Navegando por Palavras-chave "ANESTHESIA"

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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.