileira de Anestesiologia, 2011-10-01) Kraychete, Durval Campos; Sakata, Rioko Kimiko [UNIFESP]; UFBA; Universidade Federal de São Paulo (UNIFESP)
    BACKGROUND AND OBJECTIVES: Painful neuropathies are common and often difficult to treat. The objective of this report was to review the subject to facilitate diagnosis and pain relief. CONTENTS: The classification, causes, type of fibers involved, manifestations, diagnosis, adjuvant tests, questionnaires used in the diagnosis, and treatment are described. CONCLUSIONS: The subject is very broad and involves several causes and treatments that often should be combined to obtain adequate pain control.