Navegando por Palavras-chave "ANESTESIA"

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    Anestesia neuroaxial comparada à anestesia geral para procedimentos na metade inferior do corpo: revisão sistemática de revisões sistemáticas
    (Sociedade Brasileira de Anestesiologia, 2012-04-01) Barbosa, Fabiano Timbó; Castro, Aldemar Araujo [UNIFESP]; Miranda, Cláudio Torres de [UNIFESP]; Universidade Federal de Alagoas; Universidade Federal de São Paulo (UNIFESP); Universidade Estadual de Ciências da Saúde de Alagoas
    BACKGROUND AND OBJECTIVES: Systematic reviews organize literature data by combining results from published studies in order to resolve conflicts in the area of medical knowledge describing the interventions. The inadequate reporting of systematic reviews can damage the credibility and interfere in the results' quality. The objective of this study was to determine the frequency of good quality systematic reviews comparing neuraxial anesthesia with general anesthesia for procedures on the lower half of the body. METHODS: Systematic review of systematic reviews. Primary variable: The frequency of good quality systematic reviews. The information was analyzed from the following databases: LILACS (January 1982 to December 2010); PubMed (January 1950 to December 2010); The Cochrane Database of Systematic Review and Database of Abstracts of Reviews of Effects (volume 10, 2010); and SciELO (December 2010). The quality of systematic reviews was determined by the Overview Quality Assessment Questionnaire. The sample size calculation showed that it was necessary to analyze eight systematic reviews, taking into account that the frequency of good quality systematic reviews was 5%, an absolute precision of 15%, and a significance level of 5%. RESULTS: Were identified 1,995 articles. The selection process eliminated 1,968 articles. Twenty-seven articles of systematic reviews were read in full, 9 were excluded due to incompatibility with the inclusion criteria, and 8 were duplicate publications. Ten systematic reviews were assessed for their quality. The frequency of good quality systematic reviews was 40% (4/10; 95% CI 9.6 to 70.4%). CONCLUSION: The frequency of good quality systematic reviews was 40%.
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    Avaliação da indução, recuperação, agitação ao despertar e consumo com uso de duas marcas de sevoflurano para anestesia ambulatorial
    (Sociedade Brasileira de Anestesiologia, 2012-04-01) Tomal, Cíntia Reina Grisan; Silva, Ana Gabriela Padua Dias da; Yamashita, Américo Massafuni [UNIFESP]; Andrade, Pamela Vieira de [UNIFESP]; Hirano, Márcia Tamiko [UNIFESP]; Tardelli, Maria Angela [UNIFESP]; Silva, Helga Cristina Almeida da [UNIFESP]; Hospital Universitário Materno Infantil Presidente Dutra; Hospital Seabra de Carvalho; Universidade Federal de São Paulo (UNIFESP)
    BACKGROUND AND OBJECTIVES: Due to its pharmacological characteristics, sevoflurane is the ideal anesthetic for short-duration procedures. There are two brands of sevoflurane in the Brazilian market, Sevocris® and Sevorane®, with different formulations and packaging. The objective of this study was to assess whether there are differences between the two anesthetics regarding induction, maintenance, recovery, and consumption. METHODS: One hundred and thirty children were included, divided into two groups according to the brand used: Group 1 was assigned to sevoflurane Cristália® and Group 2 to sevoflurane Abbott®. The following parameters were assessed: heart rate, systolic and diastolic blood pressure, fraction of inspired and expired sevoflurane, BIS values, tympanic temperature, induction and recovery time, agitation upon awakening measured by the PAED scale, and anesthetic consumption by weighing the vaporizers. Anesthesia was induced with 1 MAC and increased every three breaths at 0.5 MAC, up to 3 MAC. RESULTS: There was no difference between groups regarding the duration of the procedure, the anesthesia, and the parameters evaluated at induction. In Group 1, the number of children who required additional bolus of sevoflurane for anesthesia maintenance was higher than in Group 2 (p < 0.05). The fraction of inspired and expired sevoflurane at the end of the procedure was lower in Group 1 (p < 0.001). Upon awakening, BIS value was lower in Group 1 (p = 0.045). Other parameters evaluated in recovery showed no difference between groups. The use of anesthesia was similar between groups.
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    O efeito dos anestésicos inalatórios halotano e sevoflurano em um modelo experimental de lesão hepática
    (Sociedade Brasileira de Anestesiologia, 2011-10-01) Soubhia, Andrea Fogaça; Medeiros, Susi Heliene Lauz [UNIFESP]; Montero, Edna Frasson de Souza [UNIFESP]; Menezes, Alessandro; Mespaque, Luciane Bicca; Facin, Emilio; FURG Faculdade de Medicina; Universidade Federal de São Paulo (UNIFESP)
    BACKGROUND AND OBJECTIVES: Hepatic injury after inhalational anesthesia is controversial. Studies have suggested that inhalational agents generate an immune response that can provoke hepatic injury. The objective of this study was to analyze the effects of the inhalational agents halothane and sevoflurane on the liver of rats submitted to hypoxia and reperfusion. METHODS: Thirty Wistar rats, pretreated with 0.1% phenobarbital for 5 days, with discontinuation of the drug 24 hours before the experiment to cause hepatic injury, were used. Animals were distributed in five groups of six rats each. The control group (C) did not receive any treatment; in the F group, phenobarbital was used to induce hepatic injury; the Hypoxia group was submitted to 14% oxygen (O2); the H group received 1% halothane and 14% O2; and the S group received 2% sevoflurane and 14% O2. Twenty-four hours after exposure to the gases, blood samples were collected to evaluate transaminases (AST and ALT), and liver samples were collected for histological evaluation. Kruskal-Wallis Analysis of Variance and the Newman-Keuls test were used. RESULTS: Enzymatic activity mean values of AST (280.33, for halothane, 181, for sevoflurane) and ALT (235 for halothane, and 48.33, for sevoflurane) did not show significant differences, and all groups showed elevated values. Compared to halothane on optical microscopy, sevoflurane had lower indices of morphologic changes with p = 0.045, for steatosis, p = 0.0075, for inflammatory infiltrate, and p = 0.0074, for necrosis. CONCLUSIONS: Compared to the halothane group, sevoflurane did not show injuries of the liver parenchyma on optical microscopy.
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    Esvaziamento gástrico após administração oral de contraste em tomografia computadorizada do abdômen: descrição de seis casos
    (Sociedade Brasileira de Anestesiologia, 2004-06-01) Martins, Fernando Antonio Nogueira da Cruz [UNIFESP]; Amaral, José Luiz Gomes do [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    BACKGROUND AND OBJECTIVES: Pulmonary injury due to gastric contents aspiration is a complication related to airway protective reflexes loss. Tomography imaging with digestive tract contrast requires special care for children below five years of age requiring general anesthesia or sedation to assure immobility during the procedure. General anesthesia induction or sedation after contrast ingestion may pose substantial risk for gastric contents bronchoaspiration, so contrast administration by gastric tube is often used after tracheal intubation, since time elapsed for emptying gastric contrast is unknown. This practice means increased anesthesia duration and leads to issues about the possibility of gastric emptying in less than one hour. Six patients submitted to abdominal tomography were evaluated concerning gastric emptying by tomographic slices in stomach topography to establish whether residual liquid contents remain in that organ after contrast administration. CASES REPORT: Participated in this study 6 children undergoing abdominal tomography. Two conscious children presented expressive gastric liquid residual 50 and 45 minutes, respectively, after oral contrast ingestion. Four anesthetized children have also presented gastric liquid residual 40-50 minutes after contrast administration through gastric tube. In two of them remarkable gastric liquid content remained even after stomach aspiration. CONCLUSIONS: In all studied cases, forty to fifty minutes were not enough for gastric emptying after contrast administration and even stomach aspiration trough gastric tube has resulted in significant residual liquid.
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    Impacto da implantação de clínica de avaliação pré-operatória em indicadores de desempenho
    (Sociedade Brasileira de Anestesiologia, 2005-04-01) Mendes, Florentino Fernandes; Mathias, Ligia Andrade Da Silva Telles; Duval Neto, Gastão Fernandes [UNIFESP]; Birck, Alan Rodrigues; FFFCMPA; FMSCSP; Santa Casa de Porto Alegre Serviço de Anestesiologia; Universidade de São Paulo (USP); Santa Casa de São Paulo Serviço e Disciplina de Anestesiologia; Universidade Federal de São Paulo (UNIFESP); UFPEL
    BACKGROUND AND OBJECTIVES: This study aimed at evaluating the effects of implementing a Preoperative Outpatient Evaluation Clinic (POEC) based on operating center performance indicators. METHODS: The following data were prospectively followed for five years: total POEC evaluations and surgeries performed; total and reasons for surgeries cancellation; inpatient or outpatient surgeries performed; procedures cancellation rate and mean hospital stay of admitted patients. Reasons for procedure cancellations were divided in medical and administrative reasons. Cancellation rate is presented in percentage. Mean hospital stay is presented in days. Other indicators are presented in total figures. The study was divided in five periods: Pre-POEC, POEC 1, 2, 3 and 4, corresponding, respectively, to the years of 1998, 1999, 2000, 2001 and 2002. For each year, indicators percentage was compared to previous year and to the year Pre-POEC. Reasons were defined to check interactions among indicators. RESULTS: Except for total performed procedures, POEC has improved all tracked indicators. This improvement was low at the beginning and more significant in the year POEC 4. There has been decrease in the total number of cancelled procedures due to administrative reasons. There was also a decrease in procedures cancellation rate and mean hospital stay. These decreases were progressive and more marked in POEC 4. There is correlation (r = 0.977) between procedures cancellation rate and mean stay of admitted patients. CONCLUSIONS: There are significant changes in indicators. Improvement is gradual and progressive as years go by with regard to POEC development, and positively affects indicators improvement.
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    Influência do óxido nitroso na velocidade de indução e de recuperação do halotano e do sevoflurano em pacientes pediátricos
    (Sociedade Brasileira de Anestesiologia, 2001-01-01) Tardelli, Maria Angela [UNIFESP]; Iwata, Nilza Mieko [UNIFESP]; Amaral, José Luiz Gomes do [UNIFESP]; Ferreira, Roberto Manara Victório [UNIFESP]; Rocha, Luciano Borges [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    BACKGROUND AND OBJECTIVES: The use of different MAC multiples of sevoflurane and halothane, and the different effect of N2O on the MAC of these agents in children, are usually argued as the reason for the same induction and recovery times of these agents which have different blood solubilities. This study evaluated the induction time to different MAC multiples and the recovery time of anesthesia maintained with a fixed expired concentration (1 MAC) of halothane or sevoflurane, associated or not to N2O, in children under epidural caudal anesthesia. METHODS: Participated in this study 63 children allocated in 4 groups according to the anesthetic drug used. Group 1 = Halothane; Group 2 = Halothane plus N2O; Group 3 = Sevoflurane; Group 4 = Sevoflurane plus N2O. All children were submitted to caudal epidural blockade. Mask Induction was started with 1 MAC of halogenate followed by 0.5 MAC increments at every three respiratory movements until a maximum of 3 MAC was obtained. The following parameters were recorded: heart rate, systolic and diastolic blood pressure, inhaled agent expired fraction and times for induction, recovery and response to commands. RESULTS: Duration of surgery did not differ significantly among groups. The times to eyelash reflex loss, end of induction, emergence and oriented responses for groups 1 and 2 were longer than for groups 3 and 4 (p < 0.001) without significant differences between groups 1 and 2 and between groups 3 and 4. There were no differences in heart rate and systolic and diastolic blood pressure. CONCLUSIONS: In the age range studied and with the anesthetic technique used, induction and recovery times were different between the halothane and the sevoflurane group, but did not differ when nitrous oxide was added to the halogenate.