Navegando por Palavras-chave "Intraoperative Complications"

Agora exibindo 1 - 3 de 3
  • Imagem de Miniatura
    Item
    Acesso aberto (Open Access)
    Fatores de risco para eventos adversos respiratórios em adultos submetidos à cirurgias não cardíacas e não torácicas
    (Universidade Federal de São Paulo (UNIFESP), 2019-04-25) Badessa, Marianne Peixoto Sobral Giroldo [UNIFESP]; Falcão, Luiz Fernando Dos Reis [UNIFESP]; http://lattes.cnpq.br/4912142925978355; http://lattes.cnpq.br/6387047589841035; Universidade Federal de São Paulo (UNIFESP)
    Justifications and objects: Adverse respiratory event is the highest class of anesthesia complications associated with high mortality. Therefore, it is important to identify the risk factors associated with these complications. This study was made to establish the principal factors of risk in intraoperative respiratory complications. Method: This retrospective descriptive research was combined with anesthesiology reports performed in the University Hospital complex in the city of São Paulo during a 6-year period. The presence of bronchospasm, apnea, dyspnea, hypoventilation, hypoxia, pneumothorax, re-intubation or accidental extubation were considered as adverse intraoperative respiratory events. Incompleted anesthesia reports with adverse events were excluded. The univariate and multivariate analysis were performed by the logistic regression model considering the stepwise variable selection technique. The significance threshold was set at p<0,05. Results: A total of 43,383 anesthetics for noncardiac and non-thoracic surgeries were performed in patients aged 18 years or older. There was a record of 401 (0.92%) anesthesias in which there was at least one intraoperative respiratory adverse event. The most frequent respiratory events were bronchospasm (n = 157, 39.2%), hypoxia (n = 110, 27.4%) and hypoventilation (n = 81, 20.2%). The following were identified as risk factors for the presence of adverse events (p <0.05): male gender (OR 1.68; IC95% 1,13- 2,51), physical health ASA P3 (OR 1.862; IC95% 1,470-2,360), ASA P4 (OR 3.266; IC95% 2.326-4.585), ASA P5 (OR 5.642; IC 95% 3.201-9.945), head and neck surgery (OR 2.927; IC 95% 2.060-4.157, gastrointestinal surgery (OR 1.591; IC95% 1.237-2.046), otorhinolaryngological surgery (OR 1.821; IC95% 1.295-2.561), general anesthesia (OR 2.934; IC95% 2.30-3.742) and presence of the first year resident of anesthesiology. Conclusions: The incidence of adverse intraoperative respiratory events in adult patients undergoing noncardiac and non-thoracic surgeries is low. It is essential that the risk factors intrinsic to the patients, anesthetic technique and surgical specialty is tracked in the preoperative period in order to plan strategies to reduce such intraoperative events.
  • Imagem de Miniatura
    Item
    Acesso aberto (Open Access)
    Feasibility analysis of loop colostomy closure in patients under local anesthesia
    (Sociedade Brasileira para o Desenvolvimento da Pesquisa em Cirurgia, 2006-10-01) Abreu, Rone Antônio Alves De [UNIFESP]; Speranzini, Manlio B.; Fernandes, Luís C. [UNIFESP]; Matos, Delcio [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); ABC School of Medicine
    PURPOSE: To verify prospectively the practicability of performing loop colostomy closure under local anesthesia and sedation. METHODS: In this study, 21 patients underwent this operation. Lidocaine 2% and bupivacaine 0.5% were utilized. Pain was evaluated during the operation, on the first postoperative day and at hospital discharge. Intraoperative events, postoperative complications and the acceptability of this procedure were analyzed. RESULTS: The mean duration of the operation was 133 minutes (range: 85 to 290 minutes). The mean postoperative hospitalization was four days (range: one to twelve days). No patients died. Complications occurred in two patients (9.4%): abdominal wall hematoma and operative wound infection. With regard to pain severity, scores of less than or equal to three were indicated in the intraoperative evaluation by 80% of the patients (17/21) and on the first postoperative day by 85% (18/21). At hospital discharge, 95.2% of the patients (20/21) said they were in favor of the local anesthesia technique. CONCLUSION: Loop colostomy closure under local anesthesia and sedation is feasible, safe and acceptable to patients.
  • Imagem de Miniatura
    Item
    Acesso aberto (Open Access)
    Hipertermia maligna no Brasil: análise da atividade do hotline em 2009
    (Sociedade Brasileira de Anestesiologia, 2013-02-01) Silva, Helga Cristina Almeida da [UNIFESP]; Almeida, Clea dos Santos [UNIFESP]; Brandão, Julio Cézar Mendes [UNIFESP]; Silva, Cleyton Amaral Nogueira e [UNIFESP]; Lorenzo, Mariana Elisa Pinto de [UNIFESP]; Ferreira, Carolina Baeta Neves Duarte [UNIFESP]; Resende, André Hosoi [UNIFESP]; Barreira, Sara Rocha [UNIFESP]; Almeida, Priscilla Antunes de [UNIFESP]; Ferraro, Leonardo Henrique Cunha [UNIFESP]; Takeda, Alexandre [UNIFESP]; Oliveira, Kátia Ferreira de [UNIFESP]; Lelis, Talitha Gonçalez [UNIFESP]; Hortense, Alexandre [UNIFESP]; Perez, Marcelo Vaz [UNIFESP]; Schmidt, Beny [UNIFESP]; Oliveira, Acary Souza Bulle [UNIFESP]; Amaral, José Luiz Gomes do [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    BACKGROUND AND OBJECTIVES: Malignant hyperthermia (MH) is a pharmacogenetic disease that causes abnormal hypermetabolic reaction to halogenated anesthetics and/or depolarizing muscle relaxants. In Brazil, there is a hotline telephone service for MH since 1991, available 24 hours a day in São Paulo. This article analyzes the activity of the Brazilian hotline service for MH in 2009. METHODS: Prospective analysis of all phone calls made to the Brazilian hotline service for MH from January to December 2009. RESULTS: Twenty-two phone calls were received: 21 from the South/Southeast region of Brazil and one from the North region. Fifteen calls were requests for general information about MH. Seven were about suspected MH acute episodes, two of which were not considered as MH. In five episodes compatible with MH, all patients received halogenated volatile anesthetics (2, isoflurane; 3, sevoflurane) and one also used succinylcholine; there were four men and one woman, with a mean age of 18 years (2-27). The problems described in the five MH episodes were tachycardia (5), increased expired carbon dioxide (4), hyperthermia (3), acidemia (1), rhabdomyolysis (1), and myoglobinuria (1). One patient received dantrolene. All five patients with MH episodes were follow-up in the intensive care unit and recovered without sequelae. Susceptibility to MH was later confirmed in two patients by in vitro muscle contracture test. CONCLUSIONS: The number of calls per year in the Brazilian hotline service for MH is still low. The characteristics of MH episode were similar to those reported in other countries. The knowledge of MH in Brazil needs to be increased.