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Id: biblio-1099387
Autor: Silva, Tássio Henrique Sousa; Araújo, Claudiane Vansoski; Santos, Khelvin Myner da Costa; Alves, Nathanael dos Santos; Gomes, Thayse Haylene Soares; Silva, Andressa Kelly Ferreira e; Silva, Nayra Cristina Lira dos Santos; Damasceno Júnior, Evandro César Bezerra; Carvalho, Andressa Maria Aguiar de; Mendes, Maria Gabriela Araújo; Caminha, Henrique Barros; Daboit, Tatiane Caroline; Ferreira, Thatiana Bragine; Andrade-Silva, Leonardo Eurípedes; Silva-Vergara, Mario León; Ferreira-Paim, Kennio; Fonseca, Fernanda Machado.
Título: Synergic effect of simvastatin in combination with amphotericin B against environmental strains of Cryptococcus neoformans from northeastern Brazil: a prospective experimental study
Fonte: Säo Paulo med. j;138(1):40-46, Jan.-Feb. 2020. tab, graf.
Idioma: en.
Resumo: BACKGROUND: Statins are used as cholesterol-lowering drugs and may also have direct antimicrobial effects. OBJECTIVE: To evaluate synergic interactions between simvastatin and both amphotericin B and fluconazole, against environmental strains of Cryptococcus neoformans isolated from captive birds' droppings. DESIGNAND SETTING: Experimental study conducted at Federal University of Piauí, Parnaíba, in collaboration with Federal University of Triângulo Mineiro, Uberaba, Brazil. METHODS: Statin susceptibility tests of Cryptococcus neoformans samples were performed as prescribed in standards. Interactions of simvastatin with amphotericin and fluconazole were evaluated using the checkerboard microdilution method. Presence of these interactions was quantitatively detected through determining the fractional inhibitory concentration index (FICI). RESULTS: Isolates of Cryptococcus neoformans were obtained from 30 of the 206 samples of dry bird excreta (14.5%) that were collected from pet shops and houses. Ten isolates were selected for susceptibility tests. All of them were susceptible to amphotericin and fluconazole. All presented minimum inhibitory concentration (MIC) > 128 µg/ml and, thus, were resistant in vitro to simvastatin. An in vitro synergic effect was shown through combined testing of amphotericin B and simvastatin, such that six isolates (60%) presented FICI < 0.500. Two isolates showed considerable reductions in MIC, from 1 µg/ml to 0.250 µg/ml. No synergic effect was observed through combining fluconazole and simvastatin. CONCLUSION: These results demonstrate that simvastatin should be considered to be a therapeutic alternative, capable of potentiating the action of amphotericin B. However, further studies are necessary to clarify the real effect of simvastatin as an antifungal agent.
Descritores: Anfotericina B/farmacologia
Sinvastatina/farmacologia
Cryptococcus neoformans
-Brasil
Testes de Sensibilidade Microbiana
Fluconazol
Estudos Prospectivos
Sinergismo Farmacológico
Antifúngicos/farmacologia
Limites: Humanos
Responsável: BR1.1 - BIREME


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Id: biblio-1091466
Autor: Chavarría-Bolaños, Daniel; Esparza-Villalpando, Vicente; Pozos-Guillén, Amaury.
Título: Pharmacological Synergism: A Multimodal Analgesia Approach to Treat Dental Pain / Sinergismo Farmacológico: Un enfoque de analgesia multimodal para el manejo de dolor dental
Fonte: Odovtos (En línea);21(1):10-14, Jan.-Apr. 2019. graf.
Idioma: en.
Resumo: Abstract Dental pain is usually managed by clinical interventions and pharmacological coadjuvants such as NSAIDs. However, its perception and modulation is mediated by different nociceptive mechanisms and these strategies can be insufficient. The multimodal analgesia refers to the use of 2 or more analgesic drugs that attenuate or blockade different mechanisms of pain, obtaining a greater clinical effect. Within this concept, pharmacological synergism plays a leading role, combining different molecules in lower doses to diminish also side effects. Since there are no standard prescriptions to be use in all the patients, multimodal approaches allow the clinician to make responsible effective combinations, individualizing analgesia as the pathway to success.

Resumen El dolor dental generalmente se trata con intervenciones clínicas y coadyuvantes farmacológicos como los AINEs. Sin embargo, su percepción y modulación está mediada por diferentes mecanismos nociceptivos y estas estrategias pueden ser insuficientes. La analgesia multimodal se refiere al uso de 2 o más fármacos analgésicos que atenúan o bloquean diferentes mecanismos de dolor, obteniendo un mayor efecto clínico. Dentro de este concepto, el sinergismo farmacológico juega un papel importante, combinando diferentes moléculas en dosis más bajas para disminuir también los efectos secundarios. Dado que no hay prescripciones estándar para ser usadas en todos los pacientes, los enfoques multimodales permiten al clínico realizar combinaciones responsables y eficaces, individualizando la analgesia como el camino hacia el éxito.
Descritores: Odontalgia/tratamento farmacológico
Terapia Combinada
Sinergismo Farmacológico
Analgesia/métodos
-Anestesia Dentária/métodos
Tipo de Publ: Revisão
Responsável: CR1.1 - BINASSS - Biblioteca Nacional de Salud y Seguridad Social


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Id: biblio-1091483
Autor: Trujillo-Hernández, Margarita; Flores-Ventura, Rebeca E; Suárez-Porras, Angélica; García-González, Leandro; Hernández-Torres, Julián; Zamora-Peredo, Luis; Suárez-Franco, José Luis.
Título: Estudio comparativo de la bioactividad de dos materiales biocerámicos / Comparative Study of the Bioactivity of Two Bioceramic Materials
Fonte: Odovtos (En línea);21(2):73-81, May.-Aug. 2019. tab, graf.
Idioma: es.
Resumo: RESUMEN Los materiales a base de silicato de calcio han demostrado ser bioactivos debido a su capacidad para producir apatita carbonatada biológicamente compatible. El objetivo de este estudio fue analizar la bioactividad de Biodentine™ y MTA Repair HP® en contacto con discos de dentina humana, que se obturaron y dividieron aleatoriamente para formar cuatro grupos: grupo 1 Biodentine™, grupo 2 MTA Repair HP®, grupo control positivo MTA Angelus® y grupo control negativo IRM®, los cuales se incubaron en solución PBS durante 10 días, para posterior análisis por medio de MEB-EDS y Espectroscopía Raman. Los tres materiales a base de silicato de calcio analizados en este estudio demostraron ser bioactivos pues al entrar en contacto con una solución a base de fosfato desencadenaron la precipitación inicial de fosfato de calcio amorfo, que actúa como precursor durante la formación de apatita carbonatada.

ABSTRACT Calcium silicate-based materials have been shown to be bioactive due to their ability to produce biologically compatible carbonated apatite. The objective of this study was to analyze the bioactivity of Biodentine ™ and MTA Repair HP® in contact with human dentine discs, which were sealed and divided randomly to form four groups: group 1 Biodentine™, group 2 MTA Repair HP®, positive control group MTA Angelus® and negative control group IRM®, which were incubated in PBS solution for 10 days, for a subsequent analysis by means of MEB-EDS and Raman spectroscopy. The three calcium-based materials analyzed in this study proved to be bioactive because upon contact with a phosphate-based solution they were triggered at the onset of amorphous calcium phosphate, as the precursor during the formation of carbonated apatite.
Descritores: Apatitas/análise
Análise Espectral Raman
Calcarea Silicata/análise
Materiais Dentários/análise
-Sinergismo Farmacológico
Tipo de Publ: Estudo Comparativo
Responsável: CR1.1 - BINASSS - Biblioteca Nacional de Salud y Seguridad Social


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Id: biblio-1159924
Autor: Callegari, Enrique; Usoz, Oscar; Diaz, Antonia.
Título: Experiencia clínica con la asociación de trimetoprima-sulfametoxazol en pediatría / [Clinical experience with a trimethoprim-sulfamethoxazole combination in pediatrics]
Fonte: Arch. argent. pediatr;69(4):159-161, 1971 Jun. tab.
Idioma: es.
Resumo: Se realizó un ensayo con una nueva asociación trimetoprima/sulfametoxazol a la dosis de 4 a 8 mg de trimetoprima/Kg/día y 20 a 40 mg/sulfametoxazol/Kg/día, según gravedad del proceso en curso, por vía oral, en 154 pacientes con afecciones respiratorias, otorrinolangológicas, cutáneas y urinarias. Se obtuvieron resultados muy buenos en 73,21 % y buenos en 21,42 % de los casos. Solo en 3 se manifestó la presencia de efectos secundarios leves.
Descritores: Pirimidinas/uso terapêutico
Sulfametoxazol/uso terapêutico
Sinergismo Farmacológico
Antagonistas do Ácido Fólico/uso terapêutico
Anti-Infecciosos/uso terapêutico
-Otorrinolaringopatias/tratamento farmacológico
Infecções Respiratórias/tratamento farmacológico
Dermatopatias Infecciosas/tratamento farmacológico
Trimetoprima/uso terapêutico
Infecções Urinárias/tratamento farmacológico
Limites: Humanos
Lactente
Pré-Escolar
Criança
Responsável: AR94.1 - Centro de Información Pediatrica


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Id: biblio-1283538
Autor: Burguer Moreira, Noelia; Nastro, Marcela; Vay, Carlos; Famiglietti, Ángela; Rodríguez, Carlos Hernán.
Título: Actividad in vitro de ampicilina-ceftriaxona frente a aislamientos de Enterococcus faecalis recuperados de infecciones invasivas / In vitro activity of ampicillin-ceftriaxone against Enterococcus faecalis isolates recovered from invasive infections
Fonte: Rev. argent. microbiol;48(1):57-61, mar. 2016. graf.
Idioma: es.
Resumo: Se evaluó la actividad in vitro de la asociación entre ampicilina y ceftriaxona frente a 30 aislamientos de Enterococcus faecalis obtenidos de infecciones invasivas de pacientes atendidos en el Hospital de Clínicas José de San Martín, Ciudad Autónoma de Buenos Aires. Las sinergias entre ampicilina y ceftriaxona se determinaron mediante la técnica de dilución en caldo Müeller-Hinton con el agregado de diferentes concentraciones subinhibitorias de ceftriaxona o sin este. La asociación fue sinérgica en 22/30 aislamientos. En 14/30 aislamientos la asociación disminuyó los valores de concentración inhibitoria mínima (CIM) y de concentración bactericida mínima (CBM); en 6/30 se observó solamente una disminución de la CIM, mientras que en 2 solo se determinó una reducción de la CBM. La actividad bactericida de la asociación fue mayor a bajas concentraciones de ampicilina (menor de 1µg/ml). Se demostró la sinergia in vitro entre ampicilina-ceftriaxona; se confirmó así la utilidad de esta asociación en el tratamiento de infecciones severas causadas por E. faecalis

In vitro activity of the combination of ampicillin- ceftriaxone against 30 Enterococcus faecalis isolates recovered from invasive infections in patients admitted to Hospital de Clínicas José de San Martin in the city of Buenos Aires was assessed. Ampicillin- ceftriaxone synergies were determined by microdilution in Müeller-Hinton (MH) broth with and without subinhibitory concentrations of ceftriaxone. Synergy was detected in 22/30 isolates. A decrease in both minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) was observed in 14/30 isolates, whereas in 6/30 isolates the decrease was observed in the MIC value and only in the MBC value in the 2 remaining isolates. The bactericidal activity of the combination showed to be higher at low concentrations of ampicillin (< 1µg/ml). We detected in vitro synergy using the ampicillin-ceftriaxone combination and thus, its efficacy was confirmed in the treatment of severe infections by E. faecalis
Descritores: Ceftriaxona/farmacologia
Testes de Sensibilidade Microbiana/estatística & dados numéricos
Enterococcus faecalis/isolamento & purificação
Ampicilina/farmacologia
Antibacterianos/análise
-Infecções Bacterianas/tratamento farmacológico
Técnicas In Vitro/métodos
Sinergismo Farmacológico
Limites: Humanos
Masculino
Feminino
Tipo de Publ: Relatos de Casos
Ensaio Clínico
Responsável: AR635.1 - FCVyS - Servicio de Información y Documentación


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Id: biblio-838975
Autor: Chen, Peng; Xu, Ruixiang; Yan, Lei; Wu, Zhengrong; Wei, Yan; Zhao, Wenbin; Wang, Xin; Xie, Qinjian; Li, Hongyu.
Título: Properties of realgar bioleaching using an extremely acidophilic bacterium and its antitumor mechanism as an anticancer agent
Fonte: Biol. Res;50:17, 2017. tab, graf.
Idioma: en.
Projeto: Gansu Province Science Foundation for Distinguished Young Scholars; . Technology Program of Gansu Province; . Technology Program of Lanzhou City; . Sub-Project of National Science and Technology Major Projects for “Major New Drugs Innovation and Development”; . National Natural Science Foundation of China.
Resumo: Realgar is a naturally occurring arsenic sulfide (or Xionghuang, in Chinese). It contains over 90% tetra-arsenic tetrasulfide (As4S4). Currently, realgar has been confirmed the antitumor activities, both in vitro and in vivo, of realgar extracted using Acidithiobacillus ferrooxidans (A. ferrooxidans). Bioleaching, a new technology to greatly improve the use rate of arsenic extraction from realgar using bacteria, is a novel methodology that addressed a limitation of the traditional method for realgar preparation. The present systematic review reports on the research progress in realgar bioleaching and its antitumor mechanism as an anticancer agent. A total of 93 research articles that report on the biological activity of extracts from realgar using bacteria and its preparation were presented in this review. The realgar bioleaching solution (RBS) works by inducing apoptosis when it is used to treat tumor cells in vitro and in vivo. When it is used to treat animal model organisms in vivo, such as mice and Caenorhabditis elegans, tumor tissues grew more slowly, with mass necrosis. Meanwhile, the agent also showed obvious inhibition of tumor cell growth. Bioleaching technology greatly improves the utilization of realgar and is a novel methodology to improve the traditional method.
Descritores: Arsenicais/farmacologia
Sulfetos/farmacologia
Acidithiobacillus thiooxidans/metabolismo
Antineoplásicos/farmacologia
-Arsenicais/metabolismo
Arsenicais/química
Sulfetos/metabolismo
Sulfetos/química
Apoptose/efeitos dos fármacos
Células K562
Linhagem Celular Tumoral
Proliferação de Células/efeitos dos fármacos
Sinergismo Farmacológico
Fenômenos Toxicológicos
Antineoplásicos/química
Limites: Humanos
Tipo de Publ: Revisão
Revisão Sistemática
Responsável: CL1.1 - Biblioteca Central


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Id: biblio-1132235
Autor: Yagi, Renato; Nazareno, Nilceu Ricetti Xavier de; Soratto, Rogério Peres.
Título: Agronomic and Economic Interactions between Sidedressed Nitrogen and Potassium Fertilizations on Atlantic Potato
Fonte: Braz. arch. biol. technol;63:e20190640, 2020. tab, graf.
Idioma: en.
Resumo: Abstract Nitrogen (N) and potassium (K) in potato crop planting synergistically increase tuber yield, but there are no studies on this interaction in sidedressing. In two experiments with 'Atlantic' potato combinations of four N rates (0, 50, 100, and 150 kg ha-1) with four K2O rates (0, 100, 200, and 300 kg ha-1) were applied in sidedressing in a 4×4 factorial scheme with three replications in a completely randomized design. Adjacent commercial fields were sampled to economic comparisons with experimental results. Significant interaction between N and K sidedressing rates with tuber yields increase also was confirmed and classified as Liebig-synergism. Compared to the isolated N and K applications in sidedressing, joint N and K fertilizations, respectively, increases by 11% and 48% marketable tuber yields in the summer-fall experiment, and 12% and 7% in the spring experiment. Joint N and K applications as sidedressing was more profitable than planting fertilization, mainly at higher N and K rates. The response of specific gravity of 'Atlantic' potato tubers to the N and K sidedressing rates was mediated by interactions between edaphoclimatic conditions and inputs of N and K. The combined application of N and K sidedressing rates increased specific gravity in the summer-fall experiment, but had a negative effect in the spring experiment. Therefore, our results provide strong evidence that the fertilization management for potato crop in Brazil can be modified by applying higher amounts of N and K in sidedressing to match nutritional needs of the crop.
Descritores: Potássio/administração & dosagem
Solanum tuberosum/crescimento & desenvolvimento
Solanum tuberosum/economia
Agricultura/economia
Fármacos para a Fertilidade/administração & dosagem
Nitrogênio/administração & dosagem
-Sinergismo Farmacológico
Fármacos para a Fertilidade/economia
Limites: Humanos
Responsável: BR1.1 - BIREME


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Id: biblio-1058081
Autor: Jiménez Toro, Ivone; Rodríguez, Carlos A; Zuluaga, Andrés F.
Título: Eficacia de las combinaciones antimicrobianas para el tratamiento de infecciones enterocócicas: una revisión crítica / Effectiveness of the antibiotic combinations for enterococcal infections treatment: a critical review
Fonte: Rev. chil. infectol;36(5):556-564, oct. 2019. tab.
Idioma: es.
Projeto: COLCIENCIAS.
Resumo: Resumen Durante las últimas décadas, especies del género Enterococcus han emergido como importantes agentes etiológicos de bacteriemia, osteomielitis, endocarditis e infecciones de tejidos blandos. La combinación de antibacterianos ha sido la estrategia terapéutica más utilizada para dichas infecciones, buscando un potencial efecto sinérgico bactericida. Sin embargo, aparte de los modelos in vitro e in vivo, la utilidad clínica del tratamiento combinado genera controversia, especialmente en infecciones sistémicas no endocárdicas. Aunque las combinaciones entre β-lactámicos y aminoglucósidos o el tratamiento dual con β-lactámicos, han mejorado las tasas de curación de la endocarditis, aún no se ha esclarecido cuál es su tratamiento óptimo o si estas combinaciones también son útiles en otro tipo de infecciones graves sistémicas. El propósito de esta revisión es analizar y resumir los resultados obtenidos de diferentes modelos experimentales de combinaciones anti-enterocócicas y de los estudios clínicos disponibles en PubMed/Medline, a fin de evaluar mejor la evidencia que soporta la utilización de estas combinaciones. En conclusión, la información disponible es escasa, e indica la necesidad de mejores modelos in vivo y estudios clínicos que permitan comprobar la potencial actividad sinérgica de las combinaciones anti-enterocóciccas.

During the last decades, enterococci have emerged as important etiological agents in bacteremia, osteomyelitis, endocarditis and soft tissue infections. Antimicrobial combinations have been the most used therapeutic strategies for these infections, aiming for a bactericidal synergistic effect. However, besides in vitro and in vivo models, the clinical usefulness of such combinations is controversial, especially in non-endocardic systemic infections. For example, although beta-lactam and aminoglycoside combinations or double beta-lactam treatment have achieved high cure rates in endocarditis, the optimal treatment has not yet been clarified or if these combinations are useful in other infections. The aim of this review was to analyze and summarize the results from several experimental models of antienterococcal combined therapy and from clinical trials available in PubMed/Medline, to better assess the evidence that supports the use of these combinations. In conclusion, the available information is scarce, and more and better in vivo models and clinical studies are required to confirm the potential synergistic activity of antienterococcal combinations.
Descritores: Infecções por Bactérias Gram-Positivas/tratamento farmacológico
Enterococcus/efeitos dos fármacos
Antibacterianos/farmacologia
-Reprodutibilidade dos Testes
Ensaios Clínicos como Assunto
Resultado do Tratamento
Sinergismo Farmacológico
Quimioterapia Combinada
Endocardite/induzido quimicamente
Limites: Humanos
Tipo de Publ: Revisão
Responsável: CL1.1 - Biblioteca Central


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Id: biblio-1149524
Autor: Ribeiro, José Francisco; Figueiredo, Maria do Livramento Fortes; Carvalho, André Luís Menezes; Sousa Neto, Benedito Pereira de.
Título: Atividades farmacológicas da manteiga de bacuri (Platonia insignis Mart): revisão integrativa / Pharmacological actions of bacuri butter (Platonia insignis Mart): an integrative review
Fonte: Rev Rene (Online);22:e59963, 2021. graf.
Idioma: pt.
Resumo: RESUMO Objetivo identificar as atividades farmacológicas da manteiga de bacuri (Platonia insignis Mart.). Métodos revisão integrativa, realizada nas bases de dados Literatura Latino-americana e do Caribe em Ciências da Saúde, Cumulative Index to Nursing and Allied Health Literature, EMBASE, MEDLINE/PubMed, Web of Science, Cochrane Library e SCOPUS, sem delimitação temporal e de idioma. A seleção se constituiu de 13 ensaios pré-clínicos. A avaliação das informações ocorreu de forma descritiva, confrontando com os achados pertinentes. Resultados observou-se que 50,0% das publicações foram indexadas na MEDLINE/PubMed, maioria das publicações ocorreram na Inglaterra (61,5%), seguidas do Brasil e dos Estados Unidos, ambos com 13,3%. Destaca-se que 100,0% dos artigos foram ensaios pré-clínicos; atividades farmacológicas para antioxidante (38,4%) e antileishmanicidas (30,7%). Registrou-se que 38,4% dos ensaios apresentaram testes de toxicidade. Conclusão a manteiga de bacuri (Platonia insignis Mart.) apresentou atividades farmacológicas em ensaios pré-clínicos, como antioxidantes, antileshimaniose, anticonvulsivante e cicatrização de feridas.

ABSTRACT Objective to identify the pharmacological activities of bacuri butter (Platonia insignis Mart.). Methods an integrative review, carried out in the databases of Latin American and Caribbean Literature in Health Sciences, Cumulative Index to Nursing and Allied Health Literature, EMBASE, MEDLINE/PubMed, Web of Science, Cochrane Library and SCOPUS, without the time and language restriction. The selection consisted of 13 pre-clinical trials. The information assessment descriptively took place, comparing with the pertinent findings. Results it was observed that 50.0% of the publications were indexed in MEDLINE/PubMed, most publications were from England (61.5%), followed by Brazil and the United States, both with 13.3%. It is noteworthy that 100.0% of the articles were pre-clinical trials; pharmacological activities for antioxidants (38.4%) and antileishmanicides (30.7%). It was found that 38.4% of the trials presented toxicity tests. Conclusion bacuri butter (Platonia insignis Mart.) Showed pharmacological activities in pre-clinical trials, such as antioxidants, antileshimaniasis, anticonvulsant and wound healing.
Descritores: Benzofenonas
Clusiaceae
Composição de Medicamentos
Sinergismo Farmacológico
Tratamento Farmacológico
Responsável: BR6.1 - BCS - Biblioteca de Ciências da Saúde


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Id: biblio-1003406
Autor: Biçer, Cihangir; Ünalan, Esra Nur; Aksu, Recep; Önal, Ömer; Güneş, Işın.
Título: Addition of dexmedetomidine to bupivacaine in ultrasonography-guided paravertebral blockade potentiates postoperative pain relief among patients undergoing thoracotomy / Adição de dexmedetomidina à bupivacaína em bloqueio paravertebral guiado por ultrassom potencializa o alívio da dor pós-operatória em pacientes submetidos à toracotomia
Fonte: Rev. bras. anestesiol;69(2):144-151, Mar.-Apr. 2019. tab, graf.
Idioma: en.
Projeto: Research Fund of the Erciyes University.
Resumo: Abstract Background and objective: Thoracic paravertebral blockade is an alternative regional technique for comforting post-thoracotomy pain, thereby decreasing opioid consumption, postoperative nausea and vomiting, dizziness, respiratory depression and health care costs. The objective of this study was to investigate the effects of bupivacaine and bupivacaine plus dexmedetomidine on postoperative pain score and analgesic consumption in thoracotomy patients who had undergone ultrasonography-guided paravertebral blockade. Material and method: 93 ASA I-II patients aged 18-65 years were included in the study and scheduled for thoracic surgery. Prior to anesthesia induction, the paravertebral blockade procedure was performed by an anesthetist with ultrasonography. Cases were randomly stratified into three groups. The paravertebral blockade procedure was performed with 20 mL 0.5% bupivacaine injection in Group B (n = 31) and 20 mL 0.5% bupivacaine + 1 mL dexmedetomidine (100 µg) injection in Group BD. Group C received postoperative i.v. morphine via patient-controlled analgesia without paravertebral blockade. Post-operative pain scores were recorded in the recovery room and post-operatively using a VAS. Hemodynamic parameters, adverse effects and morphine consumption were also recorded. Results: No significant difference was determined between Group B and Group C regarding intra-operative adverse effects such as bradicardia and hypotension, while these adverse effects were significantly higher in Group BD (p = 0.04). VAS scores with rest and upon movement were significantly lower in Group BD compared to Group C (p < 0.001). Total morphine consumption was significantly lower in both Group B and Group BD in comparison with Group C (p < 0.001). In Group BD, HR and MAP were lower, but this was not clinically significant (p < 0.05). Conclusion: The addition of dexmedetomidine to bupivacaine lowers postoperative pain scores and morphine consumption in thoracotomy patients who receive ultrasonography guided paravertebral blockade.

Resumo Justificativa e objetivo: O bloqueio paravertebral torácico é uma técnica regional opcional para o alívio da dor pós-toracotomia, deste modo diminui o consumo de opioides, náuseas e vômitos no pós-operatório, tontura, depressão respiratória e custos com saúde. O objetivo deste estudo foi investigar os efeitos de bupivacaína isolada e bupivacaína + dexmedetomidina no escore de dor pós-operatória e no consumo de analgésicos em pacientes submetidos à toracotomia sob bloqueio paravertebral guiado por ultrassom. Material e método: Noventa e três pacientes, ASA I-II, com idades entre 18 e 65 anos, foram incluídos no estudo e programados para cirurgia torácica. Antes da indução anestésica, o procedimento de bloqueio paravertebral foi realizado por um anestesista com o uso de ultrassom. Os casos foram estratificados aleatoriamente em três grupos. O procedimento de bloqueio paravertebral foi realizado com injeção de 20 mL de bupivacaína a 0,5% no Grupo B (n = 31) e de 20 mL de bupivacaína a 0,5% + 1 mL de dexmedetomidina (100 µg) no Grupo BD. O Grupo C recebeu morfina intravenosa via analgesia controlada pelo paciente sem bloqueio paravertebral. Os escores de dor pós-operatória foram registrados na sala de recuperação e no pós-operatório usando a escala VAS. Parâmetros hemodinâmicos, efeitos adversos e consumo de morfina também foram registrados. Resultados: Não houve diferença significativa entre os grupos B e C em relação a efeitos adversos intraoperatórios, como bradicardia e hipotensão, enquanto esses efeitos adversos foram significativamente maiores no Grupo BD (p = 0,04). Os escores VAS em repouso e movimento foram significativamente menores no Grupo BD em relação ao Grupo C (p < 0,001). O consumo total de morfina foi significativamente menor nos grupos B e BD em comparação com o Grupo C (p < 0,001). No Grupo BD, a frequência cardíaca e a pressão arterial média foram menores, mas esse resultado não foi clinicamente significativo (p < 0,05). Conclusão: A adição de dexmedetomidina à bupivacaína reduz os escores de dor pós-operatória e o consumo de morfina em pacientes submetidos à toracotomia sob bloqueio paravertebral guiado por ultrassom.
Descritores: Dor Pós-Operatória/prevenção & controle
Bupivacaína/administração & dosagem
Dexmedetomidina/administração & dosagem
Bloqueio Nervoso/métodos
-Toracotomia/métodos
Método Duplo-Cego
Estudos Prospectivos
Analgesia Controlada pelo Paciente/métodos
Ultrassonografia de Intervenção/métodos
Analgésicos não Narcóticos/administração & dosagem
Sinergismo Farmacológico
Quimioterapia Combinada
Analgésicos Opioides/administração & dosagem
Anestésicos Locais/administração & dosagem
Pessoa de Meia-Idade
Morfina/administração & dosagem
Limites: Humanos
Masculino
Feminino
Adolescente
Adulto
Idoso
Adulto Jovem
Tipo de Publ: Ensaio Clínico Controlado Aleatório
Responsável: BR1.1 - BIREME



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