Navegando por Palavras-chave "COMPLICATIONS"

Agora exibindo 1 - 4 de 4
  • Imagem de Miniatura
    Item
    Acesso aberto (Open Access)
    Clonidina como medicação pré-anestésica em facectomias: comparação entre as doses de 100 µg e 200 µg
    (Sociedade Brasileira de Anestesiologia, 2009-12-01) Cruz, José Roquennedy Souza; Cruz, Denise Ferreira Barroso de Melo; Branco, Bruno Castelo; Santiago, Ana Ellen de Queiroz [UNIFESP]; Amaral, José Luiz Gomes do [UNIFESP]; Universidade Federal de Sergipe; Instituto de Olhos de Sergipe; Universidade Federal da Bahia; Universidade Federal de Rondônia; Universidade Federal de São Paulo (UNIFESP)
    BACKGROUND AND OBJECTIVES: The objective of the present study was to evaluate the degree of sedation, intraocular pressure, and hemodynamic changes with premedication with low doses of oral clonidine, 100 µg and 200 µg, in outpatient cataract surgeries. METHODS: This is a randomized, double-blind, clinical study undertaken at the Universidade Federal de São Paulo (UNIFESP) with 60 patients of both genders, physical status ASA 1 and 2, ages 18 to 80 years. Patients were separated into three groups: placebo, clonidine 100 µg, and clonidine 200 µg. Intraocular pressure, heart rate, and blood pressure besides assessment of sedation were measured before and 90 minutes after the administration of clonidine. Sedation levels were classified according to the Ramsay sedation scale. RESULTS: Patients who received placebo and 100 µg of clonidine did not show reduction in heart rate, while a reduction in heart rate was observed in patients who received 200 µg of clonidine, and this difference was statistically significant. Patients who received 200 µg of clonidine also had a reduction in systolic and diastolic blood pressure (p < 0.05). One patient who received 200 µg of clonidine developed severe hypotension, with systolic pressure < 80 mmHg. Patients treated with clonidine had a reduction in intraocular pressure (p < 0.05). Ninety minutes after the oral administration of placebo and 100 µg and 200 µg of clonidine, 25%, 60%, and 80% of the patients respectively were classified as Ramsay 3 or 4. CONCLUSIONS: Clonidine 100 µg can be indicated as premedication for fasciectomies, being effective in sedation and reduction of intraocular pressure, without adverse effects on blood pressure and heart rate.
  • Imagem de Miniatura
    Item
    Acesso aberto (Open Access)
    Estamos preparados para diagnosticar e conduzir um episódio de hipertermia maligna?
    (Sociedade Brasileira de Anestesiologia, 2003-04-01) Simões, Claudia Marquez; Koishi, Giovanna Negrisoli; Rozatti, Marcelo [UNIFESP]; Amaral, José Luiz Gomes do [UNIFESP]; Universidade de São Paulo (USP); Faculdade de Medicina do ABC; Universidade Federal de São Paulo (UNIFESP)
    BACKGROUND AND OBJECTIVES: Malignant Hyperthermia (MH) is an uncommon but potentially lethal disease associated to halogenate agents and/or succinylcholine exposure. Resulting mortality and morbidity may be decreased by early diagnosis and specific treatment, including sodium dantrolene. Brazil has approximately 160 million inhabitants assisted by more than 6000 anesthesiologists. In the last decade, special attention was given to this disease, resulting in better informed anesthesiologists and more prepared hospitals to treat malignant hyperthermia (MH). This study aimed at measuring the level of information of Brazilian anesthesiologists regarding MH, in order to develop new approaches to control this disease. METHODS: A questionnaire with 20 questions on malignant hyperthermia diagnosis, prevention and treatment was mailed to the 6,164 members of the Brazilian Society of Anesthesiology. RESULTS: Questionnaires were returned by 646 anesthesiologists (10.4%). More than 90% of correct answers about clinical diagnosis and treatment were obtained. On the other hand, nearly 50% of anesthesiologists gave incorrect answers about muscle biopsy indication and clinical pharmacology of dantrolene. CONCLUSIONS: Results have indicated adequate knowledge about this topic, but has shown that some relevant issues need additional attention. The number of answers was significant to evaluate MH understanding of Brazilian anesthesiologists, but has also shown poor motivation. From these results it is possible to conclude that it is essential to intensify continuing education programs, contemplating all issues of this major anesthetic subject.
  • Imagem de Miniatura
    Item
    Acesso aberto (Open Access)
    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.
  • Imagem de Miniatura
    Item
    Acesso aberto (Open Access)
    Hiperalgesia induzida por opioides (HIO)
    (Sociedade Brasileira de Anestesiologia, 2010-12-01) Leal, Plínio da Cunha [UNIFESP]; Clivatti, Jefferson [UNIFESP]; Garcia, João Batista Santos [UNIFESP]; Sakata, Rioko Kimiko [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade Federal do Maranhão
    BACKGROUND AND OBJECTIVES: Opioids are commonly used for pain control; however, they can cause hyperalgesia. The reason why this can happen is not known. The objective of this review was to describe the mechanisms, factors implicated, and drug modulation. CONTENTS: The factors implicated in the development of opioid-induced hyperalgesia (OIH), such as duration of use, dose, and type of opioids are described. Mechanisms involved include the glutamatergic system and N-methyl-D-aspartate receptors (NMDA), spinal cyclooxygenase (COX) activation, excitatory amino acids, dynorphin, cytokines and chemokines; prostaglandins, and descending facilitation. Modulation of hyperalgesia could be done through: NMDA receptor antagonists, alpha2-adrenergic agonists, and COX inhibitors. CONCLUSIONS: This is a very complex subject, which involves a series of pathophysiological mechanisms that could contribute for OIH and patient discomfort, bringing disastrous consequences.