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Pesquisa : E03.155.086 [Categoria DeCS]
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Id: biblio-991019
Autor: Sánchez Tamayo, Marcelino; Correa, Maribel; Sánchez Martín, Miguel Livan; García Real, Eivet.
Título: Conducción anestésica de un paciente con bloqueo de rama izquierda agudo / Anesthetic approach of a patient with acute left-branch block
Fonte: Rev. cuba. anestesiol. reanim;17(1):1-6, ene.-abr. 2018. ilus.
Idioma: es.
Resumo: Introducción: El bloqueo de rama izquierda del haz de His dependiente de la frecuencia cardíaca no es una entidad común en la práctica clínica del anestesiólogo, sino que se presenta como consecuencia de enfermedades cardiacas o no que ocurren por lentitud de la frecuencia ventricular sobre todo, con enfermedad de las arterias coronarias planteadas solo como diagnóstico después de haberlas descartado. Objetivo: Describir el manejo clínico-anestésico de una paciente que presentó bloqueo de rama izquierda del haz de His para cirugía torácica electiva por tumor de mediastino. Desarrollo: Se presenta un caso clínico de una paciente con bloqueo de rama izquierda dependiente de la frecuencia cardiaca que se anunció para cirugía del tórax, sin historia previa de coronariopatía. La cirugía trascurrió sin complicaciones y con buenos resultados. Conclusiones: el bloque de rama izquierda dependiente de la frecuencia cardiaca es una entidad rara y un diagnóstico excluyente de otras entidades cardiovasculares o no como la isquemia miocárdica. Un adecuado manejo intraoperatorio del paciente proporciona excelentes resultados sin traducción clínica ni complicaciones(AU)

Introduction: Rate-dependent left bundle branch block is not a rare entity for the clinical practice in anesthesiology, but appears as a consequence of heart diseases or not always due to slowness in atrial frequency above all, with coronary artery diseases diagnosed only after their being ruled out. Objective: To describe the clinical-anesthetic management of a patient who presented left bundle branch block for elective thoracic surgery due to mediastinal tumor. Findings: We present a clinical case of a female patient with rate-dependent left bundle branch block who was announced for thoracic surgery, without a previous history of coronary artery disease. The surgery proceeded without complications and with positive outcome. Conclusions: Rate-dependent left-branch block is a rare entity and a diagnosis ruling out other cardiovascular entities or not, such as myocardial ischemia. An adequate intraoperative management of the patient provides excellent outcome without clinical translation or complications(AU)
Descritores: Frequência Cardíaca/efeitos dos fármacos
Anestesia por Condução/métodos
-Bloqueio de Ramo/cirurgia
Limites: Humanos
Feminino
Idoso
Tipo de Publ: Relatos de Casos
Responsável: CU1.1 - Biblioteca Médica Nacional


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Id: biblio-1119716
Autor: Mejía-Terrazas, Gabriel Enrique; López-Muñoz, Eunice.
Título: Implicaciones del COVID-19 (SARS-CoV-2) para la práctica anestesiológica / Implications of COVID-19 (SARS-CoV-2) for the anesthesiological practice
Fonte: Medwave;20(6):e7950, 31-07-2020.
Idioma: en; es.
Resumo: El objetivo de este artículo es revisar las características del SARS-CoV-2, los aspectos clínico-epidemiológicos de COVID-19 y las implicaciones que tienen para los anestesiólogos al realizar procedimientos generadores de aerosoles. Se realizó una búsqueda en las bases de datos PubMed, Scopus, SciELO y Web of Science hasta el 9 de abril de 2020, utilizando las palabras: "COVID-19 or COVID19 or SARS-CoV-2 and anesthesiology or anesthesia". Se incluyeron 48 artículos con información sobre el manejo del paciente en el perioperatorio o en la unidad de cuidados intensivos ante la sospecha o confirmación de infección por SARS-CoV-2. En general, se recomienda el aplazamiento de las cirugías electivas por no más de seis a ocho semanas, de acuerdo a las condiciones clínicas de los pacientes. En el caso de cirugías de urgencia o emergencia, se revisan tópicos del sistema de protección personal así como las estrategias recomendadas para la realización de los procedimientos.

The purpose of this article is to review the characteristics of SARS-CoV-2, the clinical-epidemiological aspects of COVID-19, and the implications anesthesiologists when performing aerosol-generating procedures. A search of PubMed/MEDLINE, Scopus, SciELO, and Web of Science databases was performed until April 9, 2020, using the words: "COVID-19 or COVID19 or SARS-CoV-2 and anesthesiology or anesthesia". Forty-eight articles with information on the management of the patient in the perioperative period or the intensive care unit when suspected or confirmed SARS-CoV-2 infection were included. In general, the postponement of elective surgeries for no more than 6 to 8 weeks, depending on the clinical condition of the patients is recommended. In the case of urgent or emergency surgeries, we review the use of personal protection gear, as well as the recommended strategies for carrying out the procedure.
Descritores: SARS-CoV-2/genética
COVID-19/complicações
COVID-19/epidemiologia
Anestesiologia/normas
Doenças Profissionais/prevenção & controle
-Respiração Artificial/métodos
Respiração Artificial/normas
Procedimentos Cirúrgicos Operatórios/métodos
Procedimentos Cirúrgicos Eletivos
Aerossóis
Pandemias
Avaliação de Sintomas/métodos
Equipamento de Proteção Individual
COVID-19/diagnóstico
COVID-19/transmissão
Unidades de Terapia Intensiva
Intubação Intratraqueal/métodos
Intubação Intratraqueal/normas
Anestesia por Condução/métodos
Anestesia Epidural/métodos
Anestesia Geral/métodos
Raquianestesia/métodos
Anestesiologia/organização & administração
Bloqueio Nervoso/métodos
Limites: Humanos
Responsável: CL1.1 - Biblioteca Central


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Id: biblio-1254237
Autor: Obalum, Dike Chijoke; Ibeanusi, Sydney E.
Título: The relevance of regional anesthesia in orthopaedic surgery: advantages, disadvantages and challenges
Fonte: Int. j. med. surg. sci. (Print);5(4):164-170, dic. 2018.
Idioma: en.
Resumo: The relevance of regional anaesthesia in orthopaedic surgery cannot be overemphasized because it has aided reduction in intra-operative and post-operative pain which has always been a challenge in surgical practice. It also reduces the risk of haemorrhage and infection. Though there are complications associated with regional anaesthesia, these complications are rare and can be anticipated; thus prompt intervention measures can be instituted. The outcome of every surgical procedure takes into consideration the risks and benefit of the method, and hence, since the benefits of regional anaesthesia in orthopaedic surgery outweighs the risks, it is highly recommended. Regional anaesthesia is of great importance in orthopaedic surgery because it offers continuous but controlled analgesia. It induces hypotension which leads to a reduction in blood loss during operation. It allows early recovery and ambulation of patients, thus reducing the risks associated with prolonged bed stay, which may, in turn, affect the overall outcome of surgery. This review aims to highlight the advantages and challenges of regional anaesthesia in orthopaedic surgery
Descritores: Procedimentos Ortopédicos/métodos
Anestesia por Condução/efeitos adversos
Anestesia por Condução/métodos
Limites: Humanos
Tipo de Publ: Revisão
Responsável: CL61.1 - Biblioteca Central Campus Sur


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Id: biblio-1254230
Autor: Obalum, Dike Chijoke; Ibeanusi, Sydney E.
Título: The relevance of regional anesthesia in orthopaedic surgery: concepts and techniques
Fonte: Int. j. med. surg. sci. (Print);5(4):160-163, dic. 2018.
Idioma: en.
Resumo: Before the advent of anaesthesia in surgical practice, surgeons battled with patient's maximal co-operation during surgical procedures, management of pain intra-operatively and post-operatively. Anaesthesia has greatly aided in overcoming these challenges, but a sizable proportion of reduction in these challenges but approximately 30-80% of patients complain of moderate to severe pain post-operatively indicating that post-operative pain remains a problem. Controlled epidural anaesthesia and controlled peripheral nerve block which are types of regional anaesthesia provide superior pain relief during and after surgery, making regional anaesthesia of particular relevance in orthopaedic surgery. More so, general anaesthesia has some adverse effects on the outcome of operation and the patient. These adverse effects are rare but may be disastrous and life-threatening necessitating close supervision during and after general anaesthesia. Hence, the preference should be towards regional anaesthesia with regards to the choice of anaesthesia in orthopaedic surgery. This review aims to highlight some concepts and techniques on regional anaesthesia in orthopaedic surgery.
Descritores: Procedimentos Ortopédicos/métodos
Anestesia por Condução/métodos
-Dor Pós-Operatória
Dor Processual
Limites: Humanos
Tipo de Publ: Revisão
Responsável: CL61.1 - Biblioteca Central Campus Sur


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Id: lil-628182
Autor: León, Alfonso R; Almaguer, Silvia; Martínez, Larisa.
Título: Anestesia regional y saturación de oxígeno posoperatorio en el paciente geriátrico / It anesthetizes regional and saturation of oxygen posoperatorio in the patient geriatric
Fonte: Rev. cuba. cir;40(2):144-148, abr.-jun. 2001.
Idioma: es.
Resumo: Numerosos estudios plantean la necesidad de suministrar oxígeno suplementario a pacientes geriátricos en el período posoperatorio (PO), después de anestesia regional como profilaxis de hipoxemia. Teniendo en cuenta lo anterior, se decidió comprobar cómo se comporta la saturación de oxígeno (STO2) en el PO en los pacientes geriátricos que se asistieron con el uso de esta técnica. Previa autorización del consejo científico se seleccionaron al azar 50 pacientes ASA I-II-II (F = 30, K = 20) intervenidos de hemiabdomen inferior y miembros inferiores. Preoperatoriamente se registraron variables demográficas, antecedentes patológicos personales (APP) y (STO2). Se realizó anestesia subaracnoidea (SA) o peridural (PE). En el PO se realizaron 6 mediciones de la STO2 (cada 10 min durante 1 h) a la salida del salón de operaciones. Se procesaron estadísticamente los resultados (comparación de medias). Edad promedio 76 ± 6 años, anestesia PE 20, SA 30, Hb media 10,5 g/L STO2 preoperatorio 94 por ciento ± 1,5. Mediciones en el PO 1ra. 95 por ciento ± 1,8; 2da. 94 por ciento ± 1,3; 3ra. 93 por ciento ± 2,1; 4ta. 95 por ciento ± 1,9; 5ta. 94 por ciento ± 1,5; 6ta. 93 por ciento ± 1,7. No se hallaron diferencias estadísticamente significativas entre estas mediciones, ni en relación con la SOT2 preoperatorias con el uso de esta técnica anestésica en la población geriátrica(AU)

Many studies state the need to administer supplementary oxygen to elderly patients in the postoperative period (POP) after regional anesthesia as a prophylaxis of hipoxemia. Bearing in mind the above mentioned, we decided to confirm the behaviour of oxygen saturation (O2S) in the POP of these aged patients that were assisted with this technique. Having cosulted the Scientifc Council, we proceed to a random selection of 50 ASA I-II-III patients (F = 30, K = 20) that underwent an operation of inferior hemiabdomen and lower limbs. Demographic variables, personal pathologic histories (PPH) and 02S were obtained before the operation. Subarachnoid (SA) or peridural (PE) anesthesia was administered. 6 measurements of O2S were made (every 10 min. during l hour) on leaving the operating room.The results were statistically processed (comparison of means). Average age was 76 ± 6 years, PE 20 , SA 30, mean Hb 10.5 g/L, preoperative O2S 94 percent ± 1.5. The following measurements were made during the POP: lst, 95 percent ± 1.8; 2nd, 94 percent ± l.3; 3rd, 93 percent ± 2.1; 4th, 95 percent ± 1.9; 5th, 94 percent ± l.5; 6th, 93 percent ± l.7(AU)
Descritores: Oxigênio/administração & dosagem
Oximetria/métodos
Anestesia por Condução/métodos
Anestesia Epidural/métodos
-Período Pós-Operatório
Análise Estatística
Limites: Humanos
Masculino
Feminino
Idoso
Responsável: CU1.1 - Biblioteca Médica Nacional


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Id: biblio-1134253
Autor: Denstedt, John.
Título: Editorial Comment: Flexible ureterorenoscopy and laser lithotripsy with regional anesthesia vs general anesthesia: A prospective randomized study
Fonte: Int. braz. j. urol;46(6):1019-1020, Nov.-Dec. 2020.
Idioma: en.
Descritores: Litotripsia a Laser
Anestesia por Condução
-Estudos Prospectivos
Ureteroscopia
Anestesia Geral
Tipo de Publ: Comentário
Editorial
Responsável: BR1.1 - BIREME


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Id: biblio-1134262
Autor: Sahan, Murat; Sarilar, Omer; Akbulut, Mehmet Fatih; Demir, Eren; Savun, Metin; Sen, Oznur; Ozgor, Faruk.
Título: Flexible ureterorenoscopy and laser lithotripsy with regional anesthesia vs general anesthesia: A prospective randomized study
Fonte: Int. braz. j. urol;46(6):1010-1018, Nov.-Dec. 2020. tab, graf.
Idioma: en.
Resumo: ABSTRACT Purpose To compare the effect of general anesthesia (GA) and regional anesthesia (RA) on f-URS outcomes and surgeon comfort. Material and Methods The study was conducted between June 2017 to January 2018 and data collection was applied in a prospective, randomized fashion. 120 patients participated in the study and were divided into RA group (n=56) and GA group (n=64). Demographic, operative and post-operative parameters of patients were analysed. The end point of this study was the effect of two anesthesia regimens on the comfort of the surgeon, and the comparability of feasibility and safety against perioperative complications. Results The study including 120 randomized patients, 14 patients were excluded from the study and completed with 106 patients (45 in RA group and 61 in GA group). No difference was detected between the two groups in terms of preoperative data. During the monitorization of operative vital signs, 3 patients in RA group experienced bradycardia, and this finding was significant when compared with GA group (p=0.041). Additionally, 2 patients in RA group experienced mucosal tears and 1 patient experienced hemorrhage during the operation, but no complications were observed in the GA group (p=0.041). Postoperative surgeon comfort evaluation revealed statistically significant results in favor of GA group (p=0.001). Conclusions Both GA and RA are equally effective and safe anesthesia methods for f-URS procedures. However, RA group showed significantly increased likelihood of bradycardia and mucosal injury during surgery, and significantly decreased surgeon comfort during surgery.
Descritores: Litotripsia a Laser/efeitos adversos
Anestesia por Condução
-Estudos Prospectivos
Estudos Retrospectivos
Resultado do Tratamento
Anestesia Geral
Pessoa de Meia-Idade
Limites: Humanos
Masculino
Feminino
Adulto
Tipo de Publ: Ensaio Clínico Controlado Aleatório
Responsável: BR1.1 - BIREME


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Id: biblio-1249035
Autor: Diwan, Sandeep; Blanch, Xavier Sala; Nair, Abhijit; Shah, Dipal.
Título: Anatomic and radiological correlation of injectate spread from first thoracic costotransverse junction in cervical erector spinae plane
Fonte: Autops. Case Rep;11:e2021275, 2021. tab, graf.
Idioma: en.
Resumo: Introduction Cervical erector spinae plane block (ESPB) provides postoperative pain relief when administered at the level of first thoracic costotransverse junction (CTJ) for surgeries on the proximal shoulder and cervical spine. We propose to describe the spread of 20 ml radiocontrast - dye solution administered at this level from caudad to cephalad direction in a fresh frozen cadaveric model through imaging and cross-sections. Methods An observational study with four thoracic to cervical ESP blocks at the level of first thoracic CTJ level on two fresh cadavers (total 4 specimens) was conducted using 20 ml of radiocontrast- methylene blue combination (10 ml through the needle and 10 ml through the catheter). Both cadavers were subjected to computed tomography (CT) scan. An anatomist and radiologist, respectively, analyzed cross-sections of cadavers and CT contrasted images. Results The spread was assessed in axial, sagittal, and coronal at the levels of C4, C5, C6, C7and T1. The medial limit was articular processes in both cadavers. The lateral limits were the outer border of the middle scalene muscle in cadaver 1 and posterior to the sternocleidomastoid muscle in cadaver 2. Contrast spread was visualized on the superior and anterior aspect of anterior scalene muscle in cadaver 2. An epidural spread was observed at the level of C5-6 and C6-7 in axial and coronal planes in cadaver 1. Conclusions The cervical ESPB administered at the first thoracic CTJ with injections directed cephalad has a consistent action on the dorsal spinal nerves of thoracic and cervical area, and spreads in the paravertebral space dorsal to the ventral cervical roots.
Descritores: Anestesia por Condução/métodos
Bloqueio Nervoso
-Cadáver
Ultrassonografia
Dissecação
Limites: Humanos
Tipo de Publ: Artigo Clássico
Responsável: BR26.7 - Serviço de Biblioteca e Documentação Científica


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Id: lil-388377
Autor: Martínez Ramos, Gilberto; Torres Fragela, Salvador; González Delis, Remberto; Garrido Lena, Lilia Isabel.
Título: Comportamiento de la cirugía mayor ambulatoria: estudio de 5 años / Behavior of ambulatory major surgery: a 5-year study
Fonte: Rev. cuba. cir;42(4), oct.-dic. 2003. tab, graf.
Idioma: es.
Resumo: Se realizó un estudio descriptivo, longitudinal y retrospectivo de 2 208 pacientes operados por el método de cirugía mayor ambulatoria en el servicio de cirugía del Hospital Militar Clinicoquirúrgico Docente "Comandante Manuel Fajardo Rivero" de Santa Clara, durante el período comprendido desde enero de 1997 hasta diciembre del 2001, con el propósito de demostrar las ventajas de este método para el paciente y para la institución. Los pacientes operados de hernias inguinales, epigástricas y umbilicales fueron los que predominaron. También fueron tratados por este método pacientes con litiasis vesicular, fibromiomas uterinos, nódulos de mamas, ginecomastias y hemorroides. Del total de los pacientes la mayor cantidad pertenecía al sexo femenino y en cuanto a la edad los grupos comprendidos entre 20 y 49 años fueron los que más se beneficiaron con este método. Los tipos de anestesia con preferencia a ser utilizados en estos pacientes fueron la anestesia regional y la analgesia quirúrgica acupuntural(AU)

A descriptive, cross-sectional and prospective study was conducted among 2 208 patients operated on by ambulatory major surgery at the surgery service of "Comandante Manuel Fajardo Rivero" Military Clinical and Surgical Hospital, in Santa Clara, from January, 1997, to December, 2001, aimed at showing the advantages of this method for the patient and the health institution. The patients operated on of inguinal, epigastric and umbilical hernias predominated. This method was also used with vesicular lithiasis, uterine fibromyomas, breast nodules, gynecomasties and hemorrhoids. Most of the patients were females and the groups aged 20-49 were the most benefitted with this method. The types of anesthesia preferably used were regional anesthesia and acupunctural surgical analgesia(AU)
Descritores: Analgesia por Acupuntura/métodos
Litíase/etiologia
Procedimentos Cirúrgicos Ambulatórios/métodos
Anestesia por Condução/métodos
Leiomioma/etiologia
-Estudos Prospectivos
Estudos Retrospectivos
Estudos Longitudinais
Limites: Humanos
Feminino
Adulto
Pessoa de Meia-Idade
Responsável: CU1.1 - Biblioteca Médica Nacional


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Id: biblio-1136261
Autor: Lei, Daoyun; Sha, Yeqin; He, Lianping.
Título: Is ultrasound-guided thoracic paravertebral nerve block better than intercostal nerve block for video-assisted thoracic surgery under spontaneous-ventilating anesthesia?
Fonte: Rev Assoc Med Bras (1992);66(5):568-568, 2020.
Idioma: en.
Descritores: Vértebras Torácicas/diagnóstico por imagem
Músculos Intercostais/diagnóstico por imagem
Ultrassonografia de Intervenção/métodos
Cirurgia Torácica Vídeoassistida/métodos
Anestesia por Condução/métodos
Raquianestesia/métodos
Bloqueio Nervoso/métodos
-Dor Pós-Operatória
Nervos Intercostais
Limites: Humanos
Responsável: BR1.1 - BIREME



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